Q: Fabricated medical records/misdiagnoses

A: On the federal level, several statutes and regulations address the liability and penalties for fabricated diagnoses or medical records by independent contractors in hospitals.

The False Claims Act (31 U.S.C. §§ 3729 - 3733) is a key statute. It imposes liability on individuals and entities that knowingly submit, or cause the submission of, false claims for payment to the federal government. This can include fraudulent medical records or diagnoses used to claim federal healthcare program funds.

Another important regulation is under the Health Insurance Portability and Accountability Act (HIPAA). While HIPAA primarily focuses on protecting patient privacy, it also sets standards for the integrity of health records. Violations of these standards, including fabrication of medical records, can result in significant penalties.

The Anti-Kickback Statute and the Physician Self-Referral Law (Stark Law) also play a role. Although they mainly address financial relationships in healthcare, fraudulent record-keeping to cover up illegal kickbacks or referrals falls under their purview.

When independent contractors in hospitals engage in such fraudulent activities, the hospital itself may face liability. This is especially the case if it's shown that the hospital had knowledge of, or was complicit in, the fraudulent actions.

The consequences for violations of these statutes can include substantial fines, repayment of fraudulently obtained funds, and potential exclusion from federal healthcare programs. Criminal charges are also a possibility in severe cases.

Navigating these federal regulations can be complex, and legal guidance is often necessary to understand the full extent of liability and the appropriate course of action.