Supreme Court Justices Signal Skepticism of Qui Tam Constitutionality -
On Friday, June 16, the US Supreme Court ruled that the US Department of Justice (DOJ) has the authority to dismiss qui tam suits brought under the...more
Recent Interview With FCA Plaintiff Bar Attorneys Offers Key Insight into Trends in Anti-Kickback Litigation -
During a recent interview commemorating the 50th anniversary of the enactment of the Anti-Kickback Statute, two...more
SCOTUS Denies Cert In Cases Addressing FCA Pleadings Requirements -
On Monday, October 17, 2022, the US Supreme Court rejected three petitions asking the Court to resolve a circuit split regarding the Rule 9(b)...more
10/21/2022
/ CIGNA ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Kickbacks ,
Medicare ,
Medicare Advantage ,
SCOTUS ,
Solicitor General ,
TRICARE ,
Whistleblowers
DC Circuit Adopts Pro Tanto Approach to False Claims Act Settlement Offsets -
In an opinion issued on August 30, 2022, the US Court of Appeals for the DC Circuit held in United States v. Honeywell International, Inc., ---...more
DOJ Files Complaint in AWP False Claims Act Suit Against Pharmaceutical Ingredient Seller -
On November 8, 2021, the Department of Justice (DOJ) announced that it intervened in a qui tam suit and filed a False Claims Act...more
11/15/2021
/ Anti-Kickback Statute ,
Bribery ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FBI ,
Fraud ,
Medical Devices ,
Medicare ,
Pharmaceutical Industry ,
Qui Tam ,
TRICARE ,
Whistleblowers
Court Rules Prescription Drug Event and Enrollee Encounter Data Are 'Claims for Payment' Under the False Claims Act -
US District Judge Noel L. Hillman approved a whistleblower’s request to file a Fourth Amended Complaint...more
4/26/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Fair Market Value ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Kickbacks ,
Mail Fraud ,
Medicaid ,
Medicare Part A ,
Medicare Part D ,
Oil & Gas ,
Securities Fraud ,
Whistleblowers ,
Wire Fraud
Urgent Care Provider and Management Company to pay $22.5 Million to End FCA Claims -
South Carolina urgent care providers agreed to pay $22.5 million to resolve False Claims Act claims filed by two former employees. The...more
4/19/2021
/ Corporate Integrity Agreement ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Medicaid ,
Medicare ,
Money Laundering ,
Securities and Exchange Commission (SEC) ,
Securities Fraud ,
Settlement ,
TRICARE ,
Whistleblowers ,
Wire Fraud
Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act -
On February 22, 2021, the United States Supreme Court denied petitions for certiorari in a case that could have addressed the issue of...more
3/1/2021
/ Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare Fraud ,
Hospice ,
Investment Fraud ,
Objective Falsity ,
Qui Tam ,
SCOTUS ,
Securities and Exchange Commission (SEC) ,
Whistleblowers
DOJ’s 2020 False Claims Act Recoveries Lowest Since 2008 -
On January 14, 2021, the Department of Justice (DOJ) announced that it obtained more than $2.2 billion in settlements and judgments from civil cases involving...more
1/25/2021
/ Bribery ,
CARES Act ,
Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Food Drug and Cosmetic Act (FFDCA) ,
Food and Drug Administration (FDA) ,
Fraud ,
IRS ,
Kickbacks ,
Medicaid ,
Medical Devices ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Relief Measures ,
SBA ,
Settlement ,
Whistleblowers ,
Wire Fraud
Deutsche Bank to Pay Over $130 Million to Resolve Foreign Corrupt Practices Act and Fraud Allegations -
Deutsche Bank Aktiengesellschaft (Deutsche Bank) has agreed to pay more than $130 million to resolve the government’s...more
1/18/2021
/ Accounting Controls ,
BDC ,
Bribery ,
Bristol-Myers Squibb ,
Criminal Penalties ,
Deferred Prosecution Agreements ,
Deutsche Bank ,
Disgorgement ,
Drones ,
False Claims Act (FCA) ,
Financial Institutions ,
Foreign Corrupt Practices Act (FCPA) ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Money Laundering ,
Qui Tam ,
Sanofi-Aventis ,
SCOTUS ,
Securities and Exchange Commission (SEC) ,
Spoofing ,
Telemedicine ,
U.S. Navy ,
Whistleblowers ,
Wire Fraud
False Claims Act Legal Developments -
First Circuit Upholds Whistleblower Retaliation Verdict -
On December 9, 2020, the US Court of Appeals for the First Circuit held as a matter of first impression that “the...more
12/21/2020
/ Anti-Corruption ,
Appeals ,
Bribery ,
Conspiracies ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Foreign Corrupt Practices Act (FCPA) ,
Money Laundering ,
Qui Tam ,
Retaliation ,
Title VII ,
Venezuela ,
Whistleblower Protection Policies ,
Whistleblowers
House Committee Chairs Direct White House and Federal Agencies to Preserve Documents during Transition Period to the Biden Administration -
On November 10, 2020, Committee Chairs from the House of Representatives sent...more
Russian National Sentenced to Prison for $100 Million Cyber Fraud Conspiracy -
On October 30, 2020, a Russian national was sentenced to eight years in prison for his role in a scheme to illicitly obtain and use sensitive...more
11/6/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
False Claims Act (FCA) ,
Fraud ,
Healthcare Fraud ,
Medicare ,
Physicians ,
Qui Tam ,
Russia ,
SCOTUS ,
Sensitive Personal Information ,
Whistleblowers
Biotechnology Company Settles False Claims Act Charges for $11.5 million -
The Acting U.S. Attorney for the Southern District of New York announced a settlement with Bio-Reference Laboratories, Inc. (“BRL”), a New...more
9/28/2020
/ Anti-Fraud Provisions ,
Anti-Kickback Statute ,
Biotechnology ,
Broker-Dealer ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Medicare ,
New Jersey ,
Securities and Exchange Commission (SEC) ,
Settlement Agreements ,
TRICARE ,
Whistleblowers
Florida Doctor Charged in $681 Million Fraud Scheme Involving Substance Abuse Treatment -
On July 30, 2020, a criminal complaint was unsealed charging Michael J. Ligotti, D.O., with conspiracy to commit health care fraud...more
8/10/2020
/ Drug Treatment ,
False Claims Act (FCA) ,
Healthcare Fraud ,
Individual Retirement Account (IRA) ,
Kickbacks ,
Medicare ,
Paycheck Protection Program (PPP) ,
Securities and Exchange Commission (SEC) ,
Substance Abuse ,
Whistleblowers ,
Wire Fraud
DME Provider to Plead Guilty to $109 Million Medicare Fraud Scheme -
A Florida-based individual was charged with one count of health care fraud and one count of payment of kickbacks in connection with a federal health care...more
8/3/2020
/ Durable Medical Equipment ,
Identity Theft ,
Kickbacks ,
Market Manipulation ,
Medicaid ,
Medicare ,
Medicare Fraud ,
NFL ,
Popular ,
Shell Corporations ,
Whistleblowers
DOJ Announces $72.3 Million False Claims Act Settlement -
Oklahoma Center for Orthopaedic and Multi-Specialty Surgery, its part-owner and management company, a physician group, and other affiliated entities and individuals...more
Ten Individuals Charged for $1.4 Billion Health Care Billing Schemem -
On June 29, an indictment was unsealed charging ten individuals with health care fraud and wire fraud for allegedly participating in a pass-through...more
7/6/2020
/ Audits ,
CARES Act ,
Coronavirus/COVID-19 ,
Healthcare ,
Healthcare Fraud ,
Indictments ,
Kickbacks ,
Medicare ,
Money Laundering ,
Rural Health Care Providers ,
SCOTUS ,
Skilled Nursing Facility ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Wire Fraud
SEC Adopts Aggressive Approach to COVID-19 Fraud -
The US Securities and Exchange Commission has already initiated multiple investigations into companies seeking to illegally profit from the global coronavirus pandemic...more
5/4/2020
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Fraud ,
Inspector General ,
Medicare ,
Pandemic ,
Securities and Exchange Commission (SEC) ,
Trading Suspension ,
TRICARE ,
Whistleblowers
Nonprofit Hospital System and Physician Practice Reach $10 Million Settlement for False Claims Act Allegations -
Centra Health Inc., a nonprofit hospital system, and Blue Ridge Ear, Nose, Throat and Plastic Surgery, Inc.,...more
4/27/2020
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Kickbacks ,
Maryland ,
Medicaid ,
New York ,
Patient Referrals ,
Qui Tam ,
Relators ,
Stark Law ,
State and Local Government ,
Tax Fraud ,
Whistleblower Awards ,
Whistleblowers
Supreme Court Declines to Resolve Circuit Split Over Deference Owed to Department of Justice Decisions to Dismiss Whistleblower Suits Brought Under the False Claims Act -
On April 6, 2020, the US Supreme Court denied a...more
Headlines that Matter for Companies and Executives in Regulated Industries -
DOJ News -
Tenet Healthcare Agrees to $1.41 Million Settlement of FCA Claims -
Tenet Healthcare Corporation and its affiliated hospital,...more
In the DOJ’s first-ever criminal action against an electronic health records vendor, San Francisco-based Practice Fusion Inc. agreed to pay $145 million to resolve allegations that it received kickbacks from pharmaceutical...more
2/3/2020
/ Anti-Kickback Statute ,
Criminal Penalties ,
Deferred Prosecution Agreements ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Fraud ,
Investigations ,
Kickbacks ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Software ,
Whistleblowers
Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme -
Two individuals pled guilty in Pennsylvania federal court to conspiracy to defraud the Pennsylvania Medicaid program and commit...more
1/24/2020
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Home Health Agencies ,
OIG ,
Whistleblowers
The new numbers – published in DOJ’s annual False Claims Act recoveries statistics for Fiscal Year 2019 – brings FCA recoveries since FY 1987 (the year after Congress amended the FCA to incentivize whistleblowers further to...more