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5th Circuit rules Medicaid intermediary doesn’t have sovereign immunity

The United States Court of Appeals for the Fifth Circuit has ruled that National Heritage Insurance Company is not immune from False Claims Act suits. The company had argued that, as a Medicaid fiscal intermediary, it was an arm of the state and could not be sued under the False Claims Act.

The underlying suit alleges that NHIC, along with Deloitte & Touche and Medicaid Claims Solutions of Texas, fraudulently billed Medicaid for School Health Related Services, getting Medicaid reimbursement for services the schools were already providing.

The text of the opinion, United States ex rel Barron v. Deloitte & Touche, is available at the court’s website.

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