False Claims Act liability has been based on defendants falsely certifying their compliance with laws and regulations. But in deciding which laws and regulations can be used as a basis of this type of liability, such that defendants deserve the huge fines and penalties of the False Claims Act, courts often have to make subjective decisions about what laws and regulations are “important” enough for this type of liability.
To take a recent example, in United States ex rel. Wilkins v. United Health Group, Inc., the U.S. Court of Appeals for the Third Circuit had to decide which laws and regulations among the hundreds of thousands imposed on Medicare participants were sufficiently seriously to merit False Claims Act liability through their violation.
Teleradiology is becoming more and more common. This technology involves transmitting images, such as x-rays, CT scans, MRIs, and ultrasounds, over the Internet to a radiologist at another location to read and interpret. In many cases, this allows radiologists to work from home or other remote locations. And in some cases, radiologists in non-local time zones can help out on urgent issues that develop overnight in distant locations.
So far so good. But what if the radiologist is in another country? In fact, radiology reads have been outsourced to many locations around the world in recent years. India, Australia, Brazil, Switzerland, and Israel are common sources. Many have referred to this practice as “nighthawk” teleradiology.