Qui Tam Fraud

News & Analysis as of

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

U.S. Supreme Court Rules That Seal Violations Do Not Require Dismissal of Qui Tam False Claims Act Suits

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

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

"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

First Circuit Affirms Stringent Rule 9(b) Particularity Requirement in False Claims Act Cases

On June 17, 2016, the First Circuit issued an opinion addressing, among other things, the particularity requirement that applies in False Claims Act (“FCA”) cases where the defendants are not alleged to have directly...more

Florida Federal District Court Dismisses Plaintiff’s Qui Tam Action Against Hospice Providers

On September 22, 2016, the United States District Court for the Middle District of Florida granted defendant hospice providers’ motions to dismiss plaintiff-relator’s claims under the False Claims Act, Florida’s False Claims...more

No Good Deed Goes Unpunished

Oscar Wilde observed, “No good deed goes unpunished.” Whistle-blower Michael Cascio discovered the truth of that saying when a federal court threw out his qui tam case against a national wound care provider that partners...more

District Court Rejects “Worthless Services” FCA Claim, Interprets First-to File Bar and Res Judicata in FCA Context

Earlier this month, the U.S. District Court for the Eastern District of Virginia dismissed a 2-count False Claims Act (FCA) complaint against Unisys Corporation. United States ex rel. Soodavar v. Unisys Corp., 2016 WL 1367163...more

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: April 2016

Trends & Analysis - ..We have identified 42 health care–related qui tam cases that have been unsealed in whole or in part since the cases covered in our last Qui Tam Update. Included in that count is one proceeding (the...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

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

Taxability of Shipping and Handling Charges in Illinois – Common Sense Prevails in Department's Second Notice of Proposed...

On January 14, 2016, the Illinois Department of Revenue (the “Department”) sent its Second Notice of Proposed Rulemaking to the Joint Committee on Administrative Rules (“JCAR”) regarding its proposed amendments to its...more

The FCA Impact Of DOJ’s Increased Focus on Small Business

In 2014, the Small Business Administration reported that almost a quarter of approximately $367 billion of eligible funding for small business contracting, or roughly $91.7 billion, was awarded to small businesses as prime...more

DOJ Reaffirms Commitment to Prosecuting Individuals, Toughens Expectation for Corporate Response

The U.S. Department of Justice (DOJ) recently issued a memorandum ("The Yates memo") on September 9, 2015 by Deputy Attorney General Sally Yates, reaffirming the Government's commitment to prosecuting individuals. Say...more

Judge Dismisses FCA Claim Against City of Chicago; Concludes that “Subsequent Nonperformance of a Future Commitment” Was Not a...

On September 16, 2015, the U.S. District Court for the Northern District of Chicago dismissed a False Claims Act (FCA) case against the City of Chicago, because the qui tam complaint did not satisfy the relevant pleading...more

Whistleblower Filed Too Early & Too Late for Share of $322M SCAN Scam Recovery

During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and Medicaid for years. He expressed his concerns within SCAN. When he refused a job reassignment, he was fired....more

Ninth Circuit Eases Ability for Whistleblowers to Bring Qui Tam Actions

In an important development under False Claims Act (“FCA”) case law, the U.S. Court of Appeals for the Ninth Circuit has expressly abrogated former precedent limiting the ability of whistleblowers to recover funds reimbursed...more

Wisconsin Repeals State False Claims Act

On July 12, 2015, the state of Wisconsin passed a budget that, along with many expected cuts, additions, and tweaks, unexpectedly repealed Wisconsin’s False Claims for Medical Assistance Act—the state’s version of the federal...more

Felony Conviction Bars Whistleblower from Pursuing Qui Tam Case

A relator convicted of criminal conduct is precluded from sharing in related FCA recoveries, irrespective of degree of culpability. On July 16, a US Court of Appeals for the Ninth Circuit panel upheld the dismissal from...more

Ninth Circuit Concludes that Conviction Precludes Relator Recovery

The Ninth Circuit last week held that pursuant to 31 U.S.C. 3730(d)(3) of the False Claims Act (“FCA”), a qui tam relator who is convicted of conduct giving rise to the fraud that is the subject of the FCA lawsuit must be...more

D.C. Circuit Interprets the First-to-File Rule Narrowly

A decision this week from the D.C. Circuit shed light on three important issues. United States ex rel. Heath v. AT&T, Inc., No. 14-7094 (D.C. Cir. June 23, 2015). In 2008, the appellant, Todd Heath, filed an FCA qui tam...more

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

Supreme Court Decision in Kellogg Brown & Root Services, Inc. v. United States ex rel. Carter

Last Tuesday, the U.S. Supreme Court issued its opinion in Kellogg Brown & Root Services, Inc. (KBR) v. United States ex rel. Carter, resolving two questions that had previously divided lower courts interpreting the federal...more

SCOTUS: No Unlimited Suspension of the Statute of Limitations Under the False Claims Act; “First-to-File” Doctrine Does Not Bar...

In an opinion released May 26, 2015, Kellogg Brown & Roots Services, Inc. v. United States ex rel. Carter, the U.S. Supreme Court unanimously held that whistleblowers cannot extend the statute of limitations for war-related...more

Worthless Services Investigations and Settlements: The Enforcement Trend Continues

In recent years, state and federal governments have shown their willingness to criminally pursue skilled nursing home owners and operators for allegedly administering “worthless” or substandard quality of care to their...more

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