News & Analysis as of

Qui Tam Fraud Health Care Providers

Arnall Golden Gregory LLP

Government Investigations Team Insights - July 2024

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

Perkins Coie

DOJ-Initiated False Claims Act Cases Reached Record High in Fiscal Year 2023

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The U.S. Department of Justice (DOJ) announced that it initiated a record-high 500 new False Claims Act (FCA) cases in Fiscal Year 2023. The government and whistleblowers (qui tam relators) were party to 543 settlements and...more

Hogan Lovells

The False Claims Act Guide: 2023 and the road ahead

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In the latest edition of our False Claims Act Guide: 2023 and the road ahead, we analyze the key developments from 2023 and discuss how the most important cases and issues are shaping FCA enforcement now and in the year to...more

Mintz

EnforceMintz — COVID-19 Fraud Enforcement Unlikely to Slow Down in 2024

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The government continued to dedicate enormous resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs in 2023. While we observed some civil False Claims Act settlements, criminal enforcement...more

ArentFox Schiff

Investigations Newsletter: Ultragenyx to Pay $6 Million To Settle False Claims Act Case

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Ultragenyx to Pay $6 Million To Settle False Claims Act Case - Ultragenyx Pharmaceutical Inc. recently agreed to pay $6 million to settle a qui tam action filed under the False Claims Act (FCA). Ultragenyx manufactures a...more

K&L Gates LLP

The False Claims Act and Health Care: 2022 Recoveries and 2023 Outlook

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On 7 February 2023, the US Department of Justice (DOJ) publicly reported the statistics for federal civil fraud recoveries in Fiscal Year (FY) 2022. While the DOJ emphasized in its accompanying press release that “the...more

Bass, Berry & Sims PLC

Recent False Claims Act Decisions to Know

In this post, we summarize noteworthy False Claims Act (FCA) decisions so far from 2023. Each of the three circuit court opinions discussed here ruled in favor of the defendants on different aspects of the FCA: the Sixth...more

Mintz - Health Care Viewpoints

EnforceMintz Newsletter — Quick Hits

Record Settlement in a Declined Case - While defendants typically breathe a sigh of relief when the Department of Justice (DOJ) declines to intervene in a qui tam False Claims Act (FCA) case, a more favorable outcome is by...more

ArentFox Schiff

Investigations Newsletter: Modernizing Medicine to Pay $45 Million to Settle False Claims Act Allegations

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Modernizing Medicine to Pay $45 Million to Settle False Claims Act Allegations - Modernizing Medicine Inc. (ModMed), a Florida-based electronic health record (EHR) technology vendor, has agreed to pay $45 million to...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Self-Disclosures

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When healthcare providers and other government contractors are subject to scrutiny for bills submitted to the government, it is often the result of a whistleblower complaint filed under the qui tam provisions of the False...more

Benesch

Modern Vascular is the Latest Defendant in a Growing Trend of Qui Tam Relator Cases against Office-based Lab Companies

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Earlier this month a federal judge unsealed a federal qui tam relator complaint originally filed in January 2020 by Dr. Jay Radhakrishnan and Dr. William Julien against Arizona-based Modern Vascular and certain of its...more

Wiley Rein LLP

2021 FCA Recoveries Bounce Back from Decade-Low . . . Maybe

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On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more

K&L Gates LLP

Qui Tam Quarterly - Hunting Telehealth Fraud Under Covid-19 Waivers and Expansion

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Over the COVID-19 pandemic, telehealth has evolved from an infrequent method of providing health care services that was often abused into a vital tool used by providers to connect with patients. This article examines...more

ArentFox Schiff

Investigations Newsletter: Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act

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Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act - On February 22, 2021, the United States Supreme Court denied petitions for certiorari in a case that could have addressed the issue of...more

K&L Gates LLP

Qui Tam Quarterly - Uncertain Relief: Navigating Cares Act Provider Relief Fund Guidance and False Claims Act Risks

K&L Gates LLP on

This edition of the Qui Tam Quarterly focuses on the potential False Claims Act (FCA) risk areas faced by health care provider recipients of payments from the Provider Relief Fund (PRF) created by the CARES Act, as well as...more

Holland & Knight LLP

Healthcare Law Update: July 2020

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Thomas Stephenson Winter ex rel. U.S. v. Gardens Reg'l. Hosp. and Med. Ctr., Inc., 953 F.3d 1108 (9th Cir. 2020), the court of appeals reversed a district court order dismissing the plaintiff's qui tam False Claims Act (FCA)...more

King & Spalding

Ninth Circuit Holds That Medical Opinions Do Not Automatically Preclude FCA Liability at the Pleading Stage

King & Spalding on

In late March, the United States Court of Appeals for the Ninth Circuit revived a whistleblower lawsuit under the False Claims Act (FCA) in which a former employee accused a healthcare provider of submitting reimbursement...more

ArentFox Schiff

Investigations Newsletter: Genetic Testing Company and Three Principals Settle FCA Allegations for $42.6 Million

ArentFox Schiff on

Genetic Testing Company and Three Principals Settle FCA Allegations for $42.6 Million - On October 9, 2019, New Orleans-based laboratory company UTC Laboratories Inc. (RenRX) agreed to pay $41.6 million, and its three...more

Foley & Lardner LLP

Can A Whistleblower Release Her Retaliation Claim Under The False Claims Act?

Foley & Lardner LLP on

Although a whistleblowing employee typically cannot release fraud claims against her employer brought on behalf of the United States under the False Claims Act (FCA), courts have demonstrated a willingness to enforce properly...more

Robinson+Cole Health Law Diagnosis

Government Continues to Closely Scrutinize Pharmaceutical Marketing Practices

On September 4, 2019 the Department of Justice (DOJ) announced a $15.4 million settlement with pharmaceutical company Mallinckrodt ARD LLC (Mallinckrodt) to resolve alleged violations of the Anti-Kickback Statute (AKS) in two...more

Mintz

Mintz Levin Health Care Qui Tam Update - February 2019

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Overview of Qui Tam Activity - We identified 49 health care-related qui tam cases that were unsealed in September and October 2018. The government intervened in whole or in part in 10 of those 49 unsealed cases, which...more

Bass, Berry & Sims PLC

FCA Deeper Dive: Original Sources under the FCA’s Public Disclosure Bar

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The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we...more

Holland & Knight LLP

Reasonable Interpretation of Ambiguous Regulation May Not Preclude False Claims Act Liability

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A recent appellate court ruling governing all federal court cases in Florida, Georgia and Alabama establishes that a defendant in a False Claims Act (FCA) case cannot rely on a defense that there was no intent to defraud the...more

Faegre Drinker Biddle & Reath LLP

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

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