Last week, the United States Court of Appeals for the Second Circuit affirmed the dismissal of a False Claims Act (“FCA”) whistleblower suit seeking $50 million in damages from Huron Consulting Group Inc. (“Huron”) for alleged fraudulent billing practices. The case is one of many FCA suits around the country related to health care billing practices.

The qui tam complaint accused Huron of violating the FCA by using an inaccurate reimbursement ratio to overbill Medicare and Medicaid for care provided to so-called “outlier patients”—patients who require extraordinarily expensive care. On March 6, 2013, the Southern District of New York dismissed the suit, concluding that Huron’s alleged misconduct was not fraudulent. As the district court explained, “[t]here is, in sum, no law, rule, regulation or fact rendering Huron’s submission of outlier-producing bills under these circumstances false or fraudulent.” In a summary order, the Second Circuit affirmed the district court’s conclusion, holding that “a review of the record confirms. . . that relator has failed to identify any statute or regulation prohibiting Huron’s claim submission practices.”

 

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FCA

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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