News & Analysis as of

False Claims Act (FCA) Qui Tam

DOJ Releases its 2017 False Claims Act Recovery Statistics

On December 21, 2017, the United States Department of Justice (DOJ) released its annual False Claims Act (FCA) recovery statistics for fiscal year (FY) 2017. The press release measures the DOJ’s total haul at $3.7 billion....more

Another Banner Year for False Claims Act Recoveries Signals More of the Same for 2018

by Blank Rome LLP on

The Department of Justice (“DOJ”) reported $3.7 billion in False Claims Act (“FCA”) settlements and judgments for fiscal year 2017, the 8th straight year of 3-plus-billion-dollar recoveries and 700-plus new cases filed....more

D.C. District Court Clarifies Standard for Laboratory Determination of Medical Necessity

by Epstein Becker & Green on

This past June, a federal district court in the District of Columbia made headlines when it declined to dismiss an action brought by a qui tam plaintiff (“Relator”) against defendant Boston Heart Diagnostics (“Boston Heart”),...more

Unsealed Qui Tam Alleges Nearly $325 Million in Improper Payments

by Baker Ober Health Law on

A recently unsealed qui tam action further demonstrates the growing focus on the propriety of incentive payments made under Medicare and Medicaid's Electronic Health Records (EHR) Incentive Programs. Health care providers...more

Ninth Circuit’s Application of the FCA’s Government-Action Bar Provides Finality to Defendants

by McGuireWoods LLP on

The FCA contains several provisions that are aimed at discouraging “parasitic” or duplicative qui tam actions. One such provision, known as the “government-action bar,” prohibits relators from bring a qui tam action “based...more

The Government Never Dies: Ninth Circuit Upholds Government Action Rule Dismissal - Appellate Court Affirms District Court's...

by Holland & Knight LLP on

• A key ruling by the U.S. Court of Appeals for the Ninth Circuit will block qui tam relators from bringing copycat False Claims Act suits. • In United States ex rel. Max Bennett v. Biotronik, Inc., the Ninth Circuit held...more

Will DOJ Dismiss More Meritless Qui Tam Actions?

by Holland & Knight LLP on

Is the U.S. Department of Justice (DOJ) going to dismiss more meritless qui tam actions brought under the False Claims Act (FCA)? At a conference on Oct. 30, 2017, Michael Granston, the Director of DOJ's Civil Fraud Section,...more

The Expanding False Claims Act Materiality Requirement

by Holland & Knight LLP on

There is a renewed focus on the government’s activities for purposes of the False Claims Act (FCA) materiality analysis and as demonstrated by a number of recently issued decisions, the roster of relevant government actors is...more

DOJ Should Dismiss Meritless False Claims Act Qui Tam Relator Claims

by Jones Day on

The Situation: Despite recently acknowledging the significant burden imposed by frivolous False Claims Act claims and affirming its statutory grant of power to dismiss meritless claims brought by relators, DOJ has maintained...more

Fifth Circuit Decision in Highway Guardrails Case Provides Important Guidance on Materiality in False Claims Act Cases

by Mintz Levin on

The U.S. Court of Appeals for the Fifth Circuit recently decided a case that could have a substantial impact on False Claims Act (“FCA”) jurisprudence with respect to the element of “materiality.” In U.S. ex rel. Joshua...more

Federal Government Will Seek Dismissal of False Claims Act Cases That Lack Merit

by Ruder Ware on

A top official in the U.S. Department of Justice (DOJ) recently announced a major change in the federal government’s position on claims brought under the False Claims Act (FCA). Michael Granston, the director of DOJ’s Civil...more

Change in Policy or Same Old Story? DOJ Suggests it Will Dismiss Unmeritorious Qui Tam Suits

An early report from the Health Care Compliance Association’s Health Care Enforcement Compliance Institute states that DOJ will be moving to dismiss False Claims Act cases that it concludes lack merit. DOJ has not yet posted...more

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

The Case of the Bashful Whistleblower

by Faegre Baker Daniels on

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

Taking A Toll: The Effect Of Post-Judgment Motions On Appeal Deadlines

by Carlton Fields on

Counsel contemplating an appeal often depend on the “tolling” effect of authorized post-judgment motions, which can extend an otherwise-applicable appeal deadline. In particular, in most federal civil cases, the appellant has...more

Vitas Hospice and Chemed Corporation Settle Largest-Ever FCA Claim Against a Hospice

by Baker Ober Health Law on

Vitas Hospice, the largest for-profit hospice chain in the United States, and its owner, Chemed Corporation, agreed to pay $75 million to settle allegations that Vitas Hospice submitted false claims for hospice services...more

Healthcare Employers, Beware: HIPAA Whistleblowers Could Be (Legally) Leaking Protected Health Information

by Fisher Phillips on

In this day and age, healthcare employers are quite familiar with the Health Insurance Portability and Accountability Act (HIPAA), which protects the disclosure of patients’ confidential health information. After all, in the...more

Florida Medical Group Settles False Claims Act Suit Focused Solely on Overpayment Retention

by King & Spalding on

On October 13, 2017, a Jacksonville cardiovascular practice entered into an approximately $440,000 settlement to resolve allegations concerning violations of 42 U.S.C. 1320a-7k (the 60-Day Overpayment Rule) and its Florida...more

Fifth Circuit Ruling Shows Government’s Actions Are Key Under Escobar

by Alston & Bird on

Government contractors continue to closely follow the impact of the U.S. Supreme Court’s landmark False Claims Act decision in Universal Health v. U.S. ex rel Escobar. Most recently, in U.S. ex rel Harman v. Trinity...more

Fifth Circuit Relies on Escobar in Vacating $663 Million FCA Judgment

by Bass, Berry & Sims PLC on

The U.S. Court of Appeals for the Fifth Circuit vacated a $663 million judgment, concluding that the Supreme Court’s opinion in Escobar doomed the plaintiff’s FCA claims on the issue of materiality....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

“No Fraud at All:” Fifth Circuit Reverses $663 Million False Claims Act Jury Verdict Based on Government’s Actual Knowledge

by Arnall Golden Gregory LLP on

On September 29, 2017, in United States ex rel. Harman v. Trinity Indus. Inc. (“Trinity”), the Fifth Circuit Court of Appeals reversed a $663 million jury verdict in a False Claims Act (FCA) case brought against Trinity...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

Mintz Levin Health Care Qui Tam Update - Recently Unsealed Whistleblower Cases: September 2017

by Mintz Levin on

In this month’s issue of our Qui Tam Update, we review an unusual cluster of five cases alleging that common defendants — a health care provider and its subsidiaries — provided medically unnecessary services to hospice,...more

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