Court: $1B Medicare fraud lawsuit to proceed in MN
Court: $1B Medicare fraud lawsuit to proceed in MN
The U.S. Eighth Circuit Court of Appeals has reversed a lower court ruling and ordered a $1 billion Medicare fraud lawsuit to proceed against dozens of Minnesota health care providers.
Lisa Citak, president of the Minnesota Association of Nurse Anesthetists (MANA), explains that MANA filed the case in 1994 under the federal False Claims Act, alleging Medicare fraud by Minnesota’s largest HMO, Allina Health Systems, several of its hospitals, the St. Cloud Hospital, and dozens of anesthesiologists. The case had been dismissed in 1999 on a summary judgment by the lower court, which ruled, among other things, that MANA lacked legal standing to bring the case to trial.
MANA appealed the ruling, and the appeals court recently agreed, reversing the lower court on nearly every count.
"For more than seven years, nurse anesthetists have stood up for patients against the powerful opposition of Allina and a network of hospitals and anesthesiologists who avoided trial through well-funded legal maneuvers," Citak says. "Now they will finally have to face us in court to answer the specific fraud charges."
Citak said that MANA’s case will result in long-overdue changes for patients. She said that, until now, anesthesia billing has been an invisible service in hospitals, driven by the billing practices of anesthesiologists rather than what works best for patients and payers. MANA’s lawsuit is intended to expose the billing practices for anesthesia services.
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