In This Issue:
- Conditions of participation vs. conditions of payment – a recent trend in False Claims Act cases
- SEC gives first whistleblower award to audit and compliance employee
- Whistleblower verdict upheld against Chicago State University
- Excerpt from Conditions of participation vs. conditions of payment – a recent trend in False Claims Act cases
- Recently, several courts have dismissed False Claims Act suits on the basis that the allegations involved conditions of participation, rather than conditions of payment. The rationale of these courts is that a claim for payment is only “false” for purposes of the False Claims Act when the alleged misconduct involves compliance with statutes or regulations that are a condition of governmental payment of that claim. When, instead, the alleged misconduct involves compliance with statutes or regulations that are conditions of participation in a federal health care program, there is no false claim for payment that can be regulated by the False Claims Act. For defendants facing False Claims Act allegations, then, arguing that the allegations involve conditions of participation could prove a valid defense in some cases.
Please see full publication below for more information.