Quote:
Originally Posted by Rainger99
So they probably owe more money than the $360 million? But there may be a limit as to how far back Medicare can go in getting overpayments?
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For Medicare fraud, the False Claims Act (FCA) statute of limitations is:
6 years from when the false claim was submitted or
3 years from when the government knew (or should have known) about the fraud,
but no more than 10 years total after the false claim was submitted.
That means Medicare fraud can be pursued up to 10 years back in some cases.
A couple of related points:
Criminal Medicare fraud (under federal criminal statutes, e.g., 18 U.S.C. § 1347 for health care fraud) generally has a 5-year statute of limitations, but this can be extended to 10 years for health care fraud affecting federal health care programs (like Medicare/Medicaid).
Civil FCA cases (including qui tam whistleblower suits) follow the 6/3/10 rule above.
So in practice:
Civil recovery under FCA → up to 10 years.
Criminal prosecution → usually 5 years, but extended to 10 years in Medicare/Medicaid fraud cases.