Monday, March 05, 2012

Due process

Originally enacted in 1863, the False Claims Act was the Lincoln Administration’s reaction to “a spate of frauds upon the government” by defense contractors during the Civil War. In a 1986 revision, Congress increased the law’s punitive fines and removed the requirement of specific intent to defraud the government. This revision turned the law into a sword of Damocles dangling over the heads of so many well-meaning doctors. For any reimbursement form with a single mistake, a doctor can be forced to pay a $10,000 fine plus treble damages (three times the actual damages). The False Claims Act’s penalties are so severe that it is essentially a de facto criminal law.

. . . .

The judge announced that he would hold them liable for any claims submitted in excess of “nine patient-treatment hours” per day. An article about the case noted that on the “billing side, Krizek won one battle, but he lost the war.”

The nine-hour threshold resulted from the testimony of a single psychiatrist about his normal workload. The court ignored evidence that Dr. Krizek routinely worked long hours and had occasionally worked around the clock when filling in for an absent colleague.

Working more than nine hours a day - apparently a federal offense if you're a doctor who takes poor or elderly patients. What a wonderful system. Oh well, at least the prosecutors got to put another notch in their belts.

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