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
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
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
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
Liability under the False Claims Act can result in potentially enormous payouts to individuals — and sometimes to companies — who alert the government to allegations of health care fraud.
The payouts to the whistleblower...more
Liability under the False Claims Act (FCA) can result in potentially enormous payouts to individuals, and sometimes to companies, who alert the government to allegations of healthcare fraud. The payouts to the whistleblower...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
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
Bradley’s Government Enforcement and Investigations practice group is pleased to present the 2017 False Claims Act Year in Review, our annual review of significant False Claims Act (FCA) cases, developments, and trends. The...more
1/24/2018
/ Causation ,
Damages ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
First-to-File ,
Health Care Providers ,
Healthcare Fraud ,
Materiality ,
Pro Se Litigants ,
Retaliation ,
Rule 9(b) ,
Universal Health Services Inc v United States ex rel Escobar
We are pleased to present Bradley’s annual review of significant False Claims Act (FCA) cases, developments, and trends. From a relatively short article several years ago, the Review has grown to a significant publication...more
1/10/2017
/ Anti-Kickback Statute ,
Appeals ,
Calculation of Damages ,
Civil Monetary Penalty ,
Defense Contracts ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Federal Contractors ,
FRCP 9(b) ,
Healthcare Fraud ,
Materiality ,
Objective Falsity ,
Off-Label Promotion ,
Overpayment ,
Public Disclosure ,
Qui Tam ,
Retaliation ,
SCOTUS ,
Standard of Review ,
Successor Liability ,
Transfer of Venue ,
United States ex rel Nelson v Sanford-Brown ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Yates Memorandum
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
12/22/2015
/ Anti-Kickback Statute ,
Certiorari ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Federal Contractors ,
First-to-File ,
Implied Certification ,
Public Disclosure ,
Qui Tam ,
SCOTUS ,
Split of Authority ,
Stark Law ,
Whistleblowers
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
On August 20, 2014, the Seventh Circuit struck another blow against relators’ and the federal government’s increasingly aggressive False Claims Act theories of liability. Rejecting the relators’ use of the “worthless...more
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
1/15/2014
/ Calculation of Damages ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
FERA ,
Fines ,
First-to-File ,
Fraud ,
Halliburton ,
Healthcare ,
Medicare ,
Off-Label Use ,
Overpayment ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Public Disclosure ,
Qui Tam ,
Wells Fargo ,
Whistleblowers ,
WSLA
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
The First Circuit has become the fourth federal court of appeals to address whether a first-filed yet insufficient complaint still qualifies as a pending action under the first-to-file rule of the False Claims Act....more
On April 17, 2013, the Office of Inspector General (OIG) of the United States Department of Health and Human Services (HHS) revised its Provider Self-Disclosure Protocol (SDP), originally published in 1998, and updated in...more
This spring saw two significant victories for health care providers in the federal courts of appeals. In both cases, the courts rejected an aggressive government theory under the False Claims Act (FCA), the first related to...more