Last week’s ruling by the United States Court of Appeals for the Eleventh Circuit in United States v. AseraCare is a win for hospice and other health care providers who have long argued that a mere difference of clinical opinion among physicians is not enough to prove falsity under the False Claims Act. While the AseraCare ruling specifically applied in the context of hospice reimbursement, it is in line with prior rulings regarding provider judgment and will clearly impact other cases nationwide.
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AseraCare 11th Circuit Case Holds Differences in Hospice Clinical Opinions Are Insufficient to Demonstrate Falsity Under the FCA
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