The U.S. Department of Justice (DOJ) filed its first major complaint-in-intervention under the False Claims Act (FCA) premised on a government contractor’s alleged cybersecurity deficiencies since the DOJ’s Civil Cyber-Fraud...more
9/13/2024
/ Compliance ,
Compliance Commitees ,
Controlled Unclassified Information (CUI) ,
Cybersecurity ,
Data Management ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
Fraud ,
Intervention Notices ,
NIST ,
Sensitive Personal Information ,
Whistleblowers
Companies who submit healthcare claims to private payors, provide financial services to customers, interact with domestic or foreign public officials, or otherwise operate in highly regulated industries should take note that...more
8/13/2024
/ Corporate Crimes ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Federal Pilot Programs ,
New Regulations ,
Pilot Programs ,
Regulatory Requirements ,
Self-Reporting ,
Voluntary Disclosure ,
Whistleblower Awards ,
Whistleblowers ,
White Collar Crimes
On June 28, 2024, SCOTUS overturned the long-standing Chevron doctrine in its decision Loper Bright Enterprises v. Raimondo and Relentless v. Department of Commerce. The Court’s ruling will have a significant impact on...more
7/15/2024
/ Administrative Procedure Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Chevron Deference ,
Chevron v NRDC ,
Department of Health and Human Services (HHS) ,
Fraud and Abuse ,
Government Agencies ,
Healthcare ,
Hospice ,
Judicial Authority ,
Loper Bright Enterprises v Raimondo ,
MACs ,
Medicaid ,
Medicare ,
Regulatory Authority ,
SCOTUS ,
Statutory Interpretation
This past year, the False Claims Act (FCA) continued to be a key tool for the Justice Department and whistleblowers to bring suits against companies, including those in the financial services sector. The Justice Department...more
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
Significant work goes into settling a False Claims Act action. Defendants may spend months negotiating with the government to reach an agreeable settlement — often even longer if the defendant pursues the arduous...more
The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more
10/31/2023
/ Appeals ,
Dairy Farmers ,
False Claims Act (FCA) ,
Fraud ,
Insurance Claims ,
Insurance Industry ,
Materiality ,
Qui Tam ,
Relators ,
SCOTUS ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
In its June 14, 2023, decision in United States ex rel. Michelle Calderon v. Carrington Mortgage Services, LLC, No. 22-1553, 2023 WL 3991013, (7th Cir. 2023), the Seventh Circuit explained the high bar for relators to prove...more
7/6/2023
/ Borrowers ,
Causation ,
False Claims Act (FCA) ,
False Statements ,
Federal Housing Administration (FHA) ,
HUD ,
Insurance Industry ,
Loans ,
Mortgage Insurance ,
Mortgage Lenders ,
Mortgage Servicers ,
Mortgages
On May 3, 2023, the Seventh Circuit affirmed $10 million in insurance coverage for a False Claims Act (FCA) settlement in a case based on alleged Anti-Kickback Statute violations. Astellas US Holding, Inc. v. Federal...more
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
The False Claims Act (FCA) continued to be a key tool in 2022 for the Justice Department and whistleblowers to bring suits against companies, including those in the financial services sector. While the focus stayed largely on...more
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
U.S. Supreme Court nominee Ketanji Brown Jackson is not a stranger to the False Claims Act. In her eight years as a U.S. district judge for the District of Columbia, before she was elevated to the U.S. Court of Appeals for...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
It is essential for employers that work with the federal government to stay up to date on the federal False Claims Act (“FCA”). In 2020, individual employees were front and center in the government’s enforcement of the FCA,...more
The False Claims Act (FCA) continues to be a primary tool for both the Justice Department and whistleblowers’ counsel to bring suits against companies in the financial services sector, and the nationwide pandemic did not halt...more
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
In the latest instance of courts interpreting the Supreme Court’s landmark False Claims Act ruling in Universal Health Services, Inc. v. Escobar, the Eleventh Circuit recently departed from the trend of giving great weight in...more
1/20/2021
/ Amicus Briefs ,
Appeals ,
Audits ,
Department of Veterans Affairs ,
False Claims Act (FCA) ,
Fees ,
Fraud ,
Qui Tam ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar ,
Veterans
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
1/23/2020
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Financial Services Industry ,
Healthcare Fraud ,
Medicare Advantage ,
Private Equity ,
Public Disclosure Bar ,
Qui Tam ,
Stark Law ,
Statute of Limitations ,
Whistleblowers
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