Alabama A & M University False Claims Act Report

Congress has passed a statute that says “providers of power wheelchairs must obtain a physician certification within 30 days of providing the wheelchair to a beneficiary in order to be eligible for payment.” The legislative history explains that the 30-day requirement is designed to prevent fraud by requiring a physician to contemporaneously certify the beneficiary’s need for a power wheelchair, which is much more expensive than a nonpowered wheelchair.

The evidence shows that in the past, when the Government has discovered violations of the rule, it has never sought repayment, but has always put the defendant on prepayment review (meaning it has audited all of the defendant’s claims before paying them). The Government has now brought a False Claims Act case against a wheelchair supplier for violating the 30-day rule.

Was the defendant’s failure to comply with the 30-day requirement a material violation? Why or why not?

• Posting length should be 1-2 paragraphs.