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Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed Cases: November 2014

Trends & Analysis - In the period covered by this issue, we have identified 68 whistleblower cases related to health care that were unsealed. In this Qui Tam Update, we analyze the trends and take an in-depth look at...more

Seventh Circuit Holds Pharmacy Billing Medicaid For Drug Prices Above Private Rates Is Not Fraudulent

On November 12, 2014, the Seventh Circuit upheld the dismissal of a False Claims Act action challenging a retail pharmacy chain’s practice of billing Medicaid for the price differential between the higher Medicaid-negotiated...more

The Ninth Circuit Provides Clarity on ERA Whistleblower Protections.

On November 7, 2014, the Ninth Circuit issued its ruling in Tamosaitis v. URS Inc. and provided clarity on three key aspects of the whistleblower protections afforded under the Energy Reorganization Act (ERA), 42 U.S.C. 5801...more

Sixth Circuit Dismisses Whistleblower’s Claims Made By Job Applicant

This week, the U.S. Court of Appeals for the Sixth Circuit ruled that a job applicant lacks standing to bring whistle-blower claims under the Energy Reorganization Act and the False Claims Act (“FCA”) because those laws’...more

D.C. Circuit: USAID Worker Jailed in Cuba Can’t Recover Damages from the Government

On November 14, 2014, in Alan Gross and Judith Gross v. U.S.A., a three-judge panel of the United States Court of Appeals for the D.C. Circuit unanimously held that a humanitarian aid worker, who sub-contracted with the...more

DC Circuit Dismisses Appeal By Three Hospitals Challenging Subcontractor Status

On November 14, 2014, the United States Court of Appeals for the District of Columbia dismissed as moot an appeal by three hospitals affiliated with the University of Pittsburgh Medical Center. The hospitals had challenged...more

The Seventh Circuit Rejects Medicaid False Claims Act Suit

The United States Court of Appeals for the Seventh Circuit affirmed the dismissal of a False Claims Act (“FCA”) case against Shopko Operating Stores, LLC, in which a former Shopko pharmacist asserted Medicaid billing...more

Illinois Supreme Court Debates Burdens of Proof for Wrongful Termination Cases

During its September term, the Illinois Supreme Court heard oral argument in a potentially important employment law case, Michael v. Precision Alliance Group, LLC. Michael poses questions about the parties’ burdens of proof...more

"U.S. v. Novartis: Reaffirming the Importance of Updating and Adhering to Corporate Policies"

A recent decision in a false claims act case, United States ex rel. Bilotta v. Novartis Pharmaceuticals Corporation (Novartis), underscores the importance of policing employee adherence to corporate policies and industry...more

California Trial Court Orders New Trial On Claim that Recology Violated CFCA

A California trial court recently overturned a jury verdict finding Recology San Francisco liable for violating the California False Claims Act (CFCA) and granted Recology’s motion for a new trial. The court’s ruling comes...more

Seventh Circuit: No Fraud in Billing Medicaid More than Private Insurers for Drugs

Last Wednesday the Seventh Circuit affirmed the dismissal of a whistleblower suit brought by a pharmacist against his former employer, the Shopko pharmacy chain, for what he alleged was fraudulent billing of Medicaid by...more

Uncertain Privilege: Implied Waiver of the Attorney-Client Privilege in False Claims Act Litigation

In a pending False Claims Act (“FCA”) case stemming from alleged violations of the physician self-referral law (the “Stark Law”), 42 U.S.C. § 1395nn, and the federal Anti-Kickback Statute (“AKS”), 42 U.S.C. §1320a-7b, the...more

Lopez v. City of Lawrence Decision Criticizes “Disparate Impact” Analysis

In the context of analyzing a Title VII Civil Rights and Massachusetts law “disparate impact” claim, a federal court has cast considerable doubt on the efficacy of statistical tools employed in “disparate impact” analysis. In...more

November Generality-in-Pleading Award

We’re only one-third of the way through the month of November, but we already have a winner of November’s Generality-in-Pleading Award. The hands-down winner is Dr. Warren Troxler, whose False Claims Act whistleblower suit...more

Illinois Supreme Court Holds Subcontractor Should Have Proceeded Against Project Bond

Last month, a divided Supreme Court held that a subcontractor on a public works program should have timely proceeded against the project bond, and had no remedy against the Village after the general contractor went bankrupt...more

Whistleblowers Must Have Independent Knowledge to Actually Blow the Whistle

To bring a valid qui tam action and overcome the so-called “public disclosure bar” under the False Claims Act (“FCA”), a whistleblower must have direct knowledge of the alleged fraudulent activity, independent of already...more

PilieroMazza Legal Advisor - Fourth Quarter

In this issue: - Court of Federal Claims Invalidates Key Component of the SBA’s Nonmanufacturer Rule - At the Crossroads of M&A and Government Contracts – The Novation Process - What Every Business Owner...more

Government demonstrates willingness to enforce Affordable Care Act provision that could cost providers millions of dollars

Under a little-known provision of the Patient Protection and Affordable Care Act (“ACA”), healthcare providers could face millions of dollars in liability for failing to reimburse the government for overpayments in a timely...more

Recent Developments in Cases Dealing with the False Claims Act’s First-to-File and Public Disclosure Bars

The False Claims Act, 31 U.S.C. §§ 3729-3733, enables whistleblowers—also known as qui tam relators— to file fraud suits on behalf of the United States against private government contractors. With the assistance of qui tam...more

California Court Finds Lack of Evidence Undermines False Claims Act and Retaliation Claims

The Southern District of California recently issued a favorable ruling for employers under both the False Claims Act and California’s retaliatory discharge provision codified at California Labor Code section 1102.5. The court...more

False Claims Act Does Not Protect An Employee Disclosing His Whistleblower History

On October 20, the United States District Court for the Southern District of Ohio found that the False Claims Act (“FCA”) did not protect an employee who was fired after revealing his history as a whistleblower and offering...more

Good News for Guilty Whistleblowers!

Want to be a whistleblower but worried your own wrongdoing will prevent it? If so, Tuesday’s decision by a federal court in Texas should come as welcome news. In that long-running False Claims Act case, the court rejected a...more

Third Circuit Tightens “Original Source” Requirement for Whistleblowers

Back in 2003 Karl Schumann filed a whistleblower suit alleging that as an executive with benefits company Medco, he learned that Bristol-Myers Squibb and AstraZeneca paid kickbacks to Medco to buy and recommend brand name...more

DC Circuit Ruling Confirms Reasonableness Of Resellers Relying On TAA Certifications From Suppliers

The U.S. Court of Appeals for the District of Columbia Circuit has issued a ruling bringing to an end the long-running False Claims Act (“FCA”) case filed by relator Brady Folliard and providing useful guidance to resellers...more

Security Guards Unable To Secure Certification Without Commonality

A California federal district court recently denied a motion for class certification because the evidence presented in connection with the motion refuted plaintiffs’ attempted showing of commonality through uniform exposure...more

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