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

Q: Fraudulent hospice charges in case NOT filed under False Claims Act.

Those fraudulent charges for 'hospice benefit' could or not be directly included in plaintiff's economic damages/out-of-pocket expenses;

But they are impactful since they are on Plaintiff's medicare record, that will have to be amended.

How this factor is taken into consideration when assessing current and future damages?

1 Lawyer Answer
James L. Arrasmith
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Answered

A: Your Medicare record showing fraudulent hospice charges can indeed impact your case beyond direct financial losses. This situation affects both current and future healthcare considerations.

The presence of false hospice charges on your Medicare record could lead to complications with future medical care and insurance claims, as these records influence coverage decisions and medical assessments. You may need to factor in the costs and time associated with correcting these records, including potential legal fees and administrative expenses for record amendment procedures. Additionally, if healthcare providers make decisions based on these incorrect records, it could result in denied services or delayed care, which should be considered when calculating damages.

When assessing damages, courts may consider several factors: the direct costs of correcting Medicare records, any medical care you were denied or delayed due to the fraudulent records, emotional distress caused by dealing with these issues, and potential future impacts on your healthcare access. While not filed under the False Claims Act, you can still pursue compensation for these record-related damages through other legal avenues, and it's worth documenting all instances where these incorrect records have affected or may affect your healthcare decisions and access to treatment.

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