Whistleblowers False Claims Act (FCA)

News & Analysis as of

Illinois Appellate Court Delivers Another Blow to Relator in False Claims Act Litigation

On Monday, October 17, the Illinois Appellate Court issued another taxpayer-friendly opinion in an Illinois False Claims Act case alleging a failure to collect and remit sales tax on internet and catalog sales to customers in...more

Seventh Circuit Issues Ruling Interpreting False Claim Act Whistleblower Amendments

The Seventh Circuit recently issued a decision interpreting the anti-retaliation provisions of the False Claims Act (FCA). The decision provides important clarifications about how courts may interpret recent amendments to...more

False Claims Act Developments Significantly Impact a Broad Range of Industries Doing Business with the U.S. Government

No other area of government enforcement or civil liability has experienced anything quite like the three dramatic developments in initiation, penalties and standards for False Claims Act cases over the last twelve months. FY...more

Shell Pays Big for Double Dipping with the UST Fund

Last week, the California State Water Resources Control Board (State Water Board) announced that it permanently banned 100 of Shell Oil Company’s underground storage tank (UST) claims from the California UST Cleanup Fund...more

False Claims that Don’t Violate the False Claims Act

A recent Fourth Circuit decision answers this riddle, “How can a contractor knowingly submit a false claim to the government without violating the False Claims Act (FCA)?” Give up? The answer is blindingly obvious—once...more

It’s Not Just the Response, It’s the Disclosure: SEC Charges Against a Company and Its General Counsel Highlight Importance of...

A recent complaint filed by the Securities and Exchange Commission highlights some important considerations for companies and in-house counsel facing False Claims Act investigations. The action is SEC v. RPM International...more

The False Claims Act’s Anti-Retaliation Provision Protects Employees Who Engage in Efforts to Stop Violations By Their...

In Carlson v. DynCorp, the United States Court of Appeals for the Fourth Circuit addressed 2009 and 2010 amendments to the False Claims Act (“FCA”) that broadened the scope of its anti-retaliation protection for...more

7th Cir. Demands Objective Standards in Whistleblower Complaint

On September 1 the Seventh Circuit affirmed dismissal of three of a whistleblower’s four fraud allegations against a mental health clinic, ruling that the allegations were based on the whistleblower’s subjective judgment...more

Strangest Regulatory Interpretation of the Month

The Massachusetts federal district court is hands-down winner of the August award for strangest regulatory interpretation of the month. The interpretation came in the context of denial of Omnicare’s summary judgment...more

Seventh Circuit Clarifies “Heightened” Pleading Standard for Fraud Claims under the False Claims Act

A recent decision of the United States Court of Appeals for the Seventh Circuit addressed the standard that courts should use to decide whether a whistleblower plaintiff has adequately pleaded that a defendant committed fraud...more

Fourth Circuit Issues Ruling Interpreting False Claim Act Whistleblower Amendments

The Fourth Circuit recently issued a decision interpreting the anti-retaliation provision of the False Claims Act (FCA). The decision provides important clarification about how courts may interpret 2009 and 2010 amendments...more

Healthcare Compliance: Juggling Risk Mitigation Strategies

Healthcare organizations – ranging from physician practice groups to large, multi-state hospital systems – face a variety of risks, including fraud and abuse, as well as HIPAA privacy issues. Starting from a baseline risk...more

60-Day Overpayment FCA Enforcement Action Results in $2.95 Million Settlement

On August 23, 2016, a New York hospital system settled False Claims Act (FCA) allegations that it violated the 60-day overpayment rule by improperly retaining Medicaid overpayments. The whistleblower alleged that three of the...more

Whistleblower’s Claim Survives Dismissal and Death

The Energizer Bunny has nothing on the whistleblower claim of Robert Cunningham. Here’s what’s happened since Robert files his qui tam action against Millennium Labs back in 2009: the government declined to intervene; seven...more

False Claims Act Cases: With No End In Sight, Why You Should Consider Litigating And How To Maximize Your Litigation Advantages

Over the past few years, the government’s emphasis on conducting fraud and abuse investigations – especially in the healthcare industry – has resulted in scores of settlements and billions of dollars paid to the government...more

Ninth Circuit: Manipulation of Risk Adjustment Data Subjects Insurers to False Claims Act Liability

The U.S. Court of Appeals for the Ninth Circuit has revived a whistleblower suit against Aetna, UnitedHealthcare and WellPoint for allegedly submitting false data for Medicare Advantage payments. Some of the nation’s largest...more

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

Since our last issue, we have identified 31 recently unsealed health care-related whistleblower cases. In this Qui Tam Update, we analyze the trends and take an in-depth look at a few noteworthy cases....more

Doctor Gets $4.6M for Blowing Whistle on Over-Compensated Doctors

Neurologist Dr. David Hammett will receive $4,590,000 as part of a settlement entered into by Lexington Medical Center (LMC) of West Columbia, S.C., and the federal government. Ironically, the hefty compensation comes as a...more

Increased False Claims Act Penalties Carry Hidden Risks

On June 30, 2016, the Department of Justice published an Interim Final Rule adjusting for inflation the civil monetary penalties arising from violations of the False Claims Act (FCA). Currently, civil monetary penalties range...more

Your daily dose of financial news - The Brief – 7.28.16

A pair of whistleblowers is seeking discovery-related sanctions against Wells Fargo for allegedly concealing “crucial evidence” for their False Claims Act claims over fees added to government-backed mortgages....more

Check Up on Healthcare Fraud Prosecutions

Chief compliance officers face an overwhelming level of risk in the healthcare sector. I do not mean to belittle the risks of corruption, AML, sanctions and other risks typically associated with global companies. Healthcare...more

Aveta And The Use Of Confidential Info In FCA Cases

In a recent case in the District of Puerto Rico, United States ex rel. Valdez v. Aveta Inc., et al., No. 15-cv-01140-CCC (D.P.R.), the former president of Puerto Rican-based managed health care provider Aveta Inc., Jose...more

When Inside Knowledge Is a Handicap to a Whistleblower

Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit. How can that inside knowledge be a handicap in pressing his claim? A June...more

Supreme Court Issues Long-Awaited Key Decision on False Claims Act

The U.S. Supreme Court (SCOTUS) issued a decision today in a case that has important implications for healthcare providers and other organizations that bill the U.S. government for goods or services. (Universal Health...more

Client Alert: Top Ten Things the Health Care Industry Should Know about Civil Investigative Demands

Civil Investigative Demands, or CIDs, are a favorite tool of the Federal Government to get information from all types of providers who bill federal payors. This information could form the basis of a civil or criminal...more

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