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The Patient Protection and Affordable Act of 2009 strengthens the False Claims Act (FCA)

Yet another way that the Patient Protection and Affordable Care Act (the Act), otherwise known as the Health Reform bill, impacts health care providers is the strengthening of the Federal False Claims Act (FCA).

For example, Section 6402 of the Act amends Section 1128 B of the Social Security Act to expressly define services performed or billed in violation of the anti-kickback statute as false claims: “…a claim that includes items or services resulting from a violation of this section constitutes a false or fraudulent claim…”

In addition to the reinforcement of false claims liability for anti-kickback violations, Section 6402 establishes deadlines for repaying health care overpayments. Failure to meet the deadlines causes providers to be in violation of the FCA’s “reverse false claims” provision. The deadline for reporting and returning overpayments is the later of 60 days after the date the overpayment is identified, or the date any corresponding cost report is due, if applicable.

For more information, please visit or contact a Wachler & Associates attorney at 248-544-0888.

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