William Nash filed a whistleblower case against his former employer but wanted to remain anonymous so that his new employer wouldn’t know that he is—you guessed it–a whistleblower.
William’s qui tam action alleged Medicaid...more
The False Claims Act has a scienter requirement: it makes it illegal to knowingly present a false claim to the government.
So if a company innocently presents a false claim, it can’t be guilty of violating the Act, right?...more
Three affiliated home health companies in Tennessee agreed to pay $1.8 million to settle False Claims Act (FCA) liability. That’s a lot of money, but it’s only about four percent of the $42 million in potential liability...more
There are two major, interrelated reasons why government contractors, including Medicare providers, are so afraid of the False Claims Act (FCA). One is the draconian nature of the liability: treble damages plus up to $21,916...more
If you’re a surgical device distributor and you want to reward a surgeon for using your products on Medicare and Medicaid patients, you may want to choose a reward that’s less conspicuous than a yacht. That’s one lesson in...more
At first glance, it looks nonsensical. How could it be bad news for False Claims Act whistleblowers that the defendant pleaded guilty to violating that statute—to committing the very Medicare fraud the whistleblowers alleged?...more
If you think that ignorance of the law is no excuse, take a look at the Eleventh Circuit’s opinion in US ex rel. Phalp v. Lincare Holdings. It leaves no doubt that in a False Claims Act case, ignorance can be a solid defense....more
It’s so brief—just eleven words in a 23-page, single-spaced opinion—that you could easily overlook it, but the Third Circuit’s recent opinion cites the government’s nonintervention in a qui tam case as evidence supporting...more
In yet another demonstration of the benefits of lifetime tenure, a federal judge in Florida has told the Department of Justice to take a hike. It happened when the DOJ asked for permission to submit a “statement of interest”...more
Intent is a necessary element of a False Claims Act (FCA) violation. If a defendant reasonably relied on advice of counsel in performing the actions at issue, the intent element is absent. That’s the upside of the...more
A recent Fourth Circuit opinion in a False Claims Act case demonstrates that while the government can freeze defendants’ assets before trial with lightning speed, getting them unfrozen can take anywhere from many years to...more
What happens when the government wants to settle a False Claims Act case, but the whistleblowers who filed the case don’t? That was the question before the U.S. District Court for the District of Colorado.
Airport...more
Charged with 33 counts of Medicare fraud netting some $45 million in false claims, Richard Tinimbang invoked a novel defense: “My mom made me do it!”
That, according to Law360, is the gist of the opening statement of...more
The hospital industry is accustomed to far-fetched whistleblower claims: allegations that a hospital knowingly submitted false or fraudulent Medicare or Medicaid claims or fired a whistleblower for trying to prevent such...more
The False Claims Act (FCA) establishes heavy liability (treble damages and penalties that can exceed over $20,000 per claim) for any person who knowingly presents a false claim for payment to the government. It also provides...more
Rule 9(b) requires a whistleblower alleging fraud to “state with particularity the circumstances constituting fraud.” Tom Bingham provided the particularity, but his case was nevertheless dismissed because of the way he came...more
A recent Fourth Circuit decision answers this riddle, “How can a contractor knowingly submit a false claim to the government without violating the False Claims Act (FCA)?” Give up? The answer is blindingly obvious—once...more
On September 1 the Seventh Circuit affirmed dismissal of three of a whistleblower’s four fraud allegations against a mental health clinic, ruling that the allegations were based on the whistleblower’s subjective judgment...more
The Massachusetts federal district court is hands-down winner of the August award for strangest regulatory interpretation of the month.
The interpretation came in the context of denial of Omnicare’s summary judgment...more
The Energizer Bunny has nothing on the whistleblower claim of Robert Cunningham. Here’s what’s happened since Robert files his qui tam action against Millennium Labs back in 2009: the government declined to intervene; seven...more
An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims. That made all the difference in an appeal of summary judgment in...more
Neurologist Dr. David Hammett will receive $4,590,000 as part of a settlement entered into by Lexington Medical Center (LMC) of West Columbia, S.C., and the federal government. Ironically, the hefty compensation comes as a...more
Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit. How can that inside knowledge be a handicap in pressing his claim? A June...more
On June 10 the Third Circuit affirmed a lower court’s dismissal of a physician’s qui tam action against Pottstown Memorial Medical Center (PMMC) for violating the Anti-Kickback Statute (AKS) and False Claims Act (FCA). And...more
Michael Sorenson is an optometrist formerly employed by Outreach Diagnostic Clinic. After he quit, he filed a False Claims action against the eye clinic and the two doctors who owned it. He alleged that the clinic routinely...more