Zach Shamberg

A proposal to enact a state False Claims Act in Pennsylvania “has the potential to impact the entire long-term care continuum” even though assisted living and personal care communities do not currently participate in the Keystone State’s Medicaid system, the Pennsylvania Health Care Association told McKnight’s Senior Living.

“PHCA is, however, fighting to make assisted living part of the state’s Medicaid provider system in the future,” a spokeswoman for the organization said.

The bipartisan effort in Pennsylvania would be designed to protect whistleblowers who report fraudulent Medicaid claims. Lawmakers are expected to take up the matter this spring, according to a previous memo, and several legislators took part in a press conference about it on Monday.

Nursing homes would be negatively affected by a state False Claims Act in several ways, PHCA President and CEO Zach Shamberg said. PHCA represents both skilled nursing and senior living providers.

The legislation, Shamberg said, would “create additional bureaucracy and red tape by duplicating a cause of action which already exists at the federal level for all state programs receiving federal funding” as well as “lead to a dramatic increase in frivolous claims and further stigmatize long-term care providers as well as direct caregivers in an already difficult legal and regulatory environment, requiring providers to focus their limited resources on legal battles instead of investing in quality care.”

A “significant portion” of taxpayer money, he added, would go to whistleblowers and trial lawyers instead of being invested in care for older adults.

Thirty-one states have passed similar bills, according to the Pennsylvania Capital-Star.