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65 Tenn. L. Rev. 455 (1997-1998)
The False Claims Act: A Civil War Relic Evolves into a Modern Weapon

handle is hein.journals/tenn65 and id is 465 raw text is: THE FALSE CLAIMS ACT: A CIVIL WAR RELIC EVOLVES INTO A MODERN WEAPON PATRICIA MEADOR* ELIZABETH S. WARREN** Table of Contents I. INTRODUCTION ................................... 455 II. HISTORY OF THE QuI TAM ACTION AND THE FALSE CLAIMS ACT 458 III. STATUTORY STRUCTURE OF THE FALSE CLAIMS ACT ......... 461 A. Substantive Provisions ........................... 461 B. Qui Tam Provisions ............................ 466 IV. USE OF THE FALSE CLAIMS ACT IN HEALTH CARE .......... 469 A. Traditional Applications ......................... 469 B. Unsettled Applications .......................... 472 V. THE NEED FOR CLARIFICATION OF THE FALSE CLAIMS ACT ... 474 A. Interpreting the Jurisdictional Bar of 31 US.C. § 3730(e)(4) 475 B. Harm to the Public Fisc as a Prerequisite for False Claims A ct Liability ................................. 480 VI. CONCLUSION .................................... 483 I. INTRODUCTION As the cost of health care has escalated, so have reports of health care fraud. According to one report, the federal government overpaid $23 billion in Medicare payments in fiscal year 1996 alone.' Some commentators claim that fraud accounts for three to ten percent of health care costs.' The United States Department of Justice has listed health care fraud as a priority, second only to violent crime.3 * Bass, Berry & Sims PLC, Nashville, TN. ** Bass, Berry & Sims PLC, Nashville, TN. 1. Administration Says HCFA 's $23 Billion Error Rate Shows Need for Random Audits, I Health Care Fraud Rep. (BNA) No. 15, at 477 (July 30, 1997). In the area of enteral nutrition, another report found that the government overpaid $12.2 million. Medicare Might Have Paid $12.2 Million Too Much for Enteral Nutrition in 1995, 1 Health Care Fraud Rep. (BNA) No. 14, at 450 (July 16, 1997). 2. Charles H. Roistacher & Catherine M. Cook, Battling Fraud and Abuse; Efforts to Control Health Costs Are Enlisting Law Enforcement Agencies to Pursue Fraud as a Federal Crime, RECORDER, Mar. 28, 1994, at 6. 3. Sherryl E. Michaelson, Federal Initiatives in the Prosecution of Health Care Fraud, in HEALTH CARE REFORM LAW INSTITUTE 379, 381 (1994).

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