News & Analysis as of

False Claims Act (FCA) Fraud

ASLMS Annual Meeting Special Coverage: Legal and Compliance Issues Impacting Medical Practices Using Laser Technology

by Ruder Ware on

Medical practices that routinely use laser technology are subject to some of the same legal issues as other types of practices. Use of lasers creates additional compliance issues and highlights certain compliance risk areas....more

Three Recent Fraud Cases Involving Dermatologists Illustrate Primary Compliance Risks in Dermatology Practices

by Ruder Ware on

Three relatively recent cases involving dermatology billing practices illustrate some of the main compliance risks faced by dermatology practices...more

Corporate Investigations and White Collar Defense - March 2017

DOJ's New Guidance for Evaluating Corporate Compliance Programs - Why it matters: On February 8, 2017, the DOJ released, to little fanfare, a new guidance document entitled "Evaluation of Corporate Compliance Programs."...more

OIG Releases FY 2016 Statistical Data About Medicaid Fraud Control Units

Earlier this week, the Office of Inspector General for the Department of Health and Human Services (“OIG”) posted its fiscal year (“FY”) 2016 data about Medicaid Fraud Control Units (“MFCUs”) across the country....more

A Parallel Universe: Navigating Discovery in Concurrent Civil and Criminal Proceedings

by Ward and Smith, P.A. on

As criminal law has expanded into almost every sector of the American economy, one byproduct is the rise of "parallel proceedings"—lawsuits that proceed concurrently in criminal and civil court based on largely the same...more

DOJ Issues New Guidance on the Evaluation of Corporate Compliance Programs in Federal Fraud Investigations

On February 8th, the U.S. Department of Justice (DOJ) quietly issued new guidance on how the agency evaluates corporate compliance programs during fraud investigations. The guidance, published on the agency’s website as the...more

Your Daily Dose of Financial News

by Robins Kaplan LLP on

Activist investor Carl Icahn has taken a sizeable stake in Bristol-Myers Squibb, a move that reportedly caught execs at the drugmaker unawares and sets the stage for a potential sale....more

Corporate Investigations and White Collar Defense - February 2017

When Regulatory Failings Turn Criminal: Car Edition Redux - Why it matters: To paraphrase the famous quote from the film “All About Eve”: Fasten your seatbelts, it’s going to be a bumpy car ride. In the first part of...more

Another Court Agrees That A Difference Of Opinion On Medical Necessity Is Insufficient to Show Falsity Under the False Claims Act

Last month, the U.S. District Court for the District of Utah joined the AseraCare court and others in finding that a relator cannot successfully allege violations of the False Claims Act (“FCA”) based on a purported lack of...more

You’re Fired: What Impact Will Sally Yates’ Departure Have on the DOJ’s Fraud Enforcement?

by Snell & Wilmer on

As most of the world now knows, President Trump fired acting Attorney General Sally Yates last week after she declined to defend the President’s travel ban. Dana Boente has replaced Ms. Yates, but he may not be long for the...more

This Month in Corruption: the Same Old Saga Continues

by PretiFlaherty on

As a faithful reader of the State House News Service, I have been noticing for years how often the Press Releases section of the service’s subscriber-only web site contains an account of wrongdoing and/or unsavory behavior in...more

Relax, Sixth Circuit Opinion Indicates Rule 9(b) Pleading Requirement Still Has Bite

by Bass, Berry & Sims PLC on

A recent Sixth Circuit opinion in U.S. ex rel. Hirt v. Walgreen Co. should come as welcome news for FCA defendants concerned about the implications of the Sixth Circuit’s application last year, for the first time, of a...more

State Farm Fire and Casualty Co. v. United States ex rel. Rigsby

by Nexsen Pruet, PLLC on

The Supreme Court’s unanimous decision in State Farm Fire and Casualty Co. v. United States ex rel. Rigsby addresses sanctions for violating the seal provision of the False Claims Act (FCA). ...more

First Circuit Rejects Whistleblower’s Fraud on the FDA FCA Theory

by Ropes & Gray LLP on

On December 23, 2016, the First Circuit held that a relator under the federal False Claims Act (“FCA”) failed to plausibly plead that defendant medical device manufacturers caused the submission of false claims for...more

Fraud on the FDA Doesn’t Fly Under the FCA Either

by Reed Smith on

Ever since Buckman Co. v. Plaintiffs’ Legal Committee, 531 U.S. 341 (2001), held that state-law claims alleging fraud on the FDA are preempted, plaintiffs have been attempting to find some other way of bringing claims that...more

This Month in Corruption: Snapshots of the Public Trust Betrayed

by PretiFlaherty on

If I were back in the newspaper business, I’d probably write a lead for this article with the cliché that “crime never takes a holiday.” Yes, clichés are the first resort of lazy scribes, but the good thing is, they are...more

Universities Are Prime Targets for False Claims Act Liability

by McCarter & English, LLP on

Colleges and universities receive billions of dollars in federal funds, whether through research grants or student financial aid, or even by billing Medicare or Medicaid for services rendered at academic medical centers. As a...more

SCOTUS: Dismissal Not Mandatory for False Claims Act Seal Violation

by Latham & Watkins LLP on

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

by K&L Gates LLP on

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

by Bass, Berry & Sims PLC on

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

by Dorsey & Whitney LLP on

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

Whistleblowers on Campus: DOJ Adds Research Universities to its False Claims Act Focus

by Carlton Fields on

Federal funding is the grand prize for higher education research institutions. Each year, the federal government pumps hundreds of millions of dollars in research grants and awards into the university system. These funds are...more

Supreme Court Hears Argument About Violation of FCA Seal Provision

by Dorsey & Whitney LLP on

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

When Does An Overpayment Become Fraud? How Simple Inattention Can Expose You to Penalties for Fraudulent Activities

by Ruder Ware on

If you are involved in any way in the health care system, it should be obvious by now that the government has committed ever increasing resources to the prosecution of fraud and abuse cases. Simply put, from a governmental...more

"Escobar and the Implied Certification Theory: Initial Cases Raise the Bar on Materiality in False Claims Act Litigation"

On June 16, 2016, the U.S. Supreme Court in Universal Health Services, Inc. v. United States ex rel. Escobar1 (Escobar) unanimously upheld the implied certification theory of False Claims Act (FCA) liability and strengthened...more

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