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Fraud, the silent epidemic
10 For 10: Top Compliance Stories For the Week Ending, May 3, 2025
2 Gurus Talk Compliance: Episode 51 – The Compliance Week at 20 Edition
The Next FCRA Frontier: Identity Theft and CFPB Updates — FCRA Focus Podcast
Daily Compliance News: April 29, 2025, The GenZ/RTO Edition
Adventures in Compliance: The Novels – A Study in Scarlet, Introduction to Compliance Lessons
Unlocking the Secrets of Reverse Mortgages — The Consumer Finance Podcast
False Claims Act Insights - DOJ’s Reliance on FCA to Pursue Covid-Related Fraud
10 For 10: Top Compliance Stories For the Week Ending April 12, 2025
Elder Financial Exploitation
Daily Compliance News: April 7, 2025, The Whistleblowers Awarded Edition
An Ounce of Prevention Podcast | Preparing for the UK Failure to Prevent Fraud Offence
Sunday Book Review: March 23, 2025, The Hard-Boiled Edition
10 For 10: Top Compliance Stories For The Week Ending, March 22, 2025
Daily Compliance News: March 14, 2025, The $200 Transaction Edition
PilieroMazza Annual Review: What DOJ’s 2024 FCA Report Means for Government Contractors
Episode 354 -- The New Era of Compliance: Generative AI, Data and Innovation
12 Days of Regulatory Insights: Day 4 - A Focus on the FCA – Regulatory Oversight Podcast
Corruption, Crime & Compliance: Raytheon Pays $950 Million to Resolve Fraud, FCPA, ITAR and False Claims Act Violations
Ninth Circuit Reverses Dismissal of FCA Suit - On Tuesday, the Ninth Circuit reversed the district court’s grant of Express Scripts’ motion to dismiss a whistleblower’s lawsuit accusing Express Scripts of defrauding the US...more
A valuable tool in filing whistleblower claims against companies related to government fraud took a potentially major hit this week when a federal judge in Florida ruled that a significant portion of the statutory scheme...more
On September 30, 2024, in U.S. ex rel. Zafirov v. Florida Medical Associates LLC, Judge Kathryn Mizelle in the Middle District of Florida dismissed a qui tam action under the False Claims Act (“FCA”) on the basis that the...more
On June 16, 2023, the U.S. Supreme Court affirmed that the DOJ properly secured a dismissal of a whistleblower suit accusing Executive Health Resources Inc. of violating the False Claims Act by improperly billing Medicare....more
On June 16, 2023, in United States, ex rel. Polansky v. Executive Health Resources, Inc., the US Supreme Court addressed the government’s authority to dismiss a qui tam False Claims Act (FCA) suit over a relator’s objection...more
In this post, we summarize noteworthy False Claims Act (FCA) decisions so far from 2023. Each of the three circuit court opinions discussed here ruled in favor of the defendants on different aspects of the FCA: the Sixth...more
The year 2021 marks the 10th anniversary of the Bradley False Claims Act Year in Review. In that decade, much has remained the same in FCA enforcement. To start with the obvious: It continues to result in billions of dollars...more
On January 21, 2022, the First Circuit adopted a deferential standard that gives the government broad authority to dismiss False Claims Act (FCA) suits brought by private citizens (or relators) on behalf of the government...more
Walmart successfully ended eight years of protracted litigation under the False Claims Act (“FCA”) on June 4, 2021, when the Sixth Circuit affirmed dismissal of Medicare and Medicaid fraud allegations against the major...more
To date, there has been little consistency in how Health Insurance Portability and Accountability Act (HIPAA) requirements are enforced by the U.S. Department of Health and Human Services (HHS), or the amount of settlements...more
Following the passage of the Affordable Care Act (“ACA”), which placed new limits on physician-owned hospitals, St. Luke’s Health System (“System”) took action to change one of its hospital’s ownership structures through a...more
The Second Circuit Court of Appeals recently emphasized the heightened pleading standard that a relator in a qui tam False Claims Act (“FCA”) suit must satisfy to avoid dismissal under Rule 12(b)(6). United States ex rel....more
The False Claims Act (FCA) continues to be the federal government’s primary civil enforcement tool for imposing liability on healthcare providers who defraud federal healthcare programs. A significant portion of FCA...more
Overview of Qui Tam Activity - We identified 49 health care-related qui tam cases that were unsealed in September and October 2018. The government intervened in whole or in part in 10 of those 49 unsealed cases, which...more
On December 26, 2018, the U.S. Court of Appeals for the Fourth Circuit issued an opinion in United States ex rel. Grant v. United Airlines affirming dismissal of the relator’s False Claims Act (FCA) allegations on the grounds...more
Each year, billions of dollars in damages are paid to the government as a result of False Claims Act (FCA) settlements and judgments. A significant percentage of those damages are paid out to whistleblowers – known as...more
A unanimous panel of the U.S. Court of Appeals for the Eleventh Circuit (Eleventh Circuit) recently affirmed two grants of summary judgment in favor of defendant Lincare, Inc. d/b/a Diabetic Experts of America (collectively,...more
A recent Sixth Circuit opinion in U.S. ex rel. Hirt v. Walgreen Co. should come as welcome news for FCA defendants concerned about the implications of the Sixth Circuit’s application last year, for the first time, of a...more
The Supreme Court’s unanimous decision in State Farm Fire and Casualty Co. v. United States ex rel. Rigsby addresses sanctions for violating the seal provision of the False Claims Act (FCA). ...more
Rigsby places discretion in the hands of district courts as to whether and how to sanction relators who violate the seal requirement in False Claims Act cases. On December 6, 2016, only a month after oral argument, the...more
On Tuesday, the Supreme Court issued an anxiously anticipated False Claims Act (“FCA”) decision in State Farm Fire & Casualty Co. v. United States ex rel. Rigsby, holding that a violation of the statute’s seal requirement...more
The Supreme Court held that a relator’s breach of the seal in a qui tam case does not require mandatory dismissal of the complaint, but the Court declined to articulate what factors are appropriate to consider in determining...more
The Supreme Court held yesterday that a violation of the False Claims Act’s seal provision does not mandate dismissal of a relator’s complaint. Justice Kennedy authored the Court’s opinion in the unanimous 8-0 decision. ...more
In the aftermath of the destruction caused by Hurricane Katrina in 2005, Cori and Kerri Rigsby accused State Farm Fire and Casualty Company of falsely misclassifying wind damage as flood damage, among other misdeeds, leaving...more
On Feb. 29, the Seventh Circuit affirmed the dismissal of a False Claims Act (FCA) suit, holding the relator, Cause of Action, failed to establish subject matter jurisdiction given the FCA’s public disclosure bar (Cause of...more