According to the OIG Quality of Care CIA’s:
When a False Claims Act settlement resolves allegations of fraud that impact the quality of patient care, OIG may enter into a "quality-of-care" Corporate Integrity Agreement (CIA) with the settling provider. Under this type of CIA, OIG requires that the provider retain an independent quality monitor. The quality monitor not only will address the specific issues underlying the allegations, but also will look at the entity's delivery of care and evaluate the provider's ability to prevent, detect, and respond to patient care problems.
When a provider enters into a quality-of-care CIA as part of a settlement, it is not an admission that the provider provided substandard or worthless patient care. The presence of a quality-of-care CIA and a quality monitor, alone, is not determinative of the quality of care at the provider's facility or facilities. Nor does it guarantee that the provider will provide adequate patient care going forward.Here is a link to the 19 Quality of Care CIA’s and the Department of Justice Press releases.
Related:
Office of Inspector General Advisory Opinions
Since the effective date of section 1909 of the Social Security Act, the FCA has been amended by the Fraud Enforcement and Recovery Act of 2009 (FERA), the Patient Protection and Affordable Care Act (ACA), and the Dodd-Frank Wall Street Reform and Consumer Protection Act (the Dodd-Frank Act). These three acts, among other things, amended bases for liability in the False Claims Act and expanded certain rights of qui tam relators. Click here for a brief overview of the Dodd-Frank Act.
The OIG, in consultation with the Attorney General, determines whether States have false claims acts that qualify for an incentive under section 1909 of the Social Security Act. Those States deemed to have qualifying laws receive a 10-percentage-point increase in their share of any amounts recovered under such laws.
Below is a link to the states that have been reviewed.
State False Claims Act
