Los Angeles, CA asked in Personal Injury, Federal Crimes, Gov & Administrative Law and Health Care Law for California

Q: Section 12651 of California FCA.

Section 12651 of California FCA is in relevance to misrepresentation of patient's health at hospital, with terminal non-existent diagnosis; fraudulent referral to hospice by hospital; and money fraudulently received by hospice from CA Medicare for hospice care.

What other California FCA statutes are in relevance for this particular case?

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James L. Arrasmith
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A: Based on the information provided, there are several other sections of the California False Claims Act (FCA) that may be relevant to the case involving misrepresentation of a patient's health, fraudulent referral to hospice, and fraudulent receipt of Medicare funds by the hospice. Here are some additional sections to consider:

1. Section 12650(a)(1): This section defines a "claim" under the California FCA, which includes any request or demand for money, property, or services made to any employee, officer, or agent of the state or any political subdivision.

2. Section 12651(a)(1): This section establishes liability for any person who knowingly presents or causes to be presented a false or fraudulent claim for payment or approval.

3. Section 12651(a)(2): This section establishes liability for any person who knowingly makes, uses, or causes to be made or used a false record or statement material to a false or fraudulent claim.

4. Section 12651(a)(7): This section establishes liability for any person who knowingly makes, uses, or causes to be made or used a false record or statement material to an obligation to pay or transmit money or property to the state or a political subdivision, or knowingly conceals or knowingly and improperly avoids, or decreases an obligation to pay or transmit money or property to the state or a political subdivision.

5. Section 12651(a)(8): This section establishes liability for any person who conspires to commit any of the acts mentioned in Section 12651(a).

These sections may apply to different aspects of the case, such as the false claims submitted to Medicare, the false records or statements used to support those claims, and any conspiracy among the parties involved to commit these fraudulent acts.

It is essential to consult with an attorney specializing in healthcare fraud and false claims cases to determine the most appropriate sections of the California FCA to apply to the specific facts of the case.

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