False Claims Act (FCA) Whistleblowers

News & Analysis as of

Supreme Court Seeks Meaning in Falsity and Fraud in the False Claims Act

Oral arguments were heard Tuesday, April 19th by the U.S. Supreme Court in one of the most significant False Claims Act (FCA) cases the Court has dealt with in decades on an issue with very real impact on whistleblower suits...more

Jury Sides with Defendant in Whistleblower's Suit Alleging Defendant "Caused" False Claims

Abbott Laboratories recently won a jury verdict in a high profile qui tam lawsuit alleging that Abbott “caused” health providers to submit false Medicare payment claims for off-label use of biliary stents. U.S. ex rel....more

Court Dismisses Major False Claims Act Case Against Hospice Provider: Ruling Mere Difference of Medical Opinion is Insufficient...

On March 31, 2016, the United States District Court for the Northern District of Alabama in U.S. ex rel. Paradies v. AseraCare, Inc. dismissed a major False Claims Act case against a national hospice provider after ruling...more

Bard Whistleblower Settlement Highlights Potential Risks for Higher Education Institutions

Bard College recently entered into an agreement with the United States to pay $4 million to settle a whistleblower suit alleging violations of the False Claims Act. Bard is a non-profit liberal arts institution founded in...more

OK to Exaggerate How Long Patients Need Device

Today’s riddle: Why would a federal court approve a medical device manufacturer’s practice of persuading physicians to exaggerate the period of time Medicare patients need their devices? The answer is so simple that you’ll be...more

In 10-1 Verdict, Jury Finds No FCA Violation by Abbott Laboratories

On April 7, 2016, after just three hours of deliberations following a three-week trial, a federal jury dismissed False Claims Act (“FCA”) claims against Abbott Laboratories brought by a whistleblowing former employee.  The...more

Bard College settles False Claims Act allegations; Justice, Education Departments get tough on compliance - 7 steps to support...

“Throughout this Administration, the Department of Education has aggressively enforced accountability and compliance laws for institutions of higher education to protect students, families, and taxpayers,” US Education Under...more

Whistleblowers Suffer Another Implied Certification Theory Defeat — But Supreme Court Showdown Looms

Adding its voice to an issue soon to be argued before the Supreme Court, an Alabama federal court recently dismissed a False Claims Act (“FCA”) complaint, holding that complying with a federal disclosure regulation was not a...more

U.S. Sides with Defendant Against Whistleblower—Sort of

Today’s riddle: why would the government take the defendant’s side against the whistleblower in a False Claims Act qui tam case? Why would the government challenge the whistleblower’s claim that two defendants violated the...more

Retaliation Claim Survives Though False Claim Act Claim Is False

Roxanne Perkins was employed as a clinical supervisor of prior authorizations therapy at Wellcare Health Plans. When she returned from a leave of absence, she learned that Wellcare had instituted a new practice of approving...more

Olympus to Pay $632.2 Million to Resolve Allegations of Kickbacks

Olympus Corporation of the Americas, the United States’ largest distributor of endoscopes and related medical equipment, recently agreed to pay $623.2 million to resolve criminal charges and civil claims, according to a...more

Florida Qui Tam Statute Applies to False Claims Made to State, not Local, Governments

What is the state? Before the summer of 2015, there were two schools of thought on the answer to this question in the context of the Florida False Claims Act (FFCA). The first was advanced in a February 2014 Florida Bar...more

Sixth Circuit Affirms Dismissal of $2.3 Billion FCA Case Due to Prior Public Disclosure

Last week, in U.S. ex rel. Advocates for Basic Legal Equality, Inc. (ABLE) v. U.S. Bank, the Sixth Circuit affirmed the dismissal of a False Claims Act (FCA) suit against U.S. Bank because the conduct alleged by the qui tam...more

Most Imaginative Whistleblower Claim of the Month

Vicki Sheldon is the hands-down favorite to claim this month’s Most Imaginative Whistleblower Claim award. Vicki’s at-the-time husband Duane was employed at Kettering Health Network (KHN). Duane had an affair with another KHN...more

First District Tells Relators: Know Your Role in State Whistleblower Actions

Last week, the Florida First District Court of Appeal issued a decision of first impression confirming the controlling role that the Attorney General’s office plays in the life, or death, of a whistleblower action in Florida....more

A Grossly Negligent Claim Isn’t a False Claim

You have to feel sorry for whistleblower Darilyn Johnson. The former billing clerk thought she had a sure-fire, double-barrel False Claims Act (FCA) case against the medical clinic that fired her. Barrel one was her...more

Preserving the Attorney-Client Privilege when Conducting an Internal Investigation

You may recall that, back in July 2014, we advised that the D.C. Circuit Court of Appeals had overturned a D.C. District Court decision in a False Claims Act case that required the results of an internal investigation, which...more

Hospice Care Eligible Patient Certification is a “Condition of Payment” Under False Claims Act

In order to state a cognizable claim under the False Claims Act (“FCA”) on a false certification theory, a plaintiff must allege that a defendant failed to comply with a federal statute or regulation that was a “condition of...more

Compliance Lessons from the Olympus Corporate Integrity Agreement – Part I

The recent Olympus Corporation and related entities (collectively ‘Olympus’) enforcement action demonstrated a company seemingly dedicated to lying, cheating and stealing its way across the globe in search of almighty dollar....more

Mitigating FCA Whistleblower Risk When Employees Leave

Over the past decade, efforts to enforce health care fraud regulations have been bolstered significantly with increased government funding and a dramatic increase in whistleblower claims filed under the False Claims Act’s qui...more

Ninth Circuit Rejects Whistleblower Argument that Fannie Mae and Freddie Mac are Federal Instrumentalities under the False Claims...

Liability under the False Claims Act (FCA) is premised on the submission of a claim for money or property either to a federal government “officer, employee, or agent” or, under certain circumstances, to a nongovernmental...more

A Relator by Any Other Name Not as Sweet: The Fourth Circuit Affirms Dismissal of FCA Suit Based on Facts Learned by Relator’s...

The Fourth Circuit recently held that a relator is prohibited from pursuing a False Claims Act (FCA) claim based on facts learned by relator’s counsel in a previous FCA suit. In United States ex rel. May v. Purdue Pharma...more

Another Day, Another Whistleblower Retaliation Suit

A False Claims Act (“FCA”) retaliation claim, 31 U.S.C. 3730(h), filed January 26, 2016 in federal district court in Oregon, provides a perfect example of the type of challenging cases confronting health care employers today....more

Double-check existing policies for whistleblower coverage

Whistleblower lawsuits under the False Claims Act, also known as qui tam actions, have become more common in recent years. This is particularly so in heavily regulated industries and those in which the government routinely...more

Was Whistleblowing a Reason for Firing or the Reason?

The outcome of a physician whistleblower’s retaliation claim against his former medical group turns on the question whether whistleblowing was a reason or the reason he was fired. If it was a reason, he loses. If it was the...more

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