Compliance & RegulatoryPregunta 88 de 100

A 'qui tam' provision under the False Claims Act allows:

a.Providers to appeal any denial
b.Patients to change their diagnosis
c.Payers to set fee schedules
d.A private individual (a whistleblower) to file suit on behalf of the government and potentially share in any recovery

Explicación

The qui tam provision lets a private person, often an employee who discovers fraud, bring a lawsuit on the government's behalf and receive a portion of amounts recovered. This encourages insiders to report false claims. The law also protects such whistleblowers from retaliation.

Referencia Legal: False Claims Act

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