As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA).
We start with the numbers: The Department...more
2/28/2024
/ Causation ,
Damages ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Materiality ,
Objective Falsity ,
Penalties ,
Qui Tam ,
Relators ,
Retaliation ,
Scienter ,
Settlement ,
Sovereign Immunity ,
Whistleblowers
The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends.
Although DOJ brought in the second-highest...more
2/17/2023
/ Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Physicians ,
Qui Tam ,
Relators ,
Settlement
In 2022, the False Claims Act (FCA) continued to be the federal government’s chief tool for combatting fraud. Many trends in recent years were likewise present in 2022: robust FCA enforcement generally, healthcare as the...more
Thomas Prose is the founder and owner of a Michigan-based “post-hospitalist” company named General Medicine P.C. (GM), which purports to specialize in the care of post-acute patients in long-term care facilities by providing...more
E. False Claims Act: Materiality -
1. False Claims Amendments Act of 2021 (S.2428) -
• The Senate Committee on the Judiciary has approved for the Senate’s full consideration an amendment to the FCA that would...more
On February 1, 2022, the United States District Court for the Eastern District of California ruled that a False Claims Act (FCA) case against defense contractor Aerojet Rocketdyne Holdings and Aerojet Rockdyne Inc....more
The year 2021 marks the 10th anniversary of the Bradley False Claims Act Year in Review. In that decade, much has remained the same in FCA enforcement. To start with the obvious: It continues to result in billions of dollars...more
2/3/2022
/ Alternate Remedy ,
Anti-Kickback Statute ,
CARES Act ,
Causation ,
Class Action ,
Cybersecurity ,
Damages ,
Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Government Investigations ,
Healthcare ,
Local Coverage Determination (LCD) ,
Materiality ,
Overpayment ,
Pleading Standards ,
Public Disclosure Bar ,
Request for Equitable Adjustment ,
Scienter ,
Settlement
Many observers are watching with keen interest how the new nominee for the Secretary of the Department of Health and Human Services (HHS), California Attorney General Xavier Becerra, will run the department if confirmed. In...more
3/8/2021
/ Analytics ,
Attorney General ,
Biden Administration ,
Compliance ,
Department of Health and Human Services (HHS) ,
Documentation ,
Enforcement Actions ,
Health Care Providers ,
Legal Advice ,
Medicare Advantage ,
State and Local Government
The False Claims Act (“FCA”) continued to serve as one of the primary tools utilized by the federal government against government contractors in 2020. One of the key areas that the government focused on this past year was...more
This year saw substantial activity in FCA settlements and litigated court cases. Although no single case or development dominated the discourse this year, several important court decisions were issued, including two that may...more
2/1/2021
/ Ambiguous ,
Anti-Kickback Statute ,
Damages ,
Deficit Reduction ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Department of Veterans Affairs ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Aviation Administration (FAA) ,
Fee-Shifting ,
First-to-File ,
Fraud ,
Materiality ,
Medicaid ,
Medicare ,
Qualified Immunity ,
Reasonable Interpretations ,
Retaliation ,
Speaker Programs ,
Statute of Limitations
The year 2019 was another active year in False Claims Act (FCA) investigations and litigation. Although the year lacked a singular blockbuster case, there were decisions of particular note. The Supreme Court clarified the...more
1/20/2020
/ Anti-Kickback Statute ,
Causation ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Federal Rules of Civil Procedure ,
Final Judgment ,
First-to-File ,
Government Investigations ,
Health Care Providers ,
Issue Preclusion ,
Materiality ,
Medicare Advantage ,
Objective Falsity ,
Overpayment ,
Pleading Standards ,
Public Disclosure Bar ,
Qui Tam ,
Sanctions ,
Settlement Agreements ,
Standing ,
Stark Law ,
Statute of Limitations
This week, the Department of Justice (DOJ) formalized and expanded its guidance for how defendants can earn cooperation credit in False Claims Act (FCA) cases and thereby reduce settlement amounts. New section 4-4.112 of the...more
5/13/2019
/ Compliance ,
Cooperation ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Government Agencies ,
Government Investigations ,
New Guidance ,
Remedial Actions ,
Risk Mitigation ,
Voluntary Disclosure
Companies that work with the federal government (think Medicare and Medicaid reimbursements, government contracts, grant funding) need to stay up to date on the False Claims Act (FCA). The FCA is one of the primary tools used...more
INTRODUCTION -
Unlike some recent years, 2018 was somewhat short on headline grabbing news related to the False Claims Act (FCA). There were, to be sure, significant developments in the courts and within the Department of...more
1/18/2019
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Qui Tam ,
Relators ,
Retaliation ,
Statute of Limitations ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Yates Memorandum
Last week, the Department of Justice (DOJ) issued two separate memoranda with potentially far-reaching consequences. While the practical effect of these documents remains to be seen, they may provide another avenue of...more
The federal government continues to use the False Claims Act (FCA) as one of its prime enforcement tools against government contractors. To keep you informed on the status of the law, Bradley’s Government Enforcement and...more
1/30/2018
/ Causation ,
Damages ,
Enforcement Actions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
First-to-File ,
FRCP 9(b) ,
Materiality ,
Objective Falsity ,
Overpayment ,
Pro Se Litigants ,
Reverse False Claims ,
Settlement ,
Universal Health Services Inc v United States ex rel Escobar ,
Yates Memorandum
The Foreign Corrupt Practices Act of 1977 (FCPA) makes it unlawful for certain classes of persons and entities to make payments to foreign government officials to assist in obtaining or retaining business. On November 29,...more
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
1/19/2015
/ Bank of America ,
Banking Sector ,
Banks ,
BNP Paribas ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Janssen Pharmaceuticals ,
JPMorgan Chase ,
KBR (formerly Kellogg Brown & Root) ,
Qui Tam ,
Settlement Agreements ,
SunTrust ,
US Bank ,
Wartime Suspension of Limitations Act ,
Whistleblower Awards ,
Whistleblowers
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
12/31/2014
/ ACOs ,
Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
CMP Law ,
Cybersecurity ,
Ebola ,
Enforcement ,
Enforcement Actions ,
False Claims Act (FCA) ,
Halbig v Burwell ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
King v Burwell ,
Medicare Shared Savings Program ,
OIG ,
Patient Confidentiality Breaches ,
PHI ,
Popular ,
Stark Law ,
Tax Credits