Ninth Circuit reverses precedent on False Claims Act in Kaiser fraud cases

The False Claims Act’s first-to-file rule does not prevent a federal court from hearing a case entirely, the Ninth Circuit Court of Appeal ruled Sept. 24. A concurring opinion, written by the author of the majority opinion, argued that a judge’s off-hand comments in opinions should not set Ninth Circuit precedent.

The Sept. 24 11-judge opinion restored the case of a Los Angeles Kaiser Foundation Hospital records administrator, Marcia Stein, who accused her former employee of committing Medicare fraud.

Allegations

“(Kaiser) participated in a fraudulent scheme to up-code and falsely diagnose MA (Medicare Advantage) enrollees with sepsis