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B-322525 1 (2012-03-23)

handle is hein.gao/gaobadorn0001 and id is 1 raw text is: GAO Acontblty * Integrity * Relability United States Government Accountability Office Washington, DC 20548 B-322525 March 23, 2012 Congressional Recipients Subject: Causes of Action under the Patient Protection and Affordable Care Act The Patient Protection and Affordable Care Act (PPACA) expands upon and establishes new health care quality enhancement initiatives. Although the goal of improving health care quality has garnered widespread support, some of PPACA's quality enhancement provisions have raised concerns among providers that they could unintentionally result in an increased litigation risk for those providers that do not follow the standards or guidelines used by these programs, perform poorly on the measures reported under these programs, or opt not to report performance on these standards and guidelines. For this reason, Congress directed GAO to consider whether the development, recognition, or implementation of any guideline or other standards under the 14 PPACA quality enhancement provisions identified in section 3512 of the law1 would result in a new cause of action or claim. 2 A cause of action or claim is a legal theory or set of facts that gives rise to a right to file a lawsuit.3 In response to this requirement, we considered whether implementation of the PPACA provisions could give rise to (1) new causes of action brought by private citizens to enforce compliance with guidelines, standards, and programs developed under the provisions or (2) new medical malpractice claims brought by individuals based on the guidelines or standards developed under the PPACA provisions. For the reasons discussed below, we do not believe that the implementation of the provisions identified in section 3512 of PPACA, including the development, 1 Throughout this report, we refer to these 14 PPACA provisions as the PPACA provisions. See the enclosure for a complete list and description of the provisions. 2 Patient Protection and Affordable Care Act, Pub. L. No. 111-148, § 3512, 124 Stat. 119, 923 (Mar. 23, 2010) (PPACA). 3 Bryan A. Garner, A Dictionary of Modern Legal Usage 140, 159 (2d ed. 1995); see also Bryan A. Garner, ed., Black's Law Dictionary 214 (9th ed. 2009) (defining cause of action as a factual situation that entitles one person to obtain a remedy in court from another person).

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