The False Claims Act (FCA) continues to be a primary tool for both the Justice Department and whistleblowers’ counsel to bring suits against companies in the financial services sector, and the nationwide pandemic did not halt...more
The False Claims Act (“FCA”) continued to serve as one of the primary tools utilized by the federal government against government contractors in 2020. One of the key areas that the government focused on this past year was...more
This year saw substantial activity in FCA settlements and litigated court cases. Although no single case or development dominated the discourse this year, several important court decisions were issued, including two that may...more
2/1/2021
/ Ambiguous ,
Anti-Kickback Statute ,
Damages ,
Deficit Reduction ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Department of Veterans Affairs ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Aviation Administration (FAA) ,
Fee-Shifting ,
First-to-File ,
Fraud ,
Materiality ,
Medicaid ,
Medicare ,
Qualified Immunity ,
Reasonable Interpretations ,
Retaliation ,
Speaker Programs ,
Statute of Limitations
In the latest instance of courts interpreting the Supreme Court’s landmark False Claims Act ruling in Universal Health Services, Inc. v. Escobar, the Eleventh Circuit recently departed from the trend of giving great weight in...more
1/20/2021
/ Amicus Briefs ,
Appeals ,
Audits ,
Department of Veterans Affairs ,
False Claims Act (FCA) ,
Fees ,
Fraud ,
Qui Tam ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar ,
Veterans
The year 2019 was another active year in False Claims Act (FCA) investigations and litigation. Although the year lacked a singular blockbuster case, there were decisions of particular note. The Supreme Court clarified the...more
1/23/2020
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Financial Services Industry ,
Healthcare Fraud ,
Medicare Advantage ,
Private Equity ,
Public Disclosure Bar ,
Qui Tam ,
Stark Law ,
Statute of Limitations ,
Whistleblowers
The year 2019 was another active year in False Claims Act (FCA) investigations and litigation. Although the year lacked a singular blockbuster case, there were decisions of particular note. The Supreme Court clarified the...more
1/20/2020
/ Anti-Kickback Statute ,
Causation ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Federal Rules of Civil Procedure ,
Final Judgment ,
First-to-File ,
Government Investigations ,
Health Care Providers ,
Issue Preclusion ,
Materiality ,
Medicare Advantage ,
Objective Falsity ,
Overpayment ,
Pleading Standards ,
Public Disclosure Bar ,
Qui Tam ,
Sanctions ,
Settlement Agreements ,
Standing ,
Stark Law ,
Statute of Limitations
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
5/17/2019
/ Appeals ,
Cause of Action Accrual ,
Cochise Consultancy Inc v United States ex rel Hunt ,
False Claims Act (FCA) ,
Government Officials ,
Intervenors ,
Motion to Dismiss ,
Oral Argument ,
Qui Tam ,
Reaffirmation ,
Relators ,
Reversal ,
SCOTUS ,
Split of Authority ,
Statute of Limitations
This week, the Department of Justice (DOJ) formalized and expanded its guidance for how defendants can earn cooperation credit in False Claims Act (FCA) cases and thereby reduce settlement amounts. New section 4-4.112 of the...more
5/13/2019
/ Compliance ,
Cooperation ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Government Agencies ,
Government Investigations ,
New Guidance ,
Remedial Actions ,
Risk Mitigation ,
Voluntary Disclosure
This week, the Department of Justice (DOJ) formalized and expanded its guidance for how defendants can earn cooperation credit in False Claims Act (FCA) cases and thereby reduce settlement amounts. New section 4-4.112 of the...more
Companies that work with the federal government (think Medicare and Medicaid reimbursements, government contracts, grant funding) need to stay up to date on the False Claims Act (FCA). The FCA is one of the primary tools used...more
INTRODUCTION -
Unlike some recent years, 2018 was somewhat short on headline grabbing news related to the False Claims Act (FCA). There were, to be sure, significant developments in the courts and within the Department of...more
1/18/2019
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Qui Tam ,
Relators ,
Retaliation ,
Statute of Limitations ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Yates Memorandum
Last week, the Department of Justice (DOJ) issued two separate memoranda with potentially far-reaching consequences. While the practical effect of these documents remains to be seen, they may provide another avenue of...more
The federal government continues to use the False Claims Act (FCA) as one of its prime enforcement tools against government contractors. To keep you informed on the status of the law, Bradley’s Government Enforcement and...more
1/30/2018
/ Causation ,
Damages ,
Enforcement Actions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
First-to-File ,
FRCP 9(b) ,
Materiality ,
Objective Falsity ,
Overpayment ,
Pro Se Litigants ,
Reverse False Claims ,
Settlement ,
Universal Health Services Inc v United States ex rel Escobar ,
Yates Memorandum
Uncertain. What better word to describe a year in which a new administration came to power and began to chart a new course for health policy, the fate of the Affordable Care Act (ACA) hung in the balance, and courts grappled...more
1/25/2018
/ Affordable Care Act ,
Alternative Payment Models (APM) ,
Cooperative Compliance Regime ,
Department of Justice (DOJ) ,
Electronic Health Record Incentives ,
False Claims Act (FCA) ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Reform ,
Hospital Mergers ,
Meaningful Use ,
OIG ,
Prescription Drug Coverage ,
Repeal ,
Section 340B ,
Stark Law ,
Trump Administration ,
Universal Health Services Inc v United States ex rel Escobar
Bradley’s Government Enforcement and Investigations practice group is pleased to present the 2017 False Claims Act Year in Review, our annual review of significant False Claims Act (FCA) cases, developments, and trends. The...more
1/24/2018
/ Causation ,
Damages ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
First-to-File ,
Health Care Providers ,
Healthcare Fraud ,
Materiality ,
Pro Se Litigants ,
Retaliation ,
Rule 9(b) ,
Universal Health Services Inc v United States ex rel Escobar
The Seventh Circuit finally abandoned its “but-for” causation standard for False Claims Act (FCA) damages. The decision comes 25 years after the Seventh Circuit first adopted its controversial standard requiring only a...more
A federal court in Texas recently entered a massive judgment against a mortgage originator for financial crisis conduct, transforming an already severe $93 million jury verdict into a $298 million punishment, and issuing one...more
9/26/2017
/ Calculation of Damages ,
Civil Monetary Penalty ,
False Claims Act (FCA) ,
Federal Housing Administration (FHA) ,
FHA Loans ,
FIRREA ,
Insurance Fraud ,
Jury Verdicts ,
Treble Damages ,
Underwriting ,
Whistleblowers
We are pleased to present our annual review of developments in the field of health law. The year was marked by key changes in False Claims Act jurisprudence and Medicare payment policy. 2016 also brought with it focused...more
1/25/2017
/ 60-Day Rule ,
ACOs ,
Centers for Medicare & Medicaid Services (CMS) ,
Corporate Executives ,
Corporate Misconduct ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
ESRD ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Trade Commission (FTC) ,
Final Rules ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Reform ,
Hospital Mergers ,
Long Term Care Facilities ,
Materiality ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Medicare Shared Savings Program ,
MIPS ,
OCR ,
Off-Campus Departments ,
OPPS ,
Personal Liability ,
Physician Payments ,
Presidential Elections ,
SCOTUS ,
Stark Law ,
Trump Administration ,
Universal Health Services Inc v United States ex rel Escobar ,
Yates Memorandum
We are pleased to present Bradley’s annual review of significant False Claims Act (FCA) cases, developments, and trends. From a relatively short article several years ago, the Review has grown to a significant publication...more
1/10/2017
/ Anti-Kickback Statute ,
Appeals ,
Calculation of Damages ,
Civil Monetary Penalty ,
Defense Contracts ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Federal Contractors ,
FRCP 9(b) ,
Healthcare Fraud ,
Materiality ,
Objective Falsity ,
Off-Label Promotion ,
Overpayment ,
Public Disclosure ,
Qui Tam ,
Retaliation ,
SCOTUS ,
Standard of Review ,
Successor Liability ,
Transfer of Venue ,
United States ex rel Nelson v Sanford-Brown ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Yates Memorandum
The False Claims Act (FCA) is the federal government’s chief weapon to combat false or fraudulent claims made to the government and has resulted in billions of dollars of recoveries. In recent years, broad interpretation of...more
The Supreme Court’s decision in Universal Health Services v. United States ex rel. Escobar reframes when falsity may be implied under the False Claims Act (FCA) and raises the bar for materiality under the statute. Though the...more
On Monday, the Second Circuit overturned a jury verdict and $1.27 billion penalty against Bank of America imposed under the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA), 12 U.S.C. § 1833a....more
5/25/2016
/ Bank of America ,
Breach of Contract ,
Burden of Proof ,
Countrywide ,
False Claims Act (FCA) ,
Fannie Mae ,
FIRREA ,
Fraud ,
Intent ,
Jury Verdicts ,
Penalties
Today, the Second Circuit affirmed the dismissal of False Claims Act (“FCA”) claims against Wells Fargo, finding a general certification of compliance with “any laws or regulations” too broad to support an FCA action and...more
Last week, in U.S. ex rel. Advocates for Basic Legal Equality, Inc. (ABLE) v. U.S. Bank, the Sixth Circuit affirmed the dismissal of a False Claims Act (FCA) suit against U.S. Bank because the conduct alleged by the qui tam...more
Liability under the False Claims Act (FCA) is premised on the submission of a claim for money or property either to a federal government “officer, employee, or agent” or, under certain circumstances, to a nongovernmental...more