Qui Tam

News & Analysis as of

Sixth Circuit Court of Appeals Holds Whistleblower Protection Is Not Available

The False Claims Act, 31 U.S.C. §3729 et seq. (FCA), provides for triple damages and a penalty ranging from $5,500 to $11,000 per claim for anyone who knowingly submits or causes the submission of a false or fraudulent claim...more

11th Circuit Brings Back Part of Whistleblower Suit

According to the ruling of the 11th U.S. Circuit Court of Appeals, a former health care executive that exposed a kickback and illegal referral scheme by his employer will be allowed to proceed with certain allegations listed...more

Federal Judge Awards Attorneys’ Fees to Defendant in Dismissed Qui Tam Case, Calls Whistleblower a “Serial Relator”

In November 2013 and this past October, Mintz Levin’s Health Care Qui Tam Update highlighted three separate qui tam False Claims Act (FCA) cases filed by Fox RX, Inc. (Fox), a former Medicare Part D plan sponsor. Fox filed...more

Seventh Circuit Limits the Use of the Federal Assignment Law under the False Claims Act

It’s common in the healthcare industry for large insurers to negotiate discounts from pharmacies for prescription drugs. The federal government, the granddaddy of all insurers, does this too, when it negotiates discounts on...more

Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed Cases: November 2014

Trends & Analysis - In the period covered by this issue, we have identified 68 whistleblower cases related to health care that were unsealed. In this Qui Tam Update, we analyze the trends and take an in-depth look at...more

The Seventh Circuit Rejects Medicaid False Claims Act Suit

The United States Court of Appeals for the Seventh Circuit affirmed the dismissal of a False Claims Act (“FCA”) case against Shopko Operating Stores, LLC, in which a former Shopko pharmacist asserted Medicaid billing...more

New False Claims Act Whistleblower Trends Revealed in Recent Verdict: What Can We Learn?

On October 20, 2014 in a case brought by a whistleblower under the False Claims Act (“FCA”), a federal jury handed down a $175 million verdict in favor of the plaintiff. While the outcome was newsworthy because of its size...more

Whistleblowers Must Have Independent Knowledge to Actually Blow the Whistle

To bring a valid qui tam action and overcome the so-called “public disclosure bar” under the False Claims Act (“FCA”), a whistleblower must have direct knowledge of the alleged fraudulent activity, independent of already...more

Recent Developments in Cases Dealing with the False Claims Act’s First-to-File and Public Disclosure Bars

The False Claims Act, 31 U.S.C. §§ 3729-3733, enables whistleblowers—also known as qui tam relators— to file fraud suits on behalf of the United States against private government contractors. With the assistance of qui tam...more

Blog: Litigation Round-Up: Some Recent Drug & Device Settlements, Investigations, Inquiries

Settlements - Pharmaceutical company Organon Inc. agreed to pay $31 million to settle federal and state allegations that it underpaid Medicaid drug rebates, provided kickbacks to nursing home pharmacy companies,...more

Mintz Levin Health Care Qui Tam Update - Recent Developments & Unsealed False Claims Act Cases: October 2014

Trends & Analysis - Between our last Qui Tam Update and the end of June, 65 health care–related qui tam cases were unsealed (28 in April, 18 in May, and 19 in June). Within those 65 cases...more

“Prior or Pending Litigation” Exclusion Bars Coverage for Litigation that Was Unknown to Policyholder

Companies that do business with the federal government, or whose business transactions otherwise involve payments by the government, undoubtedly understand the exposure they face to “whistleblower” or “Qui Tam” lawsuits...more

Provider Waives Attorney-Client Privilege in Qui Tam Case by Asserting Compliance with Law

A federal district court recently rejected a health care provider’s claim of attorney-client privilege and ordered the provider to produce written communications with its lawyers regarding the provider’s compliance with the...more

Health Law Alert: Case Against New York Health System May Shape the 60-Day Overpayment Rule

New York’s Mount Sinai Health System is involved in a high-stakes False Claims Act (FCA) suit alleging failure to comply with the Affordable Care Act’s (ACA) 60-day overpayment rule. This is the first time the Department of...more

U.S. Supreme Court Upholds Fourth Circuit Victory for Omnicare, Inc. in High-profile, Precedent-setting False Claims Act Case

On October 6, 2014, the U.S. Supreme Court denied review of a groundbreaking Fourth Circuit decision affirming the dismissal of a novel False Claims Act suit against Reed Smith client Omnicare, Inc. In its February 2014...more

The Supreme Court Continues to Punt on False Claims Cases

The first day of the Supreme Court term saw it decline, without comment, certiorari on two cases raising issues of liability and the sufficiency of pleading under the federal False Claims Act (FCA). ...more

Whistleblower Goes It Alone to Secure $5 Million Settlement under False Claims Act

The potential success of a whistleblower lawsuit filed under the False Claims Act (FCA) is significantly reduced when the government fails to intervene because such cases are often assumed to lack merit. However, a plaintiff...more

Pennsylvania Court Holds Pending and Prior Litigation Exclusion Applicable to Unserved False Claims Complaint

In its recent decision in AmerisourceBergen Corp. v. Ace Am. Ins. Co., 2014 PA Super 198 (Pa. Super. Sept. 15, 2014), the Superior Court of Pennsylvania, an intermediate Pennsylvania court, had occasion to consider the...more

Department of Justice Files First False Claims Act Lawsuit Against Physician-Owned Distributorship

On Sept. 8, 2014, the United States Department of Justice (DOJ) filed a 98-page civil complaint alleging that investment returns, paid to a Michigan spinal surgeon and other physicians by a spinal implant company partially...more

D.C. Circuit Supports Government Contractors’ Reliance on Supplier Certification of TAA Compliance in Qui Tam Suit

In a qui tam whistleblower suit under the False Claims Act, the D.C. Circuit affirmed a lower court finding that a federal contractor reasonably relied on certifications of Trade Agreements Act compliance from its...more

Healthcare Industry Faces Heightened Criminal Exposure Under New Criminal Division Review Process for Qui Tam Suits

The Assistant Attorney General for the Criminal Division, Leslie Caldwell, announced on September 17, 2014, that criminal prosecutors at the Justice Department in Washington will automatically review all new qui tam (i.e.,...more

Promoting the False Claims Act By Dismissing Meritless Qui Tam Actions

The False Claims Act's qui tam action is a distinctive and atypical form of litigation. Through the qui tam mechanism, Congress created a unique way for the United States to recover for false claims by empowering private...more

The Coming Qui Tam Tsunami: A New Threat to American Business

The most potent weapon in combatting corporate fraud against the U.S. government has been the False Claims Act (“FCA”). Under the FCA, the U.S. government may recover treble damages and civil fines for such fraud....more

Business Lit Ledger -- Fall 2014

In This Issue: - Promoting the False Claims Act By Dismissing Meritless Qui Tam Actions -Delaware Supreme Court Extends Shareholder Books and Records Inspection Rights to Privileged Internal Investigation...more

DOJ Announces Recently Implemented Procedure for Reviewing False Claims Act Suits for Criminal Prosecution

During a speech at the annual Taxpayers Against Fraud Education Fund conference this week, Assistant Attorney General Leslie R. Caldwell announced that the U.S. Department of Justice’s (DOJ) Criminal Division “recently...more

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