WHAT IS THE DIFFERENCE BETWEEN A “FALSE CLAIM” and FRAUD?
The False Claims Act has a much easier standard of proof than most fraud statutes. To prove a doctor or hospital has submitted false claims, one need only prove “deliberate ignorance or reckless disregard” of the actual facts.  This language was deliberately written to prevent the “head in the sand” defense where a provider simply closes his or her eyes to what is going on, all the while raking in the money. This is easier than proving fraud, which requires proof of “intentional deception or misrepresentation” which the defendant knows is false. CAN THE FALSE CLAIMS ACT ENHANCE PATIENT CARE? Tired of seeing patients abused and neglected? A nursing home operator was recently fined $600,000 for patient abuse and agree to sweeping policy changes in the way its homes are operated — all through the False Claims Act. Here’s how it worked: The 1988 Medicare Amendments included the Nursing Home Reform Act. Now, each time a long-term care facility submits a Medicaid or Medicare bill, it is
