House Committee Passes False Claims Bill

The state House of Representatives Health and Human Services Committee has passed a bill that would create a Pennsylvania version of the federal False Claims Act, possibly threatening access to care for Medicaid patients. 

The Pennsylvania Medical Society (PAMED) and the Pennsylvania Academy of Family Physicians are working on a package of amendments that would be introduced on the House floor. Further action on the bill is not expected before the General Assembly’s summer recess. 

Physicians who file false claims would have to pay three times the amount of the false claim that was submitted to the Department of Public Welfare, which runs the state’s Medicaid program, as well as penalties between $5,000 and $10,000.  

While PAMED opposes health care fraud and abuse, House Bill 1679 as written could cause physicians to stop seeing Medicaid patients, reducing their access to care.  

HB 1679 would allow a private citizen to bring a civil action against a physician who allegedly filed a false claim and would allow the citizen to collect up to 30 percent of the amount recovered.   

This incentive could spawn a new wave of frivolous lawsuits against physicians, who may determine that it is yet one more reason not to continue to see Medicaid patients. The program has some of the lowest reimbursement in the nation.

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Comments: 4


Most physcians see Medicaid patients as a service to the community and the patients. It is a charitable act for most of us in this community. the cost of filing a claim most of the time is not worth the payment you get. This type of law will just reduce the number of physicians willing to see Medicaid patients at all.

anonymous at 7/22/2010 10:47:12 PM


It's a losing proposition now to accept any Medicaid patient, but just wait until they find out they can sue you. Accepting Medicaid with those changes in the law is not charitable it's masochistic.

anonymous at 7/22/2010 8:56:27 PM


Frivolous lawsuits and the fear of frivolous lawsuits already raises the cost of health care by an immeasurable amount. We should not cover up or protect criminal activity, but that does not mean that our patients should be offered money to entrap us.

PCA at 7/22/2010 2:26:06 PM


If a physician commits fraud, he or she should pay the consequenses. We should not cover up or protect criminal activity.

anonymous at 7/22/2010 10:58:00 AM

Last Updated: 7/2/2010
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