In the wake of the United States Supreme Court’s decision in U.S. ex rel. Schutte v. SuperValue, Inc., interpreting the False Claims Act’s scienter element – referring to the defendant’s knowledge and subjective beliefs – compliance professionals’ documentation practices have become more important than ever before.
To fend off or successfully defend a False Claims Act action, providers should have documentation substantiating their interpretation and application of relevant regulations and government healthcare program policies. Without such evidence, it may be more difficult for the organization to prove it believed its claims were appropriately submitted.
On our podcast this week, we discuss the importance of the Supreme Court’s SuperValue decision and provide tips on how to develop an internal process to document your decision-making and interpretation of legal requirements, including billing and coding requirements and policies, and how to defend against allegations your organization knew claims were false or acted recklessly or with deliberate ignorance.
Check out the sample documentation form below:
