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Insurers’ Suit Against Government for Affordable Care Act Payments May Proceed; If Successful, Insurers Entitled to Billions from...

In a closely watched case, the Court of Federal Claims last week refused to dismiss a health insurer’s putative class action against the Federal government for payments authorized under the Affordable Care Act. The Court’s...more

Supreme Court Rejects Dismissal Requirement for FCA Seal Violations

In State Farm Fire & Casualty Co. v. United States ex rel. Rigsby, the United States Supreme Court rejected State Farm’s argument that a relator’s violation of the automatic seal in a False Claims Act (“FCA”) case mandates...more

Supreme Court Rules on False Claims Act’s Seal Requirement

In the midst of a False Claims Act (FCA) case, the relators have blatantly violated the FCA’s seal provision. Surely this will lead to dismissal, right? Wrong. On Tuesday, December 6, the Supreme Court unanimously...more

SCOTUS: Dismissal Not Mandatory for False Claims Act Seal Violation

Rigsby places discretion in the hands of district courts as to whether and how to sanction relators who violate the seal requirement in False Claims Act cases. On December 6, 2016, only a month after oral argument, the...more

U.S. Supreme Court Rules That Seal Violations Do Not Require Dismissal of Qui Tam False Claims Act Suits

On Tuesday, the Supreme Court issued an anxiously anticipated False Claims Act (“FCA”) decision in State Farm Fire & Casualty Co. v. United States ex rel. Rigsby, holding that a violation of the statute’s seal requirement...more

Supreme Court Rejects Mandatory Dismissal for an FCA Seal Breach

The Supreme Court held that a relator’s breach of the seal in a qui tam case does not require mandatory dismissal of the complaint, but the Court declined to articulate what factors are appropriate to consider in determining...more

Supreme Court Concludes that Violation of FCA Seal Provision Does Not Necessarily Mandate Dismissal of Qui Tam Suits

The Supreme Court held yesterday that a violation of the False Claims Act’s seal provision does not mandate dismissal of a relator’s complaint. Justice Kennedy authored the Court’s opinion in the unanimous 8-0 decision. ...more

Supreme Court Holds That Violations of the False Claims Act’s Seal Requirements Do Not Require Automatic Dismissal

On December 6, 2016, the Supreme Court of the United States ruled unanimously in State Farm Fire and Casualty Co. v. United States ex rel. Rigsby that violations of the False Claims Act’s (FCA) seal requirement do not require...more

Supreme Court Holds that Violation of False Claims Act’s Seal Requirement Does Not Mandate Dismissal

The Supreme Court ruled today (December 6, 2016) in State Farm Fire & Cas. Co. v. U.S. ex rel. Rigsby, ___ S. Ct. ___ (2016). The case probed whether a violation of the False Claims Act’s seal requirement mandated dismissal...more

Supreme Court Decides State Farm Fire & Casualty Co. v. United States ex rel. Rigsby

On December 6, 2016, the United States Supreme Court decided State Farm Fire & Casualty Co. v. United States ex rel. Rigsby, No. 15-513, holding that the False Claims Act (FCA) does not mandate dismissal of the case when a...more

Supreme Court Hears Argument About Violation of FCA Seal Provision

This month the Supreme Court heard oral argument in State Farm Fire & Casualty Co. v. United States ex rel. Rigsby, a case centered on allegations dating back to Hurricane Katrina. The Fifth Circuit had previously upheld a...more

Supreme Court Hears Argument on Sanction Standard for Violations of False Claims Act’s Seal Requirement

We blogged in September about State Farm Fire & Cas. Co. v. U.S. ex rel. Rigsby, 136 S. Ct. 2386 (2016), a case that is pending before the United States Supreme Court. On Tuesday, November 1, the Supreme Court heard oral...more

Perspectives - October/November 2016

By President Obama’s September 7, 2016 Executive Order, federal contractors and subcontractors will now be required to provide paid sick leave to their employees beginning on January 1, 2017. The Department of Labor (DOL)...more

Indiana Supreme Court Extends the Stanley Doctrine to State-Sponsored Medical Reimbursements

On October 21, 2016, the Indiana Supreme Court weighed-in on a closely watched case that drew much attention from the defense and plaintiff’s bar alike. Approximately one (1) year ago, I reported that the Indiana Court of...more

What Standard Governs the Dismissal of a Relator's Claim for Violation of the False Claims Act's Seal Requirement in an Action...

In the aftermath of the destruction caused by Hurricane Katrina in 2005, Cori and Kerri Rigsby accused State Farm Fire and Casualty Company of falsely misclassifying wind damage as flood damage, among other misdeeds, leaving...more

Nondiscrimination Standards Under ACA Section 1557: Now Is the Time to Act

Health insurers and group health plan sponsors must closely review the final rule titled “Nondiscrimination in Health Programs and Activities” (“Final Rule”) implementing Section 1557 of the Affordable Care Act (“ACA”) that...more

Do Loose Lips Sink Qui Tam Complaints? Supreme Court May Soon Determine if Violation of False Claims Act’s Seal Requirement...

The Supreme Court plans to review a decision that allowed relators to maintain their False Claims Act lawsuit even after a series of disclosures that may have violated the law’s requirement that lawsuits be “sealed” and...more

Under Construction - September 2016

Letter from the Editor - Welcome to the Fall 2016 edition of our Under Construction newsletter. We hope your summer has left you relaxed and refreshed to successfully finish out the remainder of the year. Most...more

Rules of the (International) Road, Brexit, PPP as a New Tool for Argentina, and Keeping Non-U.S. Companies Safe from Suit (Expect...

- Post-Daimler: Are Non-U.S. Companies Safe from Suit in U.S. Courts? What if the Non-U.S. Parent Registers to Do Business in a State? - Rules of the (International) Road: Choosing and Appointing a Distributor ...more

No Secret Here: Supreme Court Set to Hear Yet Another FCA Case Next Term

In May 2016, the United States Supreme Court granted the petition for a writ of certiorari in State Farm Fire & Casualty Co. v. United States, ex rel. Rigsby, et al. During the next term, the Supreme Court will hear oral...more

Court Finds that False Claims Act Suit Alleges Uninsurable “Willful Acts”

A federal court has ruled that a whistleblower suit under California’s False Claims Act alleged a “willful act” that cannot be covered by liability insurance. In Office Depot Inc. v. AIG Specialty Insurance Company, Case...more

False Claims Act Penalties Moving Full Steam Ahead

By August 1, 2016, all federal agencies must adjust their civil monetary penalties, including penalties required by the False Claims Act (“FCA”), to account for inflation. Last month, the Railroad Retirement Board, which...more

House v. Burwell: Insurer Cost-Sharing Subsidies Unauthorized

A U.S. District Judge has ruled that HHS unlawfully has spent billions of dollars to reimburse insurers for cost-sharing reductions granted to individuals who bought health insurance through an ACA Exchange such as...more

IRS Denial of Section 501(c)(3) Status for a Commercial ACO

The IRS recently released a ruling, Private Letter Ruling (“PLR”) 201615022, denying Section 501(c)(3) tax-exempt status to a “commercial” accountable care organization (“ACO”). This is the IRS’ first published guidance...more

DOL Issues Guidance Regarding Interaction Between Affordable Care Act And Fringe Benefit Requirements Under Service Contract,...

The Davis Bacon Act and the Davis Bacon Related Acts (collectively “DBRA”) and the Service Contract Act (“SCA”) impose additional obligations related to fringe benefits and wages on covered contractors. With the passing of...more

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