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DOJ Fraud Section Provides Essential Insight into How Corporate Compliance Programs Are Evaluated

On February 8, 2017, the Criminal Fraud Section of the Department of Justice published a document titled “Evaluation of Corporate Compliance Programs,” providing guidance on how the DOJ evaluates the effectiveness of a...more

Supreme Court Upholds Implied Certification Theory of Liability under False Claims Act in Limited Circumstances

The False Claims Act (FCA) is the federal government’s chief weapon to combat false or fraudulent claims made to the government and has resulted in billions of dollars of recoveries. In recent years, broad interpretation of...more

Supreme Court Narrows Application of Implied Certification under the False Claims Act and Establishes a Demanding Materiality...

The Supreme Court’s decision in Universal Health Services v. United States ex rel. Escobar reframes when falsity may be implied under the False Claims Act (FCA) and raises the bar for materiality under the statute. Though the...more

In a Major FIRREA Victory for the Banks, the Second Circuit Overturns $1.27 Billion Jury Verdict

On Monday, the Second Circuit overturned a jury verdict and $1.27 billion penalty against Bank of America imposed under the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA), 12 U.S.C. § 1833a....more

Second Circuit Rejects Broad Certification as Basis for False Claims Act Liability in Financial Industry

Today, the Second Circuit affirmed the dismissal of False Claims Act (“FCA”) claims against Wells Fargo, finding a general certification of compliance with “any laws or regulations” too broad to support an FCA action and...more

Sixth Circuit Affirms Dismissal of $2.3 Billion FCA Case Due to Prior Public Disclosure

Last week, in U.S. ex rel. Advocates for Basic Legal Equality, Inc. (ABLE) v. U.S. Bank, the Sixth Circuit affirmed the dismissal of a False Claims Act (FCA) suit against U.S. Bank because the conduct alleged by the qui tam...more

Ninth Circuit Rejects Whistleblower Argument that Fannie Mae and Freddie Mac are Federal Instrumentalities under the False Claims...

Liability under the False Claims Act (FCA) is premised on the submission of a claim for money or property either to a federal government “officer, employee, or agent” or, under certain circumstances, to a nongovernmental...more

CMS Releases Final Rule on 60-Day Requirement to Report and Return Overpayments

On February 12, 2016, the Centers for Medicare and Medicaid Services (CMS) published its long-awaited final rule (the “Final Rule”) governing the requirement that healthcare providers report and return Medicare overpayments...more

False Claims Act: 2015 Year in Review

This year continued the trend of aggressive False Claims Act (FCA) enforcement by the Department of Justice (DOJ) and high volumes of qui tam lawsuits brought by whistleblowers. In fiscal year 2015, the DOJ marked the fourth...more

When an Overpayment Becomes a False Claims Act Issue: Explaining the First Judicial Interpretation of the 60-Day Rule

On August 3, 2015, Judge Edgardo Ramos of the United States District Court for the Southern District of New York issued the first judicial opinion addressing when a health care provider has “identified” a Medicare or Medicaid...more

False Claims Act: 2014 Year In Review

In what is becoming an annual refrain, 2014 marked another year of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and mushrooming qui tam lawsuits by whistleblowers. Indeed, fiscal year 2014...more

2014 – The Health Law Year in Review

Each year brings significant changes and challenges in the laws governing the health care industry, and 2014 proved to be no exception. What the year may have lacked in the high drama that accompanies comprehensive health...more

False Claim Act: 2013 Year in Review

Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more

Rakoff Decision Supports Feds’ Broad Application of FIRREA

On August 16, 2013, Judge Jed S. Rakoff of the Southern District of New York issued a ruling in in United States v. Countrywide Financial Corp., No. 12 Civ. 1422, that will likely be relevant to any financial institution...more

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