False Claims Act

The False Claims Act is a United States federal law originally enacted in 1863 to recover fraudulently acquired funds from government contractors.  In 1986, The False Claims Act was amended to increase... more +
The False Claims Act is a United States federal law originally enacted in 1863 to recover fraudulently acquired funds from government contractors.  In 1986, The False Claims Act was amended to increase whistleblower incentives and to permit the government to seek treble damages for allegations of fraud against the government less -
News & Analysis as of

Record $17M Settlement Of False Claims Act Lawsuit Alleging Doctor Kickbacks

Hailed as “another achievement” for the government’s Health Care Fraud Prevention and Enforcement Action Team (referred to as “HEAT”), the U.S. Department of Justice has announced that a Florida skilled nursing company and...more

Healthcare Law Update

Governing boards of health care organizations can greatly benefit from reading a recently released educational document that presents practical tips for board members responsible for overseeing their organizations’ compliance...more

OIG Announces New Penalty and Exclusion Litigation Team to ‘Level the Playing Field’

The federal government’s health care fraud enforcement efforts expanded this week with an announcement by the Office of the Inspector General (OIG), of the U.S. Department of Health and Human Services, that it has created a...more

Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements

Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial...more

Corporate Investigations & White Collar Defense - June 2015

The Unfolding FIFA Scandal: Will the DOJ Show the Banks a Red Card? - Why it matters: The worldwide soccer community has for years decried the brazen corruption that permeated FIFA, international soccer’s governing...more

Whistleblowing: An Employer’s Guide To Global Compliance

In This Issue: - Foreword - A Summary Across Five Continents - Law and Sanctions - The Legislative Framework: Whistleblower Protections Across the Globe - Global Differences: The Cultural...more

Seventh Circuit Rejects FCA Implied False Certification Theory

On June 8, 2015, the U.S. Court of Appeals for the Seventh Circuit rejected the doctrine of implied false certification in a False Claims Act (“FCA”) lawsuit, U.S. ex rel. Nelson v. Sanford-Brown Ltd. No. 14-2506, 2015 WL...more

Physicians Face Increased Anti-Kickback Enforcement Focus

It appears that the Office of Inspector General (“OIG”) now has physicians squarely in the crosshairs of one of its most powerful enforcement tools: the Anti-Kickback Statute (“AKS”). The AKS is a criminal statute with...more

The Life Sciences Report - Spring 2015

In This Issue: - The Rise of Companion Diagnostics in Personalized Medicine: Challenges and Opportunities - Department of Justice Imposes More Than $110 Million in Fines on Medical Device Makers - Life...more

The Federal and Nevada False Claims Acts

Contractors are no strangers to the courts of justice. Litigation between contractors and owners frequently occurs when a project does not get completed on time or the work does not comply with the Contract Documents. The...more

U.S. Judge Limits False Claims Act Claims Involving Vague Medicare Regulations

A Missouri federal judge has issued a summary judgment order that could serve as an important limitation on the U.S. Department of Justice’s expanding use of the False Claims Act and penalties aimed at recovering funds from...more

Health Care E-Note - June 2015

In This Issue: - Why, Again, Do You Think That Worker is an Independent Contractor? - I-9 and E-Verify Compliance Practices for Temporary Labor and Contractors - Excerpt From Why, Again, Do You Think That...more

OIG Fraud Alert Serves as Stern Warning to Physicians Regarding Compensation Arrangements

Emphasizing its continued focus on physician compensation arrangements, the OIG issued a Fraud Alert on June 9, 2015, warning that physicians risk significant penalties if medical directorships and other compensation...more

Miami Nursing Home To Pay Record $17M in Whistleblower Suit

A Miami-based nursing home network agreed Tuesday to pay a record $17 million to settle a False Claims Act suit brought by its former CFO, accusing it of running a kickback scheme. The case is United States of America et al...more

The False Claims Act – the Basics Every Provider Should Know, Part Two

FCA penalties are harsh, as they are designed to truly deter attempts to defraud the federal government. The penalty for an FCA violation begins with treble damages, requiring the offender to pay three times the amount of the...more

Religious Institutions: June 2015

Religious institutions commonly make payments to or receive payments directly or indirectly from governmental agencies for services rendered; e.g., day cares that benefit from public scholarships, hospitals that participate...more

Medicaid Managed Care Update: Program Integrity Proposals Include Mandatory Reporting of Overpayments by Medicaid Managed Care...

CMS seeks to impose more rigorous program integrity requirements for contractors and states. This article is part of a series that takes an in-depth look at several proposals that would affect managed care organizations,...more

The False Claims Act – the Basics Every Provider Should Know, Part One

The federal False Claims Act (“FCA”)casts an incredibly long shadow, covering every transaction between the federal government and a private party seeking payment from it. Enacted at the height of the Civil War in 1863, the...more

Physician Estopped From Alleging FCA Violations in Contract He Previously Approved

Cooper v. Pottstown Hospital is another case where a dissatisfied party is attempting to use the federal Anti-Kickback Statute or the Stark Law in litigation arising out of the contracts to which they were willing parties at...more

Provider Alleges Retaliatory Use of Medicare Payment Suspension

A federal court has ordered discovery regarding the circumstances of a Medicare payment suspension by CMS only one week after failed settlement negotiations between a cardiology practice and the Department of Justice (DOJ) to...more

Regional Bank Agrees to Pay Over $200 Million for Alleged Violations of the False Claims Act

On June 1, a regional bank agreed to pay the United States $212.5 million to resolve allegations that it knowingly violated the False Claims Act by originating and underwriting FHA-insured mortgage loans that did not meet...more

District Court Holds False Claims Act Applies to Employee Allegedly Terminated for Engaging in Protected Activity Against...

In a matter of first impression, the U.S. District Court for the Western District of Pennsylvania in Cestra v. Mylan Inc. No. 15-0873 (E.D. Pa., May 22, 2015) held that the antiretaliation provision of the False Claims Act...more

Does the False Claims Act Preempt An Attorney Relator’s Ethical Obligations?

In United States ex rel. Holmes v. Northrop Grumman Corp., No. 1:13-cv-85, 2015 WL 3504525 (S.D. Miss. June 3, 2015), the court answered this question with a resounding “no” and provided a laundry list of ethical violations...more

Department of Justice Takes Active Role in Lawsuit Against Nursing Home Chain

For the past six years, the Ohio-based nursing home chain HCR ManorCare has been embroiled in a whistleblower lawsuit featuring allegations that the company systematically overbilled Medicare and often put its residents...more

Kentucky Federal Court Sustains Hospital Insurer’s Denial of Claim Due to Untimely Notice, Declines to Require Insurer Show...

The U.S. District Court for the Eastern District of Kentucky recently held that an insurer properly denied coverage to a hospital because the hospital gave untimely notice of the claim. In Ashland Hospital Corporation v. RLI...more

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