News & Analysis as of

Health Update - September 2015

Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more

OIG audit finds RAD risk assessment inadequate

The HUD Office of Inspector General (the “OIG”) recently released an audit of the front-end assessment (“FERA”) undertaken for the Rental Assistance Demonstration’s (the “Demonstration”) first, or public housing, component. A...more

Are FCA Retaliation Claims Against Supervisors, Executives Viable?

When the False Claims Act (FCA) retaliation provision was amended in 2009, the amendment was not explicit as to whether plaintiffs could only recover for retaliation claims against companies, or whether plaintiffs also could...more

When an Overpayment Becomes a False Claims Act Issue: Explaining the First Judicial Interpretation of the 60-Day Rule

On August 3, 2015, Judge Edgardo Ramos of the United States District Court for the Southern District of New York issued the first judicial opinion addressing when a health care provider has “identified” a Medicare or Medicaid...more

FCA 60-Day Repayment Provision Runs from Discovery of Potential Overpayment

The U.S. District Court for the Southern District of New York issued the first decision directly addressing when an overpayment is “identified” for purposes of starting the 60-day repayment clock under the federal False...more

Kane v. Healthfirst and the 60-day Repayment Rule

Case: Kane v.Healthfirst, Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., case number1:11-cv-02325, in the U.S. District Court for the Southern District of New York. As part of the Affordable Care Act...more

Lack of Materiality as a Defense in False Claims Act Cases

The False Claims Act (the “Act”) imposes liability on those who “’knowingly’ present, or cause to be presented, ‘a false or fraudulent claim for payment or approval’” to the government. Persons who act in “deliberate...more

The Continuing Far Reach of the False Claims Act

Since 2009, when Congress preserved and expanded the reach of the False Claims Act (“FCA”) through the Fraud Enforcement and Recovery Act (“FERA”), Government contractors have seen a vast increase in FCA lawsuits and...more

False Claim Act: 2013 Year in Review

Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more

Supreme Court Certiorari Denial Allows Circuit Split Regarding Retroactivity of the 2009 False Claims Act Amendments to Remain

On June 24, 2013, the Supreme Court denied certiorari to review the Sixth Circuit’s November 2012 decision in United States ex rel. Sanders v. Allison Engine Co. This allows a significant circuit split over the retroactive...more

HEALTH REFORM: OIG Issues Updated Guidelines for Evaluating State False Claims Acts: Is More State Litigation on the Horizon?

On March 15, 2013, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) released the Updated OIG Guidelines for Evaluating State False Claims Acts (“2013 Guidelines”), which replaces the...more

OIG Issues Updated Guidelines on State False Claims Laws

On March 15, HHS OIG issued updated guidelines regarding how it will evaluate State false claims acts. Under the Deficit Reduction Act of 2005, States became eligible for financial incentives (i.e., retaining a larger share...more

Amendments to California False Claims Act Expand Potential Exposure to Government Investigations and Litigation

On September 27, 2012, Governor Jerry Brown signed into law Assembly Bill 2492 (AB 2492), which amends the California False Claims Act (CFCA). These amendments closely align the CFCA with the federal False Claims Act (FFCA)....more

Sixth Circuit: FERA False Claims Act Amendment Applies Retroactively to Cases Pending as of June 7, 2008

On November 2, 2012, the Sixth Circuit held that a 2009 amendment Congress made to the liability provisions of the False Claims Act ("FCA") applies retroactively to civil FCA cases pending as of June 7, 2008. U.S. ex rel....more

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