Earlier this month, we covered the Spectocor action which involved an executive and his company’s agreement to pay $10.56M of a $13.45M total settlement to resolve allegations involving medically unnecessary Medicare...more
The 2015 Yates Memo continues to impact federal prosecutions as the Department of Justice continues to seek accountability from individuals responsible for corporate wrongdoings. As the two year anniversary of the Yates Memo...more
At the end of last month, the Seventh Circuit issued its opinion on remand in United States v. Sanford-Brown, Ltd., No. 14-2506, — F.3d —-, 2016 WL 6205746 (7th Cir. Oct. 24, 2016) (“Sanford II”). The court once again...more
$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
In May 2016, the United States Supreme Court granted the petition for a writ of certiorari in State Farm Fire & Casualty Co. v. United States, ex rel. Rigsby, et al. During the next term, the Supreme Court will hear oral...more
The Supreme Court handed down its much-anticipated opinion in Universal Health Services, Inc. v. United States ex rel. Escobar et al. yesterday—a case addressing the viability of the implied certification theory in FCA...more
The Supreme Court handed down its much-anticipated opinion in Universal Health Services, Inc. v. United States ex rel. Escobar et al. yesterday—a case addressing the viability of the implied certification theory in FCA...more
The DOJ recently intervened in a lawsuit against Prime Healthcare Services, Inc., and its subsidiaries (“Prime”). The lawsuit alleges that Prime submitted claims for medically unnecessary services and routinely pressured its...more
The FCA’s implied certification theory is based on the concept that every time a payee submits a claim to the government it has impliedly certified compliance with all contractual, statutory, and regulatory obligations, and...more
In United States ex rel. Bias v. Tangipahoa Parish School Bd., — F.3d —-, 2016 WL 906227 (5th Cir. 2016), the Fifth Circuit provided guidance on the scope of individuals with standing to bring an FCA retaliation claim under...more
In United States ex rel. Adams v. Aurora Loan Servs., Inc., 2016 WL 697771, — F.3d —- (9th Cir. Feb. 22, 2016), the Ninth Circuit found that Fannie Mae and Freddie Mac were not government entities for purposes of the False...more
It is often stated that the sine qua non (the indispensable and essential action) of a violation of the False Claims Act (FCA) is the submission of a false or fraudulent claim. This principle has been recognized and cited in...more
A whistleblower was recently denied any portion of the Government’s recovery in a False Claims case despite the Government obtaining a settlement of approximately $322 million. The decision arose in the case of United States...more
Although litigants frequently contend that the opposing party’s arguments are without factual or legal support, it is uncommon and unconventional for a litigant to contend that the opposing party has violated the FCA by...more
The qui tam provisions of the False Claims Act (FCA) are broad in scope and permit a wide array of individuals to pursue FCA litigation as relators acting on behalf of the Government. However, the ability of individuals to...more
In United States ex rel. Wilhelm v. Molina Healthcare of Florida, No. 12-24298, 2015 WL 5562313 (S.D. Fla. Sept. 22, 2015), the court provided further clarification on two frequently litigated issues of the FCA’s public...more
This rarely litigated question was presented to the Seventh Circuit in Patrick v. Commissioner of Internal Revenue, No. 14-2190, 2015 WL 5024985, — F.3d —- (Aug. 26, 2015). Previously, the First Circuit, in Fresenius Medical...more
The first to file bar is a limitation on the rights of members of the public to commence certain litigation under the FCA. In essence, the first to file bar prevents a member of the public from commencing an action based...more
CMS recently announced that it would be releasing Medicare hospital utilization and payment data, as well as physician and supplier utilization and payment data. This is the third year that the hospital data has been released...more
On January 8, 2015, the Fourth Circuit determined that, amid a circuit split, the “implied certification” theory of liability under the False Claims Act (“FCA”) was viable in the Fourth Circuit. United States v. Triple...more
7/19/2015
/ Anti-Retaliation Provisions ,
False Claims Act (FCA) ,
Fraud ,
FRCP 9(b) ,
Implied Certification ,
Pleading Standards ,
Protected Activity ,
Scienter ,
Split of Authority ,
Whistleblowers ,
Wrongful Termination
In United States ex rel. Holmes v. Northrop Grumman Corp., No. 1:13-cv-85, 2015 WL 3504525 (S.D. Miss. June 3, 2015), the court answered this question with a resounding “no” and provided a laundry list of ethical violations...more
6/9/2015
/ Confidentiality Agreements ,
Construction Contracts ,
Dismissal With Prejudice ,
False Claims Act (FCA) ,
Legal Ethics ,
Model Rules ,
Preemption ,
Protective Orders ,
Qui Tam ,
Relators ,
Rules of Professional Conduct ,
U.S. Navy ,
Vessels
On Wednesday the Supreme Court, in Kellogg Brown & Root Services, Inc. v. United States ex rel. Carter, No. 12-1497 (2015), held that the Wartime Suspension of Limitations Act (“WSLA”) only tolls the statute of limitations...more
Does the False Claims Act’s antiretaliation provision, 31 U.S.C. § 3730(h)(1), apply to an “employer that fire[s] an employee after discovering that the employee was a whistleblower and relator in an ongoing qui tam action...more
Although a Federal district court refrained from providing a definitive answer to this question, it appears unlikely given the court’s holding and reasoning in United States v. U.S. Bank, N.A., No. 3:13-cv-704, 2015 WL...more
On May 1, 2015, in United States ex rel. Jacobs v. Lambda Res., Inc., No. 14-3705, 2015 WL 1948247 (6th Cir. May 1, 2015), the Sixth Circuit Court of Appeals affirmed the lower court’s award of sanctions against a relator and...more