Government Contracting Health Civil Procedure

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Criminal Conviction Leaves Defendant Defenseless in FCA Civil Action

Pity Dr. Christina Clardy. In 2011 she was convicted of health care fraud, sentenced to 135 months in prison, and ordered to pay $16 million in restitution. Then in 2014 the government added Christina as a defendant in its...more

University of Massachusetts Medical School Not a “Person” Under FCA; 1st Circuit Adopts “Arm-of-the-State” Test

In an opinion issued on January 27, 2016, the United States Court of Appeals for the First Circuit affirmed the dismissal of a qui tam lawsuit against the University of Massachusetts, holding that the University was...more

Implied Certification and the FCA: Legally False or a False Legality? The Supreme Court Is Set to Decide

The United States Supreme Court recently granted certiorari in the case of Universal Health Services, Inc. v. U.S. ex rel. Escobar, No. 15-7, which places implied certification under the False Claims Act (FCA) squarely in the...more

Another Day, Another Whistleblower Retaliation Suit

A False Claims Act (“FCA”) retaliation claim, 31 U.S.C. 3730(h), filed January 26, 2016 in federal district court in Oregon, provides a perfect example of the type of challenging cases confronting health care employers today....more

Supreme Court Rejects Tribe’s Equitable Tolling Argument in Contract Support Litigation

On January 25, 2016, the Supreme Court issued a decision in Menominee Indian Tribe of Wisconsin v. United States, rejecting an argument that equitable tolling preserves some claims against the United States for failure to pay...more

Statistical Sampling Debate: A Growing Web Of FCA Cases

The government and qui tam plaintiffs are increasingly employing statistical sampling in False Claims Act cases, particularly in cases where addressing and analyzing large numbers of allegedly false claims poses substantial...more

District Court Dismisses Government’s False Claims Act Complaint for Failure to Allege Actual False Claims with Particularity

On January 7, 2016 the United States District Court for the Middle District of Florida took the rare step of dismissing (with leave to amend) the government’s Complaint in Intervention in a False Claims Act Case. This case...more

False Claims Act: 2015 Year-in-Review

In 2015, the Justice Department (DOJ) continued to give high priority to False Claims Act (FCA) investigations, bringing in nearly $3.6 billion in settlements and judgments. More than 630 qui tam suits were filed. DOJ's...more

False Claims Act Update: A Statistical Review of 2015 and Key Events for 2016

As reported by the Department of Justice (DOJ) in a December 2015 press release, the False Claims Act (FCA) remains the federal government’s primary means for combating fraud. In 2015, the DOJ recovered $3.583 billion in FCA...more

Nashville Pharmacy Services, LLC Settles FCA Allegations

Last week the Department Of Justice announced a settlement agreement with Nashville Pharmacy Services, LLC (“NPS”) and NPS majority owner Kevin Hartman. Under the agreement, NPS and Mr. Hartman will pay up to $7.8 million to...more

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: December 2015

Trends & Analysis - We have identified 24 health care–related qui tam cases that have been unsealed since our last Qui Tam Update. Of the 24 cases, five were filed within the past year, seven were filed in 2014, three...more

Thirty-Two Hospitals to Pay $28 Million to Resolve False Claims Act Kyphoplasty Dispute

Thirty-two hospitals have agreed to pay over $28 million to resolve outstanding False Claims Act allegations, the U.S. Department of Justice (DOJ) announced on December 18, 2015. The hospitals were accused of submitting...more

False Claims Act: 2015 Year in Review

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

First Circuit Applies Kellogg Brown & Root to Allow Relator to File Motion to Supplement Previously Dismissed Complaint

In United States ex rel. Gadbois v. PharMerica Corp., — F.3d —- (1st Cir. 2015), the First Circuit, in a matter of first impression, held that a relator’s complaint was not subject to dismissal under the first-to-file bar...more

Justice Department Reports Annual Results of False Claims Litigation: Numbers Remain Alarming for Health Care Related Industries

On December 3, 2015 the United States Justice Department made its annual public disclosure of the financial results of False Claim litigation around the country. The Department reported that it had collected more than $3.5...more

California Court Permits FCA Claim Involving Medicare “Referral and Regeneration” Scheme to Proceed Against Healthcare CEO

In a recent opinion, the Northern District of California allowed FCA claims to proceed against the CEO of a skilled nursing facility operator. John Orten, the whistleblower in the suit, was a former nursing home...more

The Twenty-Year Ascendancy of Health Care Qui Tam Litigation in Five Simple Graphs

Experienced practitioners are anecdotally aware of the growth in recent years in the volume of health care qui tam litigation. That perceived trend is validated quite graphically in the most recent Department of Justice...more

DOJ Recovers $3.5 Billion in False Claims Act Cases in FY2015 and Pays Record Amount to Qui Tam Relators

Late last week DOJ announced that in FY2015 it obtained more than $3.5 billion in settlements and judgments from civil cases involving allegations of false claims against the government. Once again, health care fraud...more

U.S. v. AseraCare and the Standard of Falsity Under the False Claims Act

Prosecutors, defense attorneys and health care providers alike have been closely watching the U.S. v. AseraCare (No. 2:12-cv-00245) matter pending in the Northern District of Alabama. The AseraCare case relates to hospice...more

Court Rules that Medicare and Medicaid Payments to Nursing Home Must Continue Pending Jurisdictional Dispute

On October 27, 2015, United States District Judge James S. Moody, Jr. extended a stay of proceedings thereby permitting Bayou Shores SNF, LLC (“Bayou Shores”) to remain viable and continue receiving Medicare and Medicaid...more

Final Curtain Call for Tuomey: Long-Running FCA/Stark Case Settled

After 10 years of litigation, including two trials and appeals to the 4th Circuit Court of Appeals, the U.S. Department of Justice (DOJ) and Tuomey Healthcare System (Tuomey) have entered into a settlement of DOJ's action...more

Millennium Health to Pay $256 million in False Claims Act Settlement

Millennium Health, one of the nation’s largest urine drug testing laboratories, has agreed to pay the government $256 million to resolve claims that it violated the Federal False Claims Act (“FCA”). The Settlement...more

Tuomey Agrees to Pay $72.4 Million, Join Multi-Hospital System in Settlement

On October 16, 2015, Tuomey Healthcare System announced it had entered into a $72.4 million settlement with the United States Department of Justice (DOJ) to resolve a $237 million False Claims Act and Stark Law judgment...more

Jury Sides with DOJ in First Phase of FCA Statistical Sampling Trial

Last week, a jury in Alabama federal court sided with the Department of Justice (DOJ) and qui tam relators in the first part of a False Claims Act (FCA) case against AseraCare Inc., a provider of hospice and palliative care...more

Toumey Healthcare Settles False Claims Act Suit for $72 Million

In a long-running False Claims Act case with significant implications for hospitals, Toumey Healthcare System last week agreed to settle its case by paying $72.4 million to the government. While this sum is significant, it is...more

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