Qui Tam

News & Analysis as of

Eighth Circuit Rules Certain FCA Whistleblowers Are Not Required To Identify Specific Examples of Fraud Under Rule 9(b)

On August 29, 2014, the Eighth Circuit ruled that False Claims Act (FCA) whistleblowers with knowledge of employer billing practices are not necessarily required to identify specific examples of fraud to survive a Rule 9(b)...more

7th Circuit Defines "Worthless Services" Under the False Claims Act

That’s the upshot from U.S. ex rel. Absher v. Momence Meadows Nursing Center, Nos. 13-1886 & 13-1936 (Aug. 20, 2014), a recent decision from the Seventh Circuit (authored by Judge Manion) that addressed the worthless-services...more

Another Court Weighs in on Rule 9(b)’s Requirements Under the False Claims Act

A federal district court recently dismissed a qui tam relator’s complaint in a declined case against the Hospital for Special Surgery (“Hospital”), its former CEO, and an outside billing company alleging that they violated...more

7th Circuit Rejects Public-Disclosure Bar in Qui Tam Case

In United States ex rel. Heath v. Wisconsin Bell, Inc., No. 12-3383 (7th Cir. July 28, 2014), the Seventh Circuit grappled with this bar on the use of publicly disclosed information, refusing to apply it in a case involving...more

Acute Care Hospitals Settle FCA Lawsuits for $98 Million

Community Health Systems, Inc. (CHS) and Community Health Systems Professional Services Corporation, together a national owner and operator of acute care hospitals, and 119 of their hospitals, agreed to pay $98 million to...more

Supreme Court to Take Up Kellogg Brown & Root Whistleblower Case

It’s impossible to understate the importance of strict adherence to procedure when initiating a qui tam action under the False Claims Act. Unfortunately under our legal system, otherwise meritorious claims can often be...more

U.S. Attorney General Intervenes in Whistleblower Suit Against Computer Software Industry Leader

The U.S. Attorney General recently intervened in a qui tam case brought by a current employee of California-based computer software giant Symantec Corporation, alleging violations of the federal, California, Florida and New...more

Lessons From Omnicare Settlement In 'Swapping' Cases

On June 25, the U.S. Department of Justice announced that it had settled with Omnicare Inc. in two matters alleging that kickbacks resulted from below-cost discounts offered to skilled nursing homes as an inducement to select...more

It’s Time to Re-Think the False Claims Act

The federal False Claims Act (FCA) is one of the government’s primary weapons in combating fraud by federal contractors, federal grantees and recipients of federal benefits. Since 1986, when the FCA was restructured into its...more

C.D. Cal. Dismisses False Claims Act Qui Tam Suit Against Group of Lenders

On July 15, the U.S. District Court for the Central District of California dismissed a relator real estate agent’s suit against a group of lenders the relator alleged submitted claims for FHA insurance benefits to HUD based...more

We Don’t Need No Intervention: Qui Tam Relator in Omnicare Wins Big Without DOJ

The United States Department of Justice (DOJ) recently announced the settlement of two qui tam whistleblower lawsuits against Omnicare Inc., the largest nursing home pharmaceutical and pharmacy services vendor in the nation....more

Texas Federal Court Dismisses FCA Claims As Insufficiently Pled

In U.S. ex rel. Williams v. McKesson Corp., No. 3:12-CV-0371-B (N.D. Tex. July 9, 2014), a Texas federal court recently dismissed a qui tam whistleblower suit by a former employee of McKesson, a Texas-based entity that...more

Software Glitch Sparks FCA Suit Against Hospitals for Late Repayment of Medicaid Reimbursements

On June 27, the New York Attorney General’s Office and the U. S. Attorney’s Office for the Southern District of New York intervened in a qui tam suit against Continuum Health Partners, Inc., Beth Israel Medical Center and St....more

Fifth Circuit: FCA Inapplicable to Claims Involving Private Funds Administered by Government-Created Programs

In United States of America ex rel Rene Shupe v. Cisco Systems, Inc. and Avnet, Inc., No. 13-40807 (5th Cir. July 7, 2014), the Fifth Circuit reversed a district court’s order denying a motion to dismiss a qui tam...more

Omnicare Settles Two Qui Tam Cases Alleging “Swapping” Kickbacks to Nursing Homes

The pharmacy provider agrees to pay US$124 million to resolve allegations of below-cost discounts. On June 25, the Department of Justice (DOJ) announced that it had settled with Omnicare, Inc. in two matters alleging...more

Do Subsidized Health Care Plans Purchased Under the Affordable Care Act Trigger the Anti-Kickback Statute?

The advent of federally subsidized private pay health insurance under the Affordable Care Act has the potential to expand the application of the federal anti-kickback statute beyond just Medicare, Medicaid, and Tricare. The...more

District Court Applies FCA's First-to-File Rule to Determine Relator's Entitlement to Settlement Proceeds

On June 23, 2014, a U.S. District Court in Pennsylvania held that the first relator to file a qui tam complaint under the FCA is the only relator eligible to recover a portion of the settlement, notwithstanding the existence...more

Unforced Errors Under Upjohn

Over thirty years ago, the Supreme Court clarified how the attorney-client privilege applies to records of internal investigations in Upjohn v. United States, 449 U.S. 383 (1981). Yet putting the principles of Upjohn into...more

The Government Intervenes In False Claims Act Case Alleging Failure To Return Overpayments Within 60 Days

On June 27, 2014, the United States intervened in a qui tam action under the False Claims Act alleging that certain New York hospitals failed to refund Medicaid overpayments within 60 days of identifying them, as required by...more

Employers Fight Back Against Whistleblowers

In 2013, the federal government recovered $3.8 billion from settlements and judgments under the False Claims Act (FCA). Whistleblowers—also called “relators”—can recover up to 30 percent of whatever a defendant pays in a...more

"Pay Me, Or Else…": California Court Rules Employee's Pre-Litigation Qui Tam Threat is Extortionate

A California appellate court recently issued a warning to employees who try to negotiate settlements with their employers by making veiled threats to report an employer's real or imagined criminal activity. In Stenehjem v....more

Lessons From A Cautionary Tale of Electronic Discovery Pitfalls in Health Care Litigation

E-discovery is especially challenging in healthcare related litigation due to the healthcare industry’s reliance on electronically stored information (ESI), the volume of medical records often at issue in health care...more

Can a Relator Be Held Liable for Using Confidential Company Documents to Support a Qui Tam Case?

Last week, the U.S. District Court for the Eastern District of Pennsylvania issued a decision in Walsh et al. v. Amerisource Bergen Corp. et al denying the Relator’s motion to dismiss a counterclaim that alleged the Relator...more

Third Circuit Adopts Relaxed Pleading Standard for False Claims Act Cases

The United States Court of Appeals for the Third Circuit recently rejected the strict approach taken by many federal circuit courts to Federal Rule of Civil Procedure 9(b) that requires a qui tam relator bringing a False...more

Third Circuit Adopts Less Demanding FCA Pleading Standard

Last week, the Third Circuit reversed a New Jersey district court’s decision to dismiss a False Claims Act (FCA) qui tam law suit, holding that the court applied an overly demanding pleading standard to relator Thomas...more

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