Q: Unjust enrichment statutes
What are statutes that define liability for unjust enrichment in healthcare/hospice fraud?
A: Unjust enrichment is essentially a common law doctrine that could be argued in many settings, regardless of whether addressed in statutes. Good luck
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A:
In California, there is no specific statute that defines liability for unjust enrichment in the context of healthcare or hospice fraud. However, unjust enrichment is a common law principle that is often used in civil litigation to recover damages when one party has unfairly benefited at the expense of another.
In healthcare and hospice fraud cases, unjust enrichment claims are typically brought in conjunction with other statutory violations, such as:
1. False Claims Act (FCA) (31 U.S.C. §§ 3729-3733): This federal law imposes liability on individuals and companies who defraud the government, including through healthcare fraud. California has its own state-level FCA (Cal. Gov't Code §§ 12650-12656).
2. Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)): This federal law prohibits offering, paying, soliciting, or receiving remuneration to induce or reward patient referrals or the generation of business involving any item or service payable by federal healthcare programs.
3. Stark Law (42 U.S.C. § 1395nn): This federal law prohibits physicians from referring patients to receive "designated health services" payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies.
4. Health Care Fraud Statute (18 U.S.C. § 1347): This federal law makes it a crime to knowingly and willfully execute, or attempt to execute, a scheme to defraud any healthcare benefit program or to obtain money or property from a healthcare benefit program through false pretenses or representations.
In cases involving these statutory violations, plaintiffs may also include a claim for unjust enrichment to recover any ill-gotten gains obtained by the defendant as a result of their fraudulent conduct. While not a standalone statute, unjust enrichment is a powerful tool in healthcare and hospice fraud litigation in California.
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