United States ex. rel. Davis v. District of Columbia

Upon remand of relator's qui tam suit, the district court ruled that the District violated the False Claims Act (FCA), 31 U.S.C. 3729(a), when it submitted a Medicaid reimbursement claim for FY 1998 and imposed the maximum penalty of $11,000. Both parties appealed. The court reversed and remanded, concluding that the relevant federal regulations, which were incorporated into the District’s Medicaid State Plan, required the District to maintain records supporting its Medicaid reimbursement claims that could be produced for audit. Pursuant to contractual obligations, relator’s firm was to prepare the FY 1998 interim Medicaid claims and year-end cost report, and consequently his firm, not the District, had physical possession of the underlying documentation supporting the District’s claim. Given this arrangement, the District reasonably understood when it submitted the claim for payment that it could, through the firm, make the supporting records available for audit. View "United States ex. rel. Davis v. District of Columbia" on Justia Law