A federal court has ruled a lack of written reports for permanent tissue sample slides does not mean the claims the Mayo Clinic submitted for them were fraudulent, according to a Law360 report.
Written reports were created for the initial slides, but not for the permanent slides, inspiring a whistle-blower suit under the False Claims Act. However, the Eighth Circuit, siding with a lower court, overturned the claim because Medicare billing requirements do not explicitly require such written reports, according to Law360.
"Nowhere in the Medicare regulations or in the American Medical Association Codebook have we found a requirement that physicians using the [current procedural technology] codes for surgical pathology services must prepare the additional written reports that relators claim Mayo fraudulently failed to provide," the Eighth Circuit ruled, according to the report. "The False Claims Act may not properly be used to impose an onerous and costly burden on the healthcare system without plausible evidence that Medicare would consider such redundant reports to be a material condition of payment."
More Articles on the False Claims Act:
HCA Wants "Serial Relator" False Claims Suit Dismissed
33 Recent Investigations, Lawsuits and Settlements Involving Hospitals
Wahiawa General Hospital to Pay $450k to Settle False Claims Allegations