The Risk of Getting Paid: Why ICD-10-CM May Increase Physician Liability under the False Claims Act
![handle is hein.journals/qhlj16 and id is 133 raw text is: The Risk of Getting Paid: Why ICD-10-CM
May Increase Physician Liability under the
False Claims Act
Peter J. Carpentier*
L Introduction
The Obama Administration has made it clear that one of its
goals is to reduce the amount of taxpayer money lost to health
care fraud and abuse.' The False Claims Act (FCA), 31 U.S.C.
§ 3729, is an intimidating enforcement tool used to complete
this objective. In 2012, the United States Department of Justice
(DOJ) recovered nearly five billion dollars in settlements and
judgments in civil cases involving fraud against the government.2
This figure brings the total recoveries under the FCA since Janu-
ary 2009 to $13.3 billion, which according to the DOJ is the larg-
est four-year total since the FCA was amended in 1986.' The
DOJ recovered roughly five billion dollars in 2012 and its efforts
included record recoveries for health care fraud of over three
billion dollars.' Over the past four years, recoveries under the
FCA for health care fraud have yielded a staggering nine and a
half billion dollars.5 Cases concerning the pharmaceutical and
medical device industry were responsible for the largest health
care settlements;' however, other cases and settlements under
* J.D., 2013, Quinnipiac University School of Law; B.S., 2010, Providence College.
I would like to thank my family and friends for their support. In particular, I would like
to thank my parents for their support of my academic endeavors.
I Barack Obama, President of The United States, Remarks by the President to a
Joint Session of Congress on Health Care (Sep. 9, 2009) (transcript available in the
Office of the Press Secretary Archives, or at http://www.whitehouse.gov/the-press-of-
fice/remarks-president-ajoint-session-congress-health-care).
2 Press Release, U.S. Department of Justice Office of Public Affairs, Justice De-
partment Recovers Nearly $5 Billion in False Claims Act Cases in Fiscal Year 2012 (Dec.
4, 2012), available at http://wwwjustice.gov/opa/pr/2012/December/ 12-ag-1439.html.
3 Id.
4 Id.
5 Catherine Tomasko, DO] Gains Record $5 billion from False-Claims Cases, THE
KNOWLEDGE EFFEcT (Jan. 4, 2013), http://blog.thomsonreuters.com/index.php/doj-
gains-record-5-billion-from-false-claims-cases/
6 U.S. Department of Justice Office of Public Affairs, supra note 2.
117](ViewImageLocal?handle=hein.journals/qhlj16&div=9&collection=&method=preview&ext=.png&size=3)
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The Risk of Getting Paid: Why ICD-10-CM May Increase Physician Liability under the False Claims Act
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