News & Analysis as of

False Claims Act (FCA) Statistical Sampling

K&L Gates LLP

Qui Tam Quarterly - Data on Defense: Invalidating FCA Allegations Based on Statistical Sampling and Extrapolation

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Statistical sampling and extrapolation have become accepted tools for establishing damages in health care administrative proceedings and False Claims Act (FCA) litigation over the past 30 years. Key Takeaways - 1....more

Polsinelli

DOJ Cuts Bait in High-Profile Statistical Sampling FCA Case

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On Thursday, AseraCare, a national hospice care provider, announced that it had settled a long-standing Medicare billing dispute with the DOJ, a case that has garnered nationwide attention in healthcare since 2008. At issue...more

American Conference Institute (ACI)

[Event] False Claims and Qui Tam Enforcement Forum – Strategies to Respond to the Rapidly Changing Landscape of False Claims Act...

With more than 34.8 billion recovered by the government since 2010 under the federal False Claims Act, it has never been more crucial for private practitioners and corporate in-house counsel to keep abreast of the changes and...more

King & Spalding

Two Recent FCA Cases Reflect Courts’ Continued Skepticism of Statistical Sampling To Prove FCA Liability

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Courts are continuing to grapple with whether relators can use statistical sampling to prove liability in False Claims Act (FCA) cases. As demonstrated by two recent cases, courts remain skeptical that relators can meet...more

Sheppard Mullin Richter & Hampton LLP

Healthcare Industry Beware: The Use of Statistical Sampling to Establish Damages and Liability Under the False Claims Act Remains...

The False Claims Act contains numerous requirements that are designed to prevent meritless cases from proceeding to discovery and trial. Among these provisions is the rule that, to establish liability, the government or a...more

Arnall Golden Gregory LLP

Health Care Fraud Institute Held at Georgia Bar Headquarters

On December 7, 2017, the Institute for Continuing Legal Education (ICLE) of the State Bar of Georgia held its annual Health Care Fraud Institute. Topics discussed at the Institute included recent federal and state fraud and...more

Saul Ewing LLP

Statistical Sampling and Individual Liability: FCA Lessons Learned from Whopping $298.5 Million Verdict in United States v....

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Imposing civil penalties and treble damages under the False Claims Act (“FCA”), the Southern District of Texas recently denied defendants’ post-trial motions and entered a staggering $298,498,325 verdict against two mortgage...more

McGuireWoods LLP

Managed Care Quarterly Review: Issue 1

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Tips for Managing Large Claims Disputes Part 1: Pre-Litigation Avoidance and Early Litigation Strategies - Large claims disputes brought by providers against payers are on the rise. Based on previous experience with dozens...more

Bass, Berry & Sims PLC

FCA Deeper Dive: Objective Falsity and Medical Necessity Cases

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we will...more

Hogan Lovells

Top False Claims Act developments In 2017 for ADG companies

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The False Claims Act, 31 U.S.C. §§ 3729-3733, continues to pose unique liability risk for aerospace, defense, and government services (ADG) companies that directly or indirectly conduct business with the U.S. Government. In...more

Morrison & Foerster LLP

The Latest On Statistical Sampling In FCA Cases

After waiting over a year to hear what the Fourth Circuit would say about statistical sampling in False Claims Act cases, the court of appeals recently chose to keep us in suspense. Despite initially granting the relators’...more

Poyner Spruill LLP

Agape Take Two - 4th Circuit Court of Appeals Rules on FCA Statistical Sampling Case

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Last May, we reported on a False Claims Act (FCA) case pending in the 4th Circuit Court of Appeals regarding a claim brought in the U.S. District Court in South Carolina against a network of 24 nursing home providers...more

Bass, Berry & Sims PLC

False Claims Act Dangers on Display in Ruckh

Bass, Berry & Sims PLC on

A recent jury verdict in an FCA lawsuit pending in the United States District Court for the Middle District of Florida resulted in a not-so-subtle reminder of just how high the stakes can be in such litigation....more

King & Spalding

Fourth Circuit Declines to Review Issue of Statistical Sampling Use in FCA Case

King & Spalding on

On February 14, 2017, the U.S. Court of Appeals for the Fourth Circuit issued a long-awaited opinion in the case U.S. ex rel. Michaels v. Agape Senior Community, Inc. et al. (case number 15-2145 and 15-2147). In this FCA...more

BakerHostetler

Improvidently Granted Appeal Statistically Yields Sampling Uncertainty

BakerHostetler on

The Fourth Circuit Court of Appeals agreed in 2015 to hear an interlocutory appeal of a district court’s decision to prohibit a qui tam relator from using statistical sampling to prove liability and damages in a False Claims...more

Latham & Watkins LLP

Fourth Circuit Declines to Address Use of Statistical Sampling in False Claims Act Cases

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Court of Appeals panel rules use of statistical sampling is inappropriate for interlocutory appeal, leaving FCA litigants without any direct appellate court guidance. In the closely watched case United States ex rel....more

Morgan Lewis

Proof by Proxy in FCA Suits? District Court Says It Depends

Morgan Lewis on

Admissibility of statistical sampling to prove liability in FCA suit is fact dependent. In a February 14, 2017 decision, the Fourth Circuit declined to rule on the question of whether statistical sampling can be used to...more

Bass, Berry & Sims PLC

Fourth Circuit Takes a Pass on Statistical Sampling, Finds DOJ's Settlement Veto Authority Unreviewable

Bass, Berry & Sims PLC on

After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more

Mintz - Health Care Viewpoints

Fourth Circuit Permits DOJ to Reject an FCA Settlement, But Punts Decision on Statistical Sampling

In a closely watched False Claims Act (“FCA”) case, the Fourth Circuit Court of Appeals decided that the Department of Justice (“DOJ”) has an unreviewable right to object to a proposed settlement agreement between a relator...more

BCLP

Statistical Sampling in FCA Cases Remains Uncertain, But the Government’s Absolute Veto Power Regarding Settlements Gets Affirmed

BCLP on

While all hoped the Fourth Circuit would finally provide some clarity regarding the use of statistical sampling in False Claims Act (FCA) cases, Valentine’s Day 2017 yielded some surprising events for those awaiting the...more

Hogan Lovells

False Claims Act Alert: Fourth Circuit Punts on Sampling and Extrapolation

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Tuesday, the Fourth Circuit Court of Appeals ruled in the interlocutory appeal in United States ex rel. Michaels v. Agape Senior Community, Inc.. In an opinion considering two significant questions arising under the qui tam...more

Saul Ewing LLP

Fourth Circuit Sidesteps Statistical Sampling Issue

Saul Ewing LLP on

In a decision issued yesterday, the United States Court of Appeals for the Fourth Circuit dismissed an appeal that would have addressed one of the most pressing unresolved issues in False Claims Act jurisprudence: whether...more

McGuireWoods LLP

DOJ Announces Will Appeal Loss in AseraCare, Triggering Issues on Battle of the Experts, Statistical Sampling, and Bifurcation

McGuireWoods LLP on

$200 million and pivotal legal precedent are at stake in the False Claims Act (“FCA”) case against AseraCare, Inc. (“AseraCare”), a for-profit hospice chain that was alleged to have fraudulently submitted claims that falsely...more

Arnall Golden Gregory LLP

Another Court Rejects Statistical Sampling and Rules That Difference of Opinion About Hospice Eligibility Is Insufficient for...

Back in March of this year, in U.S. ex rel. Paradies v. AseraCare, Inc., a district court in Alabama granted summary judgment to a defendant hospice finding that an expert physician’s disagreement with a certifying...more

Poyner Spruill LLP

Corridors - June 2016 - News for North Carolina Hospitals

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Final CMS Rule on the Reporting and Returning of Medicare Overpayments Is a Wake-Up Call for Physicians - Effective March 14, 2016, a final rule published in February 2016 by the Centers for Medicare and Medicaid...more

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