Government Contracting Insurance

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Orthopedic Patient Doesn’t Have a Leg to Stand On

It’s well known that Medicare, Medicaid and commercial insurers hate the ever-increasing trend of hospitals buying facilities and practices and then charging provider-based (i.e., higher) rates than the facilities and...more

“Prior or Pending Litigation” Exclusion Bars Coverage for Litigation that Was Unknown to Policyholder

Companies that do business with the federal government, or whose business transactions otherwise involve payments by the government, undoubtedly understand the exposure they face to “whistleblower” or “Qui Tam” lawsuits...more

A Cautionary Tale for Companies With Potential False Claims Act Exposure

A False Claims Act suit can be a company’s worst nightmare, as it may potentially result in large settlements and awards on account of the statute’s trebled damages provision. However, the nightmare for AmerisourceBergen was...more

Pennsylvania Court Holds Pending and Prior Litigation Exclusion Applicable to Unserved False Claims Complaint

In its recent decision in AmerisourceBergen Corp. v. Ace Am. Ins. Co., 2014 PA Super 198 (Pa. Super. Sept. 15, 2014), the Superior Court of Pennsylvania, an intermediate Pennsylvania court, had occasion to consider the...more

Developments in Life Insurance in Florida

Life insurers will find the following Florida decisions regarding the state’s unclaimed property law and false claims act important: - Total Asset Recovery Services, LLC v. Metlife, Inc. and Prudential Financial Inc.,...more

HealthCare Fraud and Courtesies: What to Know Before Waiving a Copayment

Many healthcare facilities and physicians waive the insurance copayment for physicians and their families (known as professional courtesy) or other patients. Yet, despite how prevalent the practice is and the limited...more

Eleventh Circuit Reverses Coverage Ruling Under Reinsurance Agreement

Public Risk Management of Florida, an intergovernmental risk management association that functions as a primary insurer for certain government entities in Florida, ceded some of its risk to One Beacon under a reinsurance...more

Appellate Court Notes

AC35632- U.S. Bank, N.A. v. Foote - Second time is the charm. Defendant succeeded in getting plaintiff’s foreclosure action dismissed for lack of standing due to the inability of the witnesses to establish that the...more

Unpaid Prevailing Wage Assessments and Actions: Ways a General Contractor (and Its Surety) Can Protect Itself or Limit Its...

General contractors and their sureties on public works construction projects in California have faced an onslaught of claims, assessments, and lawsuits based on the failure of subcontractors, regardless of tier, to pay their...more

Construction E-Note - June 27, 2014

In This Issue: - Mississippi Legislature Expands State’s Lien Law to Protect Subcontractors, Suppliers, and Materialmen - The Alabama Supreme Court Broadens the Definition of “Occurrence” in a General...more

Williams Mullen Construction Industry Newsletter - Spring/Summer 2014

In This Issue: - CGL Insurance & Defects - No Sure Thing - Contract Quicksand - The Nuclear Option - Federal Contractors - Excerpt from CGL Insurance & Defects: Does Your Insurance Cover...more

OIG Issues Proposed Rules on Its Exclusion and CMP Authorities

OIG has issued two proposed rules that would expand the agency’s ability to impose certain sanctions on entities and individuals involved with Federal health care programs. OIG’s first proposed rule—published in the Federal...more

OFCCP Setting Its Sites On TRICARE Providers?

Healthcare providers are waiting anxiously to see the Office of Federal Contract Compliance Programs’ (OFCCP) most recent position on whether it will continue trying to assert jurisdiction over them on the basis of...more

The False Conception That FCA Claims Are Not Covered

In 2013, the United States Department of Justice recovered $3.8 billion under the False Claims Act (“FCA”), bringing the total amount secured by the Justice Department since 2009 to $17 billion. Whistleblowers recovered...more

D&O Carrier Allowed to Recoup Defense and Indemnity Costs After Employees Plead Guilty to Misconduct

In Protection Strategies, Inc. v. Starr Indemnity & Liability Co., the U.S. District Court for the Eastern District of Virginia allowed an insurer to recoup more than $670,000 in costs paid for the insured first to respond to...more

Virginia Federal Court Allows Recoupment by Insurer – Where Guilty Pleas Triggered Coverage Exclusions

In Protection Strategies, Inc. v. Starr Indemnity & Liability Co., Civil Action No. 1:13-cv-00763 (E.D. Va. Apr. 23, 2014), the United States District Court for the Eastern District of Virginia granted Starr Indemnity &...more

Florida’s False Claims Act – Did You Know It Changed Last Year?

In June 2013, Florida’s legislature significantly amended Florida’s False Claims Act, Fla. Stat. §§ 68.081-68.092 (“FFCA”), effective July 1, 2013. Although these amendments have not received much publicity or commentary,...more

DOJ Obtains Settlement In FHA False Claims Act Case

On February 4, the DOJ announced the filing and simultaneous settlement of a complaint by the U.S. Attorney for the Southern District of New York (SDNY) against a mortgage lender alleged to have violated the False Claims Act...more

People ex rel. Farmers Insurance Exchange, et al v. Maurice Hale, M.D., et al

People ex rel. Farmers Insurance Exchange, et al v. Maurice Hale, M.D., et al, case No. BC515676 (California Superior Court, County of Los Angeles; filed July 18, 2013)...more

Under Construction - December 2013

Welcome to our final issue of Under Construction in 2013. We hope your year has been filled with health, happiness, peace and prosperity. We thank you for your readership, and we continue to appreciate the opportunities we...more

U.S. District Court Finds Halifax Hospital Violated the Stark Law in Summary Judgment

A United States District Court in the Middle District of Florida recently granted partial summary judgment in favor of the United States in connection with its motion against Halifax Hospital Medical Center (Halifax...more

If it Walks Like a Duck and Talks Like a Duck . . . It May Just be a Goose

If you’re involved in public works projects you know that direct contractors are required to furnish payment bonds on public works projects exceeding $25,000. Specifically, Civil Code section 9550 provides that “[a] direct...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

GAO Examines Effectiveness of Health Care Fraud and Abuse Control Program Activities

The U.S. Government Accountability Office (GAO) recently published a report analyzing the effectiveness of Health Care Fraud and Abuse Control (HCFAC) program activities titled, “Indicators Provide Information on Program...more

Second Circuit Affirms Dismissal of Qui Tam Case Based on Attorney’s Use of Confidential Information

The US Court of Appeals for the Second Circuit recently affirmed the decision of the District Court for the Southern District of New York to disqualify Fair Laboratory Practices Associates (FLPA) from its qui tam suit against...more

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