HCA defeats billing fraud claims

A whistleblower failed to adequately allege Nashville, Tenn.-based HCA Healthcare submitted false claims to government healthcare programs for physical therapy services, a Kansas district court said Nov. 19, according to Bloomberg Law

Edward Ernst, a former employee of a physical therapy business owned by HCA, filed the lawsuit in 2019. In his second amended complaint, he alleges several defendants, including HCA, improperly billed Medicare and Tricare for physical therapy services provided in Overland Park, Kan., and Olathe, Kan.

HCA filed a motion to dismiss, arguing the complaint failed to satisfy pleading requirements. On Nov. 19, Judge Toby Crouse of the U.S. District Court for the District of Kansas dismissed the claims against HCA, ruling Mr. Ernst failed to plausibly show that HCA knowingly submitted false claims. 

"The second amended complaint makes only bare allegations of their knowledge, using collective references to 'Defendants' without specifying each defendant's knowledge," the court order said. "These generalized allegations are insufficient for the HCA Defendants because the second amended complaint does not specifically describe what they knew concerning fraudulent billing or how they knew it."

Although the claims against HCA were dismissed, other defendants still face improper supervision claims, according to Bloomberg Law.

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