Another Reason for a Compliance Program

Healthcare Compliance Law

A United States Supreme Court ruling last week underscored the importance of employing a strong and dynamic healthcare compliance program.  On Tuesday, in a unanimous decision, the justices ruled on Kellogg, Brown & Root Services Inc. v. United States ex. rel. Carter.  The case has nothing to do with healthcare but rather, a whistleblower allegation of fraudulent invoicing by a water services contractor in Iraq.  The court’s ruling partly affirmed on one hand and party reversed on the other hand, a lower court decision.

Good news, bad news for providers

Let’s start off with the good news.  (I know that all you optimists out there will be happy with that!)  The court decided that the Wartime Suspensionof Limitations Act, first enacted back in 1942, extends the statute of limitations only in criminal cases during times of war and not civil cases such as this whistleblower suit filed under the False Claims Act.  Had the court ruled that the WSLA was applicable to this case, it could have opened up the floodgates by essentially eliminating any statute of limitations on any and all whistleblower suits in healthcare civil cases.

Now for the bad news…the court ruled in favor of a plaintiff friendly interpretation of the “first to file” rule which allows for a stronger case to proceed even if a weaker but prior case with similar allegations has already been filed.  This interpretation exposes providers to the potential of having multiple false claims acts from multiple parties.

A compliance program is a good place to start…

With all this legal wrangling going on, what’s a provider to do?  Well, to start with, we advocate (and have advocated this many times in the past) for an active and dynamic healthcare compliance program.  If you’re not sure about how one works, check out our prior posts for more direction.  And if you already have a compliance program in place, sleep better at night with the knowledge that you’ve done your best to insulate your business from those nasty legal proceedings.

When you need proven expertise and performance

Craig Fukushima, NHA, MBA

Mr. Craig T. Fukushima’s health care experience spans more than 35 years with special expertise in the long term care sector, including implementation of innovative health care projects in domestic and international locations.

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