But the Justice Department is bringing the case under the Medical Care Recovery Act, which provides for direct recovery of damages against any third party that can be shown to have caused Medicare costs to increase.

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The study comes less than 15 months before the Affordable Care Act is expected to bring broader medical care coverage to 30 million Americans who do not have health insurance.

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Obama also does even more to empower the Independent Payment Advisory Board, a controversial body created in the Affordable Care Act that will inevitably act as a brake on American medical innovation.

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