News & Analysis as of

Summary Judgment Hospice

Bradley Arant Boult Cummings LLP

Third Circuit Finds Documentation Issues May Be “Material” under the FCA

On August 25, 2023, the Third Circuit continued its trend of rulings unfavorable to FCA healthcare defendants in the latest appeal of U.S. ex rel. Druding et al. v. Care Alternatives et al., No. 22-1035, 2023 WL 5494333 (3d...more

Bass, Berry & Sims PLC

Supreme Court Declines to Weigh in on Key Falsity Question

Bass, Berry & Sims PLC on

For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA)...more

Foley & Lardner LLP

AseraCare FCA Ruling Is A Boon For Health Providers

Foley & Lardner LLP on

All hospice providers routinely should assess risk exposure under the False Claims Act — now with the benefit of the U.S. Court of Appeals for the Eleventh Circuit’s long-awaited decision in United States v. AseraCare Inc. ...more

Foley Hoag LLP - White Collar Law &...

Eleventh Circuit Holds Differences in Clinical Judgment Do Not Create FCA Liability for Hospice Provider

The Eleventh Circuit agreed with the trial court that the government must do more than present expert evidence that a physician’s clinical judgment was inaccurate to establish falsity under the False Claims Act. Nonetheless,...more

McGuireWoods LLP

DOJ Announces Will Appeal Loss in AseraCare, Triggering Issues on Battle of the Experts, Statistical Sampling, and Bifurcation

McGuireWoods LLP on

$200 million and pivotal legal precedent are at stake in the False Claims Act (“FCA”) case against AseraCare, Inc. (“AseraCare”), a for-profit hospice chain that was alleged to have fraudulently submitted claims that falsely...more

Arnall Golden Gregory LLP

Another Court Rejects Statistical Sampling and Rules That Difference of Opinion About Hospice Eligibility Is Insufficient for...

Back in March of this year, in U.S. ex rel. Paradies v. AseraCare, Inc., a district court in Alabama granted summary judgment to a defendant hospice finding that an expert physician’s disagreement with a certifying...more

Parker Poe Adams & Bernstein LLP

Court Dismisses Major False Claims Act Case Against Hospice Provider: Ruling Mere Difference of Medical Opinion is Insufficient...

On March 31, 2016, the United States District Court for the Northern District of Alabama in U.S. ex rel. Paradies v. AseraCare, Inc. dismissed a major False Claims Act case against a national hospice provider after ruling...more

Foley & Lardner LLP

Differences in Medical Opinion Are Not False Claims Act Violations

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In an important win for hospice and other health care providers facing claims under the False Claims Act (FCA), a federal court in Alabama gave a summary judgment victory last week to hospice provider Aseracare Inc. Key...more

Bryan Cave Leighton Paisner

AseraCare Defeats DOJ False Claims Act Suit: Plaintiffs Must Present Evidence of an Objective Falsehood to Prove Falsity Under the...

On March 31, 2016, in United States v. AseraCare, Inc, No. 2:12-cv-245-KOB, 2016 U.S. Dist. LEXIS 42986 (N.D. Ala. Mar. 31, 2016), the district court granted summary judgment for AseraCare and emphasized that contradicting...more

Faegre Drinker Biddle & Reath LLP

Difference of Medical Opinions Doesn’t Prove One Was False

A federal court in Alabama dealt a blow to the theory that in matters of medical judgment, a false claim action can rest on expert opinion evidence alone. A patient is eligible for hospice if the prognosis is life...more

Arnall Golden Gregory LLP

Key Ruling In False Claims Act Case Could Have Important Implications For Defendants

A recent decision out of a United States District Court in Alabama may signal that the playing field traditionally dominated by the government will no longer be so one-sided against providers defending against False Claim Act...more

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