title: The federal effort to eliminate fraud and ensure quality care.
abstract: In 1996, the United States filed a lawsuit against a nursing home that it alleged was providing inadequate nutrition and wound care to residents, despite the fact that the facility had submitted claims to Medicare and Medicaid for payment for nutrition services. The lawsuit alleged that these submissions for payment violated the False Claims Act. This was the first time the False Claims Act was used to enforce quality-of-care standards set by Congress in the Nursing Home Reform Act. A federal prosecutor involved in the case discusses the steps leading up to the lawsuit and the details of the settlement.
authors.forename: D R
authors.initials: DR
authors.lastname: Hoffman
mesh_terms: D005380:Financing, Government / Q000331:legislation & jurisprudence*; D005607:Fraud; D006801:Humans; D008484:Medicaid / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D009735:Nursing Homes / Q000331:legislation & jurisprudence*; D011787:Quality of Health Care / Q000331:legislation & jurisprudence*; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence; D014481:United States