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Whistleblower Filed Too Early & Too Late for Share of $322M SCAN Scam Recovery

During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and Medicaid for years. He expressed his concerns within SCAN. When he refused a job reassignment, he was fired....more

Fourth Circuit Affirms $237 Million Jury Verdict for Stark and FCA Violations; Rejects Advice-of-Counsel Defense

On July 2, the U.S. Court of Appeals for the Fourth Circuit affirmed a jury verdict of more than $237 million against Tuomey Healthcare System, a nonprofit hospital in South Carolina, based on Stark Law and False Claims Act...more

Dialysis Provider Settles Whistleblower Lawsuit for $450 Million

The Department of Justice and dialysis provider DaVita Healthcare Partners recently finalized a $450 million agreement settling claims that the company intentionally inflated Medicare billings. The parties had filed a joint...more

Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements

Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial...more

Successful Rule 9(b) Defense of False Claims Act Whistleblower Litigation

The lure of significant monetary awards continues to stimulate high-risk whistleblower actions under the False Claims Act (FCA), and these claims are increasingly common in the pharmaceutical and medical device industry. The...more

New Jersey Federal Court Allows “Self-Help” Counterclaims Against Potential FCA Whistleblowers To Proceed

Last week, a New Jersey federal court allowed medical device maker Boston Scientific Neuromodulation Corp. (“Boston Scientific”) to proceed with counterclaims against two of its former employees for violating their contracts...more

In Government's Shoes: The Continuing Force Behind the False Claims Act & Qui Tam Complaints

To combat fraud by contractors selling faulty war supplies to the Union Army, in 1863 President Abraham Lincoln signed into law the False Claims Act (the “FCA”). Designed to root out fraud on the federal government, this act...more

Eighth Circuit Addresses Scope of False Claims Act Liability

Last month, the Eighth Circuit Court of Appeals addressed the scope of “fraud-in-the-inducement” liability under the False Claims Act (FCA), 31 U.S.C. §§ 3729-3733, and, in doing so, reversed the dismissal of a claim related...more

Eighth Circuit Adopts Novel False Claims Act Fraud-in-the-Inducement Theory Long Espoused by Government

On October 15, 2013, a divided three-judge panel of the United States Court of Appeals for the Eighth Circuit rendered a federal False Claims Act ("FCA") judgment against Bayer Healthcare Pharmaceuticals ("Bayer"), based on a...more

PRIME Act: New Legislation to Curb Health Care Fraud

The United States Senate and House of Representatives recently introduced bipartisan legislation designed to reduce fraud, waste, and abuse in the Medicare and Medicaid programs. The legislation, entitled “Preventing and...more

Fourth Circuit Holds False Claims Act Relators to Strict Pleading Standard: Ruling Will Be Particularly Useful in Defending...

On January 11, 2013, the United States Court of Appeals for the Fourth Circuit issued an opinion reaffirming the requirement that False Claims Act relators plead presentment of a false claim with particularity. United States...more

Los Angeles Battle Over Owens Lake Dust Mitigation Costs Boils Over

There’s a dust up occurring between the City of Los Angeles and the Great Basin Unified Air Pollution Control District (“Great Basin”). What’s the dust up about? Dust! Yes, even something as naturally occurring and...more

First Circuit’s Oral Argument in Rost Revisits Prior Case Law Expanding False Claims Act Liability

On May 8, 2012, the United States Court of Appeals for the First Circuit heard oral arguments in United States ex rel. Rost v. Pfizer, Inc. (10-2215). The central issues in the case are whether compliance with the federal...more

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