On March 26, 2025, the U.S. Department of Justice (DOJ) announced that it settled a False Claims Act (FCA) action against a California-based healthcare provider and a separate radiology group for allegedly submitting and...more
On February 21, 2025, the Supreme Court unanimously held that requests for reimbursement from a privately administered fund qualified as “claims” under the False Claims Act (FCA) because the government “provide[d]” a...more
On January 8, 2025, the U.S. Department of Justice (DOJ) announced that a federal grand jury indicted the Chesapeake Regional Medical Center (CRMC) in Virginia for conspiracy to defraud the United States and health care...more
1/30/2025
/ Criminal Conspiracy ,
Criminal Liability ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Hospitals ,
Indictments ,
Medicaid ,
Medicare Advantage ,
Physicians ,
Whistleblowers
On January 21, 2025, President Trump issued an executive order titled “Ending Illegal Discrimination and Restoring Merit-Based Opportunity” (the Order), which seeks to eliminate diversity, equity, and inclusion (DEI) policies...more
1/28/2025
/ Affirmative Action ,
Civil Rights Act ,
Corporate Counsel ,
Department of Labor (DOL) ,
Diversity and Inclusion Standards (D&I) ,
Employment Litigation ,
Executive Orders ,
False Claims Act (FCA) ,
Federal Contractors ,
OFCCP ,
Trump Administration
In a groundbreaking opinion issued on September 30, 2024, Judge Kathryn Kimball Mizelle of the U.S. District Court for the Middle District of Florida dismissed a False Claims Act (FCA) lawsuit, holding that the qui tam...more
In October, the U.S. Department of Justice announced a rare criminal indictment involving the Medicare Advantage program — a contrast from the DOJ's more typical use of its civil enforcement authority to pursue similar issues...more
The U.S. Department of Justice (DOJ) recently announced a rare criminal indictment involving the Medicare Advantage program—a contrast from DOJ’s more typical use of its civil enforcement authority to pursue similar issues...more
11/17/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Cooperation ,
Criminal Prosecution ,
Declination ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Indictments ,
Medicare ,
Medicare Advantage ,
Medicare Advantage Organizations (MAOs) ,
Medicare Part C ,
Voluntary Disclosure
On June 1, 2023, the Supreme Court decided a pair of closely watched False Claims Act (FCA) cases, U.S. ex rel. Schutte v. SuperValu Inc., No. 21-1326, and U.S. ex rel. Proctor v. Safeway, Inc., No. 22-111....more
6/5/2023
/ Drug Pricing ,
False Claims Act (FCA) ,
Materiality ,
Medicaid ,
Medicare ,
Misrepresentation ,
Objective Falsity ,
Pharmacies ,
Prescription Drugs ,
Safeco Insurance Co of America v Burr ,
Scienter ,
SCOTUS ,
Subjective Standard ,
Universal Health Services Inc v United States ex rel Escobar ,
US ex rel Thomas Proctor v Safeway Inc ,
US ex rel Tracy Schutte et al v SuperValu Inc et al
On January 13, 2023, the Supreme Court granted certiorari in a pair of consolidated cases from the Seventh Circuit that could result in one of the most consequential False Claims Act (FCA) decisions since the FCA was amended...more
On January 25, 2022, in United States ex rel. Sheldon v. Allergan Sales, LLC, a divided panel of the U.S. Court of Appeals for the Fourth Circuit held that a defendant accused of violating the False Claims Act (FCA) by...more