News & Analysis as of

Certifications False Claims Act (FCA)

Maynard Nexsen

Recent FCA Settlement Highlights Small Business Certification Issues in Private Equity Transactions

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The Department of Justice ("DOJ") recently announced a $1.75 million false claims settlement with a contractor that "improperly obtained government contracts that were set-aside for small businesses." The DOJ settlement...more

Nelson Mullins Riley & Scarborough LLP

Supreme Court Declines Request to Address False Claims Act Liability For Medically Unnecessary Services

The Supreme Court of the United States declined to take up two circuit court decisions on whether “objective falsity” is a requirement for False Claims Act (FCA) liability. The two cases, United States v. Care Alternatives...more

Bass, Berry & Sims PLC

Supreme Court Declines to Weigh in on Key Falsity Question

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For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes of establishing False Claims Act (FCA)...more

Parker Poe Adams & Bernstein LLP

SBA Releases Long-Awaited Guidance on M&A Rules for Paycheck Protection Program Borrowers

The Small Business Administration (SBA) recently released a procedural notice concerning when a borrower of a Paycheck Protection Program (PPP) loan may forgo SBA approval in connection with a merger or acquisition. The...more

Miles & Stockbridge P.C.

Preparing for Government Investigations in Wake of PPP Loan Certifications

The U.S. Department of Justice (“DOJ”) is scrutinizing borrowers who have applied for loans through the Small Business Administration’s Paycheck Protection Program (“PPP”), established by the Coronavirus Aid, Relief, and...more

PilieroMazza PLLC

The False Claims Act: 2019 Takeaways and 2020 Trends

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The Department of Justice (DOJ) recovered more than $3 billion in settlements and judgments from civil cases involving fraud and the False Claims Act (FCA) in Fiscal Year 2019, and it remains the primary vehicle for the...more

Baker Donelson

CMS Improves Stark Advisory Opinion Process

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The Centers for Medicare & Medicaid Services (CMS) recently updated its advisory opinion regulations, codified at 42 CFR §§ 411.370 through 411.389, in a final rule issued November 15, 2019. The update liberalizes and...more

Dorsey & Whitney LLP

Sixth Circuit: Timing of Physician Certification for In-Home Care Remains Material After Escobar

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A divided panel of the U.S. Court of Appeals for the Sixth Circuit again revived an FCA suit against home-health services providers premised on the providers’ alleged improper procurement of physician medical necessity...more

Jones Day

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

Jones Day on

The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

Ruder Ware

OIG Report Indicates Areas of Hospice Fraud Vulnerability and Issues a Warning to Hospice Providers

Ruder Ware on

The HHS Office of Inspector General recently released a report indicating deficiencies in hospice election statements and physician certification of patient eligibility for hospice care. Medicare hospice care provides help...more

Saul Ewing Arnstein & Lehr LLP

Hospice Care Eligible Patient Certification is a “Condition of Payment” Under False Claims Act

In order to state a cognizable claim under the False Claims Act (“FCA”) on a false certification theory, a plaintiff must allege that a defendant failed to comply with a federal statute or regulation that was a “condition of...more

McGuireWoods LLP

Circuit Court Rules that Ambiguous Regulatory Requirements Cannot Give Rise to FCA Liability

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A recent decision from the United States Court of Appeals for the District of Columbia Circuit evaluated whether a regulatory requirement was sufficiently ambiguous that it precluded a finding of liability under the False...more

Morrison & Foerster LLP

The FCA Impact Of DOJ’s Increased Focus on Small Business

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In 2014, the Small Business Administration reported that almost a quarter of approximately $367 billion of eligible funding for small business contracting, or roughly $91.7 billion, was awarded to small businesses as prime...more

Latham & Watkins LLP

Certifications Under the Trade Agreements Act: 10 Tips to Avoid TAA Traps for the Unwary

Latham & Watkins LLP on

On September 3, 2014, U.K.-based medical device maker Smith & Nephew (the ‘‘Company’’) agreed to pay $8.3 million (plus an additional $3 million in attorney’s fees) to resolve a lawsuit filed under the federal civil False...more

King & Spalding

False Claims Act Update: GSA Contractor Reasonably Relied Upon Distributor Certifications Of Product Origin And Trade Agreements...

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The United States Court of Appeals for the District of Columbia Circuit recently upheld a District Court’s dismissal of a False Claims Act (FCA) complaint against a federal government contractor in a case that will be of...more

Akin Gump Strauss Hauer & Feld LLP

New York Federal Court Holds that False Certification is Not Actionable Under False Claims Act Unless it Involves a Condition for...

United States ex rel. Qazi v. Bushwick United Housing Dev. Fund Corp., et al., 11 Civ. 1592 (BMC) (E.D.N.Y.): A New York federal district court dismissed an action alleging that a day care provider violated the federal and...more

Bradley Arant Boult Cummings LLP

Construction And Procurement Law News- 2012 Fourth Quarter

In this issue: - Ninth Circuit: Underbids Can Constitute False Claims - State Courts Limit CGL Coverage for Property Damage Arising From Defective Construction - Construction Contractor Prevails in...more

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