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The US Department of Justice recently intervened in an qui tam alleging false and fraudulent claims involving the acquisition of physician practice locations by a health system and subsequent management of the health system’s...more
Jane Winter, former Director of Care Management at Gardens Regional Hospital filed a qui tam action under the False Claims Act (FCA). Winter alleged Gardens Regional Hospital and Medical Center, Inc. submitted, or caused to...more
William F. Gould In United States v. Merino, No. 19-50291, 2021 WL 754589 (9th Cir. Feb. 26, 2021), the court of appeals reversed the conviction of Marina Merino of conspiracy to commit healthcare fraud in violation of 18...more
How should a court evaluate the FCA’s materiality requirement when the government’s ability to deny claims is constrained? According to a recent decision from the Eleventh Circuit, the court should “broadly” consider the...more
Report on Research Compliance 17, no. 8 (August 2020) - Higher education groups and others are hailing a decision by the administration to rescind planned rules that would have required students in the United States on...more
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
In the Care Alternatives False Claims Act (FCA) appeal, a panel of the US Court of Appeals for the Third Circuit on March 4 reversed the summary judgment granted to hospice provider Care Alternatives at the district court,...more
The Department of Justice (DOJ) recently released its report detailing the settlements and judgments obtained in 2019 from civil cases involving fraud and abuse claims. As in years past, the substantial majority of these...more
On December 20, 2019, the U.S. Court of Appeals for the Third Circuit granted in part a petition for rehearing filed by the University of Pittsburgh Medical Center (UPMC) in a False Claims Act (FCA) case that has generated...more
In a recent 9-0 decision issued by the United States Supreme Court (SCOTUS), the Court has set to rest the applicable statutes of limitations for claims brought under the False Claims Act, 31 U.S.C. §3731(b) (FCA). Cochise...more
The U.S. Court of Appeals for the Third Circuit recently issued a False Claims Act (FCA) decision calling into question productivity-based physician compensation structures under the Stark Law, in reliance on a controversial...more
The US Court of Appeals for the Third Circuit endorsed two controversial interpretations of the Stark Law’s “volume or value” standard, known as the correlation theory and the practice “loss” theory in U.S. ex rel. J. William...more
On September 17, 2019, the U.S. Court of Appeals for the Third Circuit revived three whistleblowers’ claims alleging that the University of Pittsburgh Medical Center (UPMC) and neurosurgeons employed by three subsidiary...more
Last week, the 11th Circuit Federal Court of Appeals reversed summary judgment given to AseraCare in its hospice false claims case, setting up more litigation on the question whether AseraCare’s certifications were made in...more
In a 3-0 decision issued September 9, 2019, the U.S. Court of Appeals for the Eleventh Circuit affirmed a three-year-old district court ruling in United States v. AseraCare, Inc. that a Medicare claim for hospice services...more
On May 13, the US Supreme Court (the Court) unanimously ruled in Cochise Consultancy, Inc., v. U.S. ex rel. Hunt that the “government knowledge” statute of limitations under the federal False Claims Act (FCA), §31 U.S.C....more
On May 13, 2019, the Supreme Court handed down its decision in Cochise Consultancy, Inc. v. United States ex rel. Hunt, wherein it recognized a prolonged statute of limitations for a qui tam relator bringing an action under...more
Health care providers, government contractors, and others who receive money from the federal government are at greater risk of suit under the False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., following the Supreme Court’s...more
Earlier this month, the U.S. Court of Appeals for the First Circuit overturned its own precedent to hold the FCA’s first-to-file rule is “non-jurisdictional.” In so doing, the First Circuit flipped the district court’s award...more
On May 13, 2019, in a unanimous decision, the United States Supreme Court held that even in cases where the government does not intervene in a False Claims Act (FCA) action, a relator is entitled to rely on the portion of the...more
In Cochise Consultancy Inc. v. United States, ex rel. Hunt, the Supreme Court expanded the time in which False Claims Act (“FCA”) lawsuits may be filed by qui tam relators in which the government does not intervene. The Court...more
The U.S. Supreme Court has just issued a unanimous decision in the case Cochise Consultancy Inc. et al. v. U.S. ex. rel Hunt (decided on May 13, 2019), that qui tam whistleblowers can invoke the ‘”government knowledge”...more
Resolving a circuit split, the United States Supreme Court in Cochise Consultancy, Inc. v. U.S. ex rel. Hunt held that False Claims Act (FCA) whistleblowers are able to take advantage of an expanded statute of limitations,...more
The US Supreme Court issued its decision on May 13 in Cochise Consultancy v. United States ex rel Hunt, unanimously holding that the three-year tolling provision in 31 U.S.C. 3731 (b)(2) applies in favor of relators in...more
In a unanimous decision, the US Supreme Court held on Monday that the three-year False Claims Act (FCA) tolling provision applies in all FCA actions. In Cochise Consultancy, Inc. et al. v. United States ex rel. Hunt, the...more