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Supreme Court Turns Down Chance To Review False Claims Act Standard

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OPINION: This article may contain commentary which reflects the author's opinion.


The U.S. Supreme Court turned down three cases over whether whistleblowers accusing providers of defrauding the government are legally required to provide details about alleged false claims submitted by the providers.

“Whistleblowers in all three cases had argued that fraud could be inferred from circumstances, even without details about false claims. The Supreme Court’s decision leaves in place a ruling by the 7th U.S. Circuit Court of Appeals allowing a whistleblower case to go forward against managed care company Molina Healthcare, and rulings by the 6th and 11th Circuits upholding the dismissal of whistleblower cases against home health provider Care Connection of Cincinnati and hospice provider Bethany Hospice & Palliative Care, respectively,” Reuters reported.

“Tejinder Singh of Sparacino, who represents the whistleblowers in all three cases, declined to comment. Lawyers for the defendants did not immediately respond to requests for comment. Illinois-based Molina was sued in 2017 by Thomas Prose, the founder of a former contractor for the company, who claimed that it improperly billed the state’s Medicaid program for a higher level of care than it was actually able to provide its nursing facility residents. The difference in billing could be more than $3,000 per patient per month,” the report added.

“The 6th Circuit’s ruling stems from a 2015 lawsuit by nurse Cathy Owsley accusing Envision Healthcare subsidiary Care Connection of Cincinnati and its third-party coding contractor, Fazzi Associates, of systematically “upcoding,” or billing government health insurance for more expensive services than it provided. The appeals court affirmed the dismissal of the case. The 11th Circuit, similarly, affirmed the dismissal of a 2019 lawsuit accusing Georgia-based Bethany Hospice of paying kickbacks to doctors for referrals and then billing Medicare and Medicaid for services provided to those patients,” the report continued.

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In a separate case, the U.S. Supreme Court rejected a request to block President Joe Biden’s plan for broad federal student loan debt cancellation.

“Conservative Justice Amy Coney Barrett rejected the motion from a Wisconsin group without offering an explanation. The Brown County Taxpayers Association filed the motion Wednesday, asking the court to immediately pause the loan relief program while it moves forward with litigation against the Biden Administration,” Forbes reported.

“A federal district court tossed a lawsuit from the group aiming to stop the program, which they have since appealed to the 7th Circuit Court of Appeals. The motion to the Supreme Court argued the program should be halted immediately because Biden overstepped his authority by authorizing loan forgiveness, which they claimed will lead to a gargantuan increase in the national debt,” the outlet added.

The student-loan forgiveness application site officially went live on Monday.

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“After conducting beta testing over the weekend, President Joe Biden — alongside Education Secretary Miguel Cardona — announced that the application website is officially live, and borrowers can apply for up to $20,000 in debt relief that will start being processed by the Education Department. During his remarks, Biden noted that over 8 million borrowers applied over the weekend without a glitch or any difficulty,” Business Insider reported.

“It means more than 8 million Americans are starting this week on their way to receiving life-changing relief,” Biden said. “Millions more are going to have the opportunity to do it as well. As millions of people fill out the application, we’re going to make sure the system continues to work as smoothly as possible.”

The Insider report added: “Borrowers who submitted their applications during the beta testing period do not need to resubmit — their forms will now begin getting processed. As Biden noted, it takes just five minutes to apply — borrowers just need to enter basic information like their names, email addresses, and Social Security numbers. The department recommends applying before mid-November to ensure relief hits borrowers’ accounts before payments resume in January 2023.”

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Biden spoke about the pending lawsuits on Monday, saying he does not believe the Republican-led groups have any standing.

“I will never apologize for helping working Americans and middle-class people as they recover from the pandemic,” Biden said. “Especially not the same Republicans who voted for a $2 trillion tax cut in the last administration.”

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