News & Analysis as of

Dept. of Justice False Claims Act (FCA)

The United States Department of Justice is a federal executive department established in 1870 by federal statute. The Department is headed by the Attorney General and is responsible for administering and... more +
The United States Department of Justice is a federal executive department established in 1870 by federal statute. The Department is headed by the Attorney General and is responsible for administering and enforcing federal law. The Department is compromised of many different divisions which handle a wide variety of civil and criminal issues.    less -

What the DOJ’s Potential Policy Shift on Qui Tam Actions May Mean for Businesses

by Polsinelli on

In a surprise announcement, the Department of Justice (DOJ) announced that the government will move to dismiss a qui tam action brought under the False Claims Act when it determines that the case has no merit. ...more

Unreliable Expert Collapses DOJ-Led False Claims Act Case

by Holland & Knight LLP on

False Claims Act cases often turn into battles of the experts. But only rarely does that battle turn into a rout. It did last week in a case out of the Eastern District of Virginia, United States ex rel. Ribik v. HCR...more

DOJ Settles Second 60-Day Overpayment Case, Highlights Broader Reach of the FCA’s Reverse False Claims Provision

by Reed Smith on

A recent False Claims Act (“FCA”) settlement involving an allegedly overpaid Florida medical practice reaffirms the interplay between the 60-Day Overpayment Statute and the FCA, but also highlights the importance for all...more

The Past, Present, and Future of Government Regulation of Off-Label Communications – Part 5

In this post, I will be focusing on the intersection of off-label communications with government enforcement of health care fraud through the False Claims Act. Over the past eight years, the U.S. Department of Justice (“DOJ”)...more

Justice Department Abandons Medicare Advantage FCA Suit Against UnitedHealth

On October 13, 2017, the U.S. Department of Justice (DOJ) decided to abandon its lawsuit accusing UnitedHealth Group and affiliated health plans (UnitedHealth) of exaggerating how sick its patients were to procure millions of...more

Repayment Delay Fuels Whistleblower Settlement

On October 13, 2017, the United States Department of Justice (DOJ) revealed that First Coast Cardiovascular Institute, P.A. (FCCI) entered into a Settlement Agreement with the federal government and the State of Florida...more

Early Victory: Judge Dismisses Qui Tam Suit Against UnitedHealthcare

by Arnall Golden Gregory LLP on

On October 5, 2017, in United States of America ex rel. Swoben v. Scan Health Plan, et al. (“Swoben”), Judge John F. Walter of the United States District Court for the Central District of California granted United Health...more

Corporate Actors Held Individually Accountable in Recent False Claims Act Settlement

The Department of Justice (“DOJ”) has sent a clear message that individuals cannot hide behind the corporate shield in its recent settlement with Med-Fast Pharmacy, Inc. and the charges brought against its associated...more

Physicians in the Bulls-eye

by BakerHostetler on

Several recently reported cases highlight the growing risk physicians face if they succumb to competitive pressures, especially offers of remuneration from labs, pharmacies, home health agencies and other providers to whom...more

Dismissal of Medicare Advantage FCA Suit Marks Significant Defeat for Government

by Bass, Berry & Sims PLC on

The U.S. District Court for the Central District of California recently dismissed a complaint-in-intervention filed by the U.S. Department of Justice (DOJ) in U.S. ex rel. Swoben v. Secure Horizons. As previously reported,...more

FY 2018 Forecasts: Winds Shifting on Data Security, Industry Consolidation, and DOJ Enforcement Efforts

In the second of our series about what to watch for in government contracts in fiscal year 2018, we focus on Cybersecurity, Cloud-Based Services, Employment Regulations, M&A, FCA enforcement, and Block Chain....more

Under What Circumstances Can a Private Qui Tam Plaintiff Overrule Government Agency Experts' Use of Administrative Discretion to...

• How have appellate courts applied the Supreme Court’s ruling in Escobar? • If the government is aware of the relator’s allegation, but does not undertake any administrative action to address the defendant’s alleged...more

Red Notice Newsletter - Chinese

ANTICORRUPTION DEVELOPMENTS - Alere Inc. Agrees to Pay More Than $13 Million to Resolve SEC FCPA Enforcement Action - On September 28, 2017, Alere Inc. (“Alere”), a Massachusetts based manufacturer of medical diagnostic...more

Red Notice Newsletter - Russian

ANTICORRUPTION DEVELOPMENTS - Alere Inc. Agrees to Pay More Than $13 Million to Resolve SEC FCPA Enforcement Action - On September 28, 2017, Alere Inc. (“Alere”), a Massachusetts based manufacturer of medical diagnostic...more

False Claims Act Watch: California Federal Judge Dismisses DOJ Complaint Alleging Medicare Advantage Fraud

by Kelley Drye & Warren LLP on

On October 5, the U.S. Department of Justice suffered a setback when a California federal judge dismissed its complaint under the civil False Claims Act (“FCA”). Billed as a test case for the Government, it marked the first...more

Alert: In a Surprise Decision Issued on October 5, 2017, Honorable John Walter, United States District Judge, Dismissed a Medicare...

On October 5, 2017, the Honorable Judge John Walter of the United States District Court, Central District of California, granted the Defendants’ Motion to Dismiss the Medicare Advantage (“MA”) Federal False Claims Act (“FCA”)...more

Red Notice Newsletter - September 2017

ANTICORRUPTION DEVELOPMENTS - Alere Inc. Agrees to Pay More Than $13 Million to Resolve SEC FCPA Enforcement Action - On September 28, 2017, Alere Inc. (“Alere”), a Massachusetts based manufacturer of medical...more

Aegerion Settles Criminal and Civil Probe of Promotional Practices, REMS and HIPAA Compliance, and Patient Assistance Programs

On September 22, 2017, Aegerion Pharmaceuticals resolved a wide-ranging probe by the Department of Justice (DOJ) regarding the company’s U.S. commercial activities relating to Juxtapid, a lipid-lowering agent for the...more

Holding Executives Personally Responsible: An Increasing Government Priority

by McGuireWoods LLP on

Earlier this month, we covered the Spectocor action which involved an executive and his company’s agreement to pay $10.56M of a $13.45M total settlement to resolve allegations involving medically unnecessary Medicare...more

Department of Justice use of Parallel Proceedings

by Dickinson Wright on

Corporations and individuals engaged in a heavily regulated industry, particularly those doing business with the federal government, stand a good chance of being called upon to provide information related to a government...more

A Year Into the Elder Justice Task Force: Is Your Community a Target?

by Baker Ober Health Law on

On March 30, 2016, the Department of Justice issued a press release announcing its launch of ten Elder Justice Task Forces in the Northern District of California, Northern District of Georgia, District of Kansas, Western...more

Six Home Health Providers Agree to Pay $1.8 Million to Settle False Claims Act Liability

by King & Spalding on

On September 5, 2017, the Department of Justice (DOJ) announced that six Tennessee-based home health entities agreed to pay the United States $1.8 million to settle potential violations of the Stark Law and/or Anti-Kickback...more

The Yates Memo: A Reminder that Executives are Vulnerable Too

by McGuireWoods LLP on

The 2015 Yates Memo continues to impact federal prosecutions as the Department of Justice continues to seek accountability from individuals responsible for corporate wrongdoings. As the two year anniversary of the Yates Memo...more

Healthcare Law Update: September 2017

by Holland & Knight LLP on

OIG Advisory Opinions - Manufacturer's Free Replacement of Spoiled Pharmaceutical Products Authorized - On Aug. 25, 2017, the U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG)...more

Department of Justice use of Parallel Proceedings

by Dickinson Wright on

Corporations and individuals engaged in a heavily regulated industry, particularly those doing business with the federal government, stand a good chance of being called upon to provide information related to a government...more

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