Department of Justice (DOJ), Bifurcation

Disagreements over a Medical Judgment Cannot Form the Basis for Liability Under the False Claims Act

Baker Donelson on 9/13/2019

A new federal court decision offers a ray of light to those providers defending false claims actions based on an alleged lack of medical necessity. On September 9, 2019, the United States Court of Appeals for the Eleventh...more

Eleventh Circuit Says Difference Of Opinion Does Not Establish Falsity In False Claims Act Case

Troutman Pepper on 9/13/2019

On September 9, in a setback for AseraCare but an overall win for hospice providers, the Eleventh Circuit affirmed a Northern District of Alabama decision to grant a new trial in a False Claims Act (FCA) case against...more

Eleventh Circuit Confirms: Mere Difference of Opinion Between Physicians Does Not Establish Falsity Under the False Claims Act

Hogan Lovells on 9/11/2019

More than two years after the Northern District of Alabama granted summary judgment in a False Claims Act (FCA) case in favor of AseraCare Inc., holding that “contradiction based on clinical judgment or opinion alone cannot...more

DOJ Modifies White-Collar Policy Targeting Individuals

Pillsbury Winthrop Shaw Pittman LLP on 12/3/2018

Speaking at FCPA event, Rosenstein sets out adjustments to Yates Memo. DOJ is modifying its focus on individual accountability in government investigations to substantially culpable individuals....more

DOJ Announces Will Appeal Loss in AseraCare, Triggering Issues on Battle of the Experts, Statistical Sampling, and Bifurcation

McGuireWoods LLP on 7/15/2016

$200 million and pivotal legal precedent are at stake in the False Claims Act (“FCA”) case against AseraCare, Inc. (“AseraCare”), a for-profit hospice chain that was alleged to have fraudulently submitted claims that falsely...more

AseraCare Defeats DOJ False Claims Act Suit: Plaintiffs Must Present Evidence of an Objective Falsehood to Prove Falsity Under the...

Bryan Cave Leighton Paisner on 4/5/2016

On March 31, 2016, in United States v. AseraCare, Inc, No. 2:12-cv-245-KOB, 2016 U.S. Dist. LEXIS 42986 (N.D. Ala. Mar. 31, 2016), the district court granted summary judgment for AseraCare and emphasized that contradicting...more

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

Mintz - Health Care Viewpoints on 10/21/2015

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

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