News & Analysis as of

FRCP 9(b) Medicare

Akin Gump Strauss Hauer & Feld LLP

False Claims Act - Year In Review: Five Decisions That Will Affect the Future of FCA Litigation - The Salcido Report: False Claims...

Key Points: - False Claims Act plaintiff cannot use discovery to satisfy Fed. R. Civ. P. 9(b). - Payment of fair market value is a dispositive defense in FCA actions alleging a violation of the Anti-Kickback Statute. ...more

Baker Donelson

Plausibility Requirement for Pleading in FCA Cases Remains a Viable Defensive Tool

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The recent federal court opinion issued in United States ex rel. Integra Med Analytics, LLC v. Baylor Scott & White Health, et al, illustrates the continued importance of examining the plausibility of allegations made in qui...more

Mintz - Health Care Viewpoints

Health Care Fraud Investigations and Litigation Offer Unexpected Lessons for Bankruptcy Counsel

WHAT’S INSIDE - Who Decides How Bankruptcy Laws Are Applied? PROMESA: An Experiment Doomed to Fail - The Role of Alter Ego in Restructuring - SPECIAL FRAUD SECTION - Don’t Depend on a Handshake - Health...more

Troutman Pepper

Relators Continue to Face Pleading Hurdles in FCA Cases Post-Escobar

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The Northern District of Illinois is the latest court to grant a defendant’s motion to dismiss in a False Claims Act (FCA) case, after the relator failed to meet the substantial pleading burden established in the U.S. Supreme...more

McDermott Will & Emery

Eighth Circuit Rejects FCA Claim for Failure to Allege Actual Claims for Payment

McDermott Will & Emery on

On February 11, 2019, the Eighth Circuit affirmed the dismissal of a group of relators’ qui tam suit against Crawford County Memorial Hospital for failure to meet the pleading standards required by Federal Rule of Civil...more

Mintz - Health Care Viewpoints

FCA Defendant Petitions Supreme Court, Argues Statute is Unconstitutional

As many of our readers know, we have been closely following the Polukoff False Claims Act (FCA) qui tam case, which is based on allegations that certain heart procedures performed by a cardiologist were not medically...more

Jones Day

Sixth Circuit 2-1 Ruling Addresses False Claims Act Materiality and Scienter Standards

Jones Day on

The Decision: A divided Sixth Circuit panel held that allegations of submitting late-signed supporting documents to Medicare could plead False Claims Act ("FCA") materiality and scienter. The Reasoning: Timing regulations...more

Holland & Knight LLP

Healthcare Law Update: February 2018

Holland & Knight LLP on

Antitrust - FTC Announces Revised Hart-Scott-Rodino Thresholds for Acquisitions and Exclusive Licenses - The Federal Trade Commission (FTC) has announced this year's revisions to the thresholds under the...more

Troutman Pepper

Federal Court Strikes DOJ's Risk Adjustment False Claims Act Case - For Now

Troutman Pepper on

On October 5, a federal district court in California dealt a significant setback to the government’s efforts to extend False Claims Act (FCA) liability to Medicare risk adjustment submissions....more

Holland & Knight LLP

Healthcare Law Update: September 2017

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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

Bass, Berry & Sims PLC

FCA Deeper Dive: Pleading the Alleged Fraud Scheme

Bass, Berry & Sims PLC on

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 are...more

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