This past year, the False Claims Act (FCA) continued to be a key tool for the Justice Department and whistleblowers to bring suits against companies, including those in the financial services sector. The Justice Department...more
As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA).
We start with the numbers: The Department...more
2/28/2024
/ Causation ,
Damages ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Materiality ,
Objective Falsity ,
Penalties ,
Qui Tam ,
Relators ,
Retaliation ,
Scienter ,
Settlement ,
Sovereign Immunity ,
Whistleblowers
Significant work goes into settling a False Claims Act action. Defendants may spend months negotiating with the government to reach an agreeable settlement — often even longer if the defendant pursues the arduous...more
The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more
10/31/2023
/ Appeals ,
Dairy Farmers ,
False Claims Act (FCA) ,
Fraud ,
Insurance Claims ,
Insurance Industry ,
Materiality ,
Qui Tam ,
Relators ,
SCOTUS ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends.
Although DOJ brought in the second-highest...more
2/17/2023
/ Antitrust Violations ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Cybersecurity ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Physicians ,
Qui Tam ,
Relators ,
Settlement
Thomas Prose is the founder and owner of a Michigan-based “post-hospitalist” company named General Medicine P.C. (GM), which purports to specialize in the care of post-acute patients in long-term care facilities by providing...more
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
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
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
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
This year continued the trend of aggressive False Claims Act (FCA) enforcement by the Department of Justice (DOJ) and high volumes of qui tam lawsuits brought by whistleblowers. In fiscal year 2015, the DOJ marked the fourth...more
12/22/2015
/ Anti-Kickback Statute ,
Certiorari ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Federal Contractors ,
First-to-File ,
Implied Certification ,
Public Disclosure ,
Qui Tam ,
SCOTUS ,
Split of Authority ,
Stark Law ,
Whistleblowers
On August 3, 2015, Judge Edgardo Ramos of the United States District Court for the Southern District of New York issued the first judicial opinion addressing when a health care provider has “identified” a Medicare or Medicaid...more
8/14/2015
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
FERA ,
Hospitals ,
Intervenors ,
Medicaid ,
Medicare ,
Motion to Dismiss ,
Overpayment ,
Overpayment Recovery Time Limits ,
Qui Tam
In what is becoming an annual refrain, 2014 marked another year of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and mushrooming qui tam lawsuits by whistleblowers. Indeed, fiscal year 2014...more
1/19/2015
/ Bank of America ,
Banking Sector ,
Banks ,
BNP Paribas ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Janssen Pharmaceuticals ,
JPMorgan Chase ,
KBR (formerly Kellogg Brown & Root) ,
Qui Tam ,
Settlement Agreements ,
SunTrust ,
US Bank ,
Wartime Suspension of Limitations Act ,
Whistleblower Awards ,
Whistleblowers
Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more
1/15/2014
/ Calculation of Damages ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
FERA ,
Fines ,
First-to-File ,
Fraud ,
Halliburton ,
Healthcare ,
Medicare ,
Off-Label Use ,
Overpayment ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Public Disclosure ,
Qui Tam ,
Wells Fargo ,
Whistleblowers ,
WSLA