An Economic Model to Analyze the Impact of False Claims Act Cases on Access to Healthcare for the Elderly, Disabled, Rural and Inner-City Poor
This article discusses false certification claims, an aggressive and arguably abusive application of the False Claims Act to medical fraud cases. It analyzes false certification claim case law and summarizes two doctrinal flaws in applying the false certification theory to medical fraud cases. It examines the key role of Medicare and Medicaid in providing access to healthcare for this country s poor and underserved and suggests an economic model that may be used to analyze the potentially damaging effect of false certification cases on the nation s healthcare safety net. The article concludes that as long as false certification cases continue to proliferate, the healthcare access goals of the War on Poverty may be the greatest casualty of the war against medical fraud.