Qui Tam Fraud

News & Analysis as of

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2015, the state of Wisconsin passed a budget that, along with many expected cuts, additions, and tweaks, unexpectedly repealed Wisconsin’s False Claims for Medical Assistance Act—the state’s version of the federal...more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

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

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

The False Claims Act 2015: DOJ Policies and Judicial Decisions Likely to Lead to an Increase in FCA Claims

By all accounts, 2014 was a banner year in False Claims Act (FCA) enforcement, with the Department of Justice (DOJ) announcing a record $5.69 billion in FCA recoveries. 2015 promises to be an equally active year and is...more

The Federal False Claims Act...Liability Even When There Is No Government Reliance

In its recent opinion, United States v. Triple Canopy, Inc., Nos. 13-2190, 13-2191 (4th Cir., January 8, 2015), the Fourth Circuit emphasized that the Federal False Claims Act (FCA) is a “strong remedy,” designed to target...more

Supreme Court Hears Argument On Two Procedural Issues In False Claims Act Litigation

On January 13, 2015, the United States Supreme Court heard oral argument in Kellogg Brown & Root v. United States ex rel. Carter, No. 12-1497, a False Claims Act (FCA) qui tam case involving allegations of fraudulent billing...more

Government Joins Lawsuit Against Florida Doctor Alleging Fraud and Kickbacks

In a move demonstrating the government’s continued aim to combat health care fraud through its Health Care Fraud Prevention and Enforcement Action Team (HEAT), the Department of Justice announced today that the government has...more

DOJ Criminal Division Will Pursue All FCA Claims in Departure from Current Practice

The Criminal Division of the U.S. Department of Justice (“DOJ”) will now be reviewing all new qui tam complaints filed under the False Claims Act. A spokesperson for the Criminal Division announced the new procedure on...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

False Claims Act Update

New Criminal Division Review Process for Qui Tam Complaints Expands Main Justice Involvement and Threatens Greater Criminal Exposure in Whistleblower Investigations. The Assistant Attorney General for the Criminal...more

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

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

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

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

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

Qui tam relators target – and gain access to – internal investigation on ground that attorney-client privilege does not apply

In Brief - A federal district court recently held that documents relating to a government contractor’s internal compliance investigations regarding fraud were not protected by the attorney-client privilege because...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

JM Eagle Pays $2.5 million to Settle False Claims Allegations

On November 14, 2013, a federal jury in California found that JM Eagle (formerly J-M Manufacturing Company, Inc.) defrauded several states and municipalities by selling them defective plastic pipe in violation of the federal...more

Eighth Circuit Adopts Novel False Claims Act Fraud-in-the-Inducement Theory Long Espoused by Government

On October 15, 2013, a divided three-judge panel of the United States Court of Appeals for the Eighth Circuit rendered a federal False Claims Act ("FCA") judgment against Bayer Healthcare Pharmaceuticals ("Bayer"), based on a...more

California Insurance Commissioner Announces Settlement with Sutter Hospitals Over False Claims Allegations

Insurance Commissioner Dave Jones announced yesterday that Sutter Health, which operates over 20 hospitals in northern California, agreed to pay $46 million and change its billing and disclosure of anesthesia charges and...more

Drug Manufacturer’s Liability Under Insurance Frauds Prevention Act May Not Be Inferred From Alleged Kickbacks to Physicians

Three former employees of Bristol Myers Squibb, Inc. (BMS) brought a qui tam action alleging that BMS violated California’s Insurance Frauds Prevention Act, California Insurance Code section 1871.7 et seq. (IFPA), by giving...more

First Circuit Rules First-Filed Complaint Need Not Satisfy Rule 9(b) to Bar Subsequent Qui Tam Actions

To incentivize whistleblowers to bring false claims promptly to the government’s attention, the False Claims Act (FCA) includes a so-called “first-to-file rule“ (31 U.S.C § 3730(b)(5)), which bars a person other than the...more

Weekly Law Resume - February 7, 2013: Protection for Whistleblowers Extended From Employers to Violations by Third Parties,...

Brian McVeigh v. Recology San Francisco et al. Court of Appeal, First District (January 31, 2013) Under the California False Claims Act (“CFCA”), whistleblowers are given protection when they disclose information to...more

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