News & Analysis as of

False Claims Act (FCA)

AGG Food and Drug Newsletter - May 2017

by Arnall Golden Gregory LLP on

Arnall Golden Gregory LLP's Food and Drug Newsletter is a monthly update of legal and regulatory issues that affect the FDA-regulated community, including regular updates on legislative initiatives from AGG’s Washington, DC...more

Reverse Mortgage Servicer to Pay $89 Million to Resolve False Claims Act and FIRREA Claims

by Goodwin on

On May 16, 2017, the U.S. Department of Justice (“DOJ”) announced that it had reached a settlement with a company engaged in reverse mortgage servicing, in connection with the company’s participation in the Department of...more

Fourth Circuit Re-Affirms Sufficiency of Triple Canopy Complaint

by Bass, Berry & Sims PLC on

U.S. ex rel. Badr v. Triple Canopy, Inc., an intervened case arising out of the Fourth Circuit, has been one of the more closely-watched recent FCA cases. Previously, the Fourth Circuit held that the government’s complaint...more

FCA Deeper Dive: Escobar and Its Aftermath – Part I

by Bass, Berry & Sims PLC on

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we are...more

FCA Issues to Watch: Pharmaceutical and Device Developments | INSIDE THE FCA

by Bass, Berry & Sims PLC on

The government’s FCA enforcement efforts have continued to focus on key areas concerning the pharmaceutical and medical device industries. In fact, drug and device manufacturers accounted for nearly half of the enforcement...more

Health System Defeats FCA Suit Based on Alleged Provision of Free Parking Benefits and Tax Exemptions

by King & Spalding on

On April 18, 2017, the United States District Court for the Middle District of Florida adopted the magistrate judge’s report and recommendation and granted BayCare Health System’s (BayCare’s) motion for summary judgment. The...more

District Court Rules Online Auction for Medical Supplies Violates Anti-Kickback Statute

by Jones Day on

On March 6, 2017, the U.S. District Court for the District of Connecticut held that an arrangement between a company operating an online portal for purchases of medical equipment and a supplier of medical products violates...more

FCA Claim of “Phantom Students” Won’t Continue to Haunt College, Says Ninth Circuit

by Saul Ewing LLP on

The for-profit education company Kaplan, Inc. recently scored a win when the Court of Appeals for the Ninth Circuit affirmed Kaplan’s summary judgment victory in a decade-long False Claims Act suit. This case shows that while...more

U.S. District Court Holds that a State University Is Immune from False Claims Act Liability Despite Intervention by United States

by King & Spalding on

On April 11, 2017, the U.S. District Court for the District of Oregon granted Oregon Health and Sciences University’s (OHSU) motion to dismiss a qui tam False Claim Act (FCA) suit, holding that (1) OHSU is an “arm of the...more

FCA Deeper Dive: Pleading the Alleged Fraud Scheme

by Bass, Berry & Sims PLC on

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we are...more

Third Circuit’s Gift to Qui Tam Defendants

by Faegre Baker Daniels on

It’s so brief—just eleven words in a 23-page, single-spaced opinion—that you could easily overlook it, but the Third Circuit’s recent opinion cites the government’s nonintervention in a qui tam case as evidence supporting...more

Escobar in Action – Materiality is a Tall Hurdle to Clear

by Butler Snow LLP on

In the recent Third Circuit decision United States of America, ex rel. Gerasimos Petratos, et al. v. Genentech Inc; et al., No. 15-3805, 2017 WL 1541919 (3d Cir. May 1, 2017), the Third Circuit addressed a “false...more

False Claims Act Litigation and Implications for D&O and Professional Liability Insurers

by Sedgwick LLP on

The Federal False Claims Act - 31 U.S.C. §§ 3729-3733 (the ‘‘FCA’’) permits private plaintiffs to pursue claims on behalf of, and sometimes with the intervention of, the U.S. Department of Justice (‘‘DOJ’’), against those...more

Why Healthcare and Life Sciences Companies Need to Step Up Their Compliance Efforts in Advance of a U.S. Government Investigation

by Hogan Lovells on

In this hoganlovells.com interview, Hogan Lovells partner Gejaa Gobena discusses how the perception of compliance, remediation, and self-disclosure has evolved in the eyes of government prosecutors from how they factor at...more

FCA Issues to Watch: FCA Claims Concerning Physician Compensation

by Bass, Berry & Sims PLC on

Physician employment arrangements with hospitals have remained a significant area of regulatory scrutiny in recent months with the announcement of several high profile settlements and decisions in key FCA cases involving...more

Third Circuit joins other circuits in enforcing Escobar's strict materiality requirement

by DLA Piper on

The Third Circuit has affirmed the district court's dismissal of a relator's claims in United States ex rel. Petratos, et al. v. Genentech Inc, et al, a False Claims Act (FCA) case alleging that the defendants-appellees...more

Third Circuit Weighs in on Materiality for First Time Since Escobar

by Pepper Hamilton LLP on

A recent circuit court decision will be a welcome development for False Claims Act defendants because it reinforces a significant pleading hurdle for claims to proceed, with the court citing lack of government intervention as...more

Guest Post – Justice for Patriots’ Fans

by Reed Smith on

This guest post by Andrew C. Bernasconi, of Counsel at Reed Smith, is about a hopeful development in a False Claims Act case we’ve already blogged about once. The previous post queried, what happens when a FCA relator,...more

Repayment and Self Disclosure of Known Overpayments

by Ruder Ware on

The 60-day repayment rule adopted as part of the Affordable Care Act is a very strong arrow in the quiver of federal enforcement agencies. Under the 60-day rule a known overpayment can become a False Claim if it is not repaid...more

Judge Has No Interest in DOJ’s Statement of Interest

by Faegre Baker Daniels on

In yet another demonstration of the benefits of lifetime tenure, a federal judge in Florida has told the Department of Justice to take a hike. It happened when the DOJ asked for permission to submit a “statement of interest”...more

Stark Law: What Providers Should Know About New CMS Form

by Polsinelli on

The Centers for Medicare and Medicaid Services (CMS) has finalized Form CMS-10328 (the SRDP Form), a new OMB-approved information collection instrument that must be used by providers and suppliers utilizing the Stark Law...more

Contractor Execs Not Subject to Individual Whistleblower FCA Claims, Says Federal Judge

by PilieroMazza PLLC on

In a recent Memorandum Opinion, T.S. Ellis, III, U. S. District Judge for the Eastern District of Virginia, has ruled that the retaliation provision of the False Claims Act (“FCA”) does not permit a whistleblower plaintiff to...more

California Regents File State False Claims Act Case Against Healthcare Providers And Pharmacies For Allegedly Defrauding UC...

The Regents of the University of California (UC) have filed a lawsuit against Studio Pharmacy, Excel Care Pharmacy, Pharma Pro Solutions, California Clinical Trials, and 17 individual defendants, including four physicians and...more

FCA Deeper Dive: Rule 9(b) and Pleading Actual Claims

by Bass, Berry & Sims PLC on

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we are...more

Buy American and Hire American: What it Means for the Construction Industry

On April 18, 2017, President Donald Trump signed into law the “Buy American and Hire American” Executive Order (No. 13788). The Order requires agencies to do a wholesale evaluation of their compliance with “Buy American” laws...more

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