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United States v. Krizek

United States Court of Appeals for the District of Columbia Circuit

111 F.3d 934 (1997)

Facts

The federal government brought an action against Krizek, a psychiatrist, and his wife for violations of the False Claims Act (FCA), 31 U.S.C. §§ 3729-3731. Krizek’s wife worked in his office and submitted claims to the federal government for reimbursement based on poorly kept records. She did not verify the amount of time Dr. Krizek actually spent with patients. Dr. Krizek was equally reckless by failing to review bills that were being submitted on his behalf. Under the federal government’s proposed definition of “claim” the total fine would reach $81 million. Actual damages totaled closer to $245,000. The district court found the Krizeks liable for knowingly submitting false claims and assessed penalties of $168,105. The government appealed, and the Krizeks cross-appealed to the court of appeals claiming the district court improperly treated each CPT code as a separate claim for purposes of computing penalties. The court of appeals then examined Krizeks’ conduct to determine if they knowingly intended each CPT code to be a separate claim.

Rule of Law

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Issue

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Holding and Reasoning (Sentelle, J.)

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A "yes" or "no" answer to the question framed in the issue section;
A summary of the majority or plurality opinion, using the CREAC method; and
The procedural disposition (e.g., reversed and remanded, affirmed, etc.).

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