A proposal to enact a state False Claims Act in Pennsylvania is being described as another “attack on [the state’s] nursing home providers” by industry advocates.
State lawmakers announced on Monday morning a bipartisan effort that would protect whistleblowers who come forward and report fraudulent Medicaid claims. The legislation is expected to be introduced in both the Pennsylvania House and Senate this spring, according to a previous memo.
Despite there already being a federal law, about 30 states and the District of Columbia have adopted their own False Claims Act legislation. The Pennsylvania Health Care Association quickly said the effort could place additional burdens on providers.
“It’s unfortunate that we are once again faced with what seems to be an attack on Pennsylvania’s nursing home providers — this time, in the form of a state False Claims Act. Not only would this legislation create a new cause of action against hardworking long-term care providers, it would create additional bureaucracy and red tape by duplicating a cause of action which already exists at the federal level for all state programs receiving federal funding,” said Zach Shamberg, the organization’s president and CEO, in a statement.
“We are particularly concerned a state False Claims Act will lead to a dramatic increase in frivolous claims and further stigmatize long-term care providers as well as direct caregivers in an already difficult legal and regulatory environment, requiring providers to focus their limited resources on legal battles instead of investing in quality care,” he added.
Shamberg also argued that a significant portion of taxpayer dollars recovered from suits will end up with whistleblowers and trial lawyers instead of being reinvested in patient care, meaning less funding for providers.
“PHCA strongly supports efforts to eliminate waste, fraud and abuse in the state Medicaid system and to continue to improve the quality of long-term care,” Shamberg said. “Therefore, we cannot – in good faith – support any action that would undoubtedly place increased costs and an undue burden on the shoulders of a critical segment of the healthcare continuum already struggling to provide more specialized, advanced care with a reimbursement rate far below the true cost of that care.”
