On January 8, 2021, in the first appellate decision of the year addressing a False Claims Act case, the Fourth Circuit affirmed the summary judgment dismissal of relators’ claims that a manufacturer of allergenic extracts...more
1/12/2021
/ Appeals ,
Dismissals ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Medicaid ,
Medicare ,
Protected Activity ,
Regulatory Violations ,
Relators ,
Scienter ,
Universal Health Services Inc v United States ex rel Escobar
This month the Department of Justice brought a “first of its kind” action against two pharmacies, their owner, and three pharmacists for allegedly dispensing and billing Medicare for prescriptions in violation of both the...more
Under 42 U.S.C. § 1320a-7b(b)(1)(A) it is a felony for a physician to solicit or receive a kickback “in return for referring” a Medicaid or Medicare patient to another medical provider. But as a recent decision by the Eighth...more
On February 12, 2016, the Centers for Medicare & Medicaid Services (CMS) published its final rule regulating how healthcare providers must report and return overpayments. This rule implements the Affordable Care Act’s...more
For 23 years, the Ninth Circuit required that a relator establish three elements to qualify as an “original source” under the False Claims Act: (1) the relator must have direct and independent knowledge of the information on...more
7/8/2015
/ Appeals ,
False Billing ,
False Claims Act (FCA) ,
First-to-File ,
Medicare ,
Original Source ,
Public Disclosure ,
Qui Tam ,
Relators ,
Remand ,
Reversal ,
Wang Requirements
In a brief unpublished memorandum opinion released on June 15, 2015, the Ninth Circuit affirmed the district court’s dismissal of an FCA claim brought against a tribe, holding that tribes do not fit within the FCA’s...more