News & Analysis as of

Liability False Claims Act (FCA)

Epstein Becker & Green

First Circuit Joins Sixth and Eighth Circuits in Adopting “But-For” Causation Standard Under the Federal Anti-Kickback Statute for...

Epstein Becker & Green on

In 2010, as part of the Affordable Care Act, Congress resolved a highly litigated issue about whether a violation of the Anti-Kickback Statute (AKS) can serve as a basis for liability under the federal False Claims Act (FCA)....more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Hidden Dangers Lurking in Corporate Integrity Agreements

When I litigated False Claims Act (FCA) cases at the U.S. Department of Justice (DOJ), it was common practice for settlements to require Corporate Integrity Agreements (CIAs) setting forth ongoing duties and responsibilities...more

Perkins Coie

Trump DEI Executive Order Signals Risks of False Claims Act Liability for Government Contractors and Grantees

Perkins Coie on

Among the many issues raised by President Trump’s Executive Order (EO) 14173 (“Ending Illegal Discrimination and Restoring Merit-Based Opportunity”) targeting diversity, equity, and inclusion (DEI) programs is the prospect...more

Proskauer - Health Care Law Brief

Spurred on by the Steward Health Care Bankruptcy, Massachusetts Adopts Bill Regulating Private Equity and REITs in Health Care,...

On January 8, 2025, Massachusetts Governor Maura Healey signed into law House Bill 5159 (the “Bill”). The Bill grants the state new regulatory powers to oversee and review health care transactions involving private equity...more

Dentons

Ep. 45 – Update Your Return of Overpayments Policy to Align With CMS Changes to the 60-day Rule

Dentons on

Providers are required by federal law to return Medicare and Medicaid overpayments within 60 days of identifying the overpayment or they can be liable under the False Claims Act. Since 2016, providers have relied on Centers...more

Troutman Pepper Locke

New Year, New Liability for Private Equity

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Private equity firms and health care companies operating in Massachusetts will now face enhanced liability risks following the recent passage and enactment of legislation regulating private equity investment in Massachusetts...more

Davis Wright Tremaine LLP

CMS Finalizes Changes to the Medicare Parts A and B Overpayment Rule

In the Calendar Year 2025 Medicare Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) finalized changes to the Medicare Parts A and B Overpayment Rule that were proposed in two prior rulemakings. This...more

ArentFox Schiff

Investigations Newsletter: Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties

ArentFox Schiff on

Connecticut State Court Finds Defunct Pharmacy Liable for $39.2 Million in Damages and Penalties - A Connecticut Superior Court judge found Assured Rx, LLC, a Florida-based pharmacy, liable for violating the Connecticut...more

Arnall Golden Gregory LLP

Seventh Circuit Affirms Liability in AKS-Based FCA Suit But Vacates Award of Damages

The United States Court of Appeals for the Seventh Circuit recently considered a district court’s nearly $6 million judgment in a qui tam False Claims Act (“FCA”) suit based on Anti-Kickback Statute (“AKS”) violations. The...more

ArentFox Schiff

Investigations Newsletter: Deputy Attorney General Monaco Warns Industries: “Fraud Using AI is Still Fraud”

ArentFox Schiff on

On March 7, Deputy Attorney General Lisa Monaco delivered the keynote remarks at the American Bar Association’s (ABA) 39th National Institute on White Collar Crime. She noted that artificial intelligence (AI) “holds great...more

Mintz

EnforceMintz — Some of 2023’s Largest FCA Resolutions Involved Stark Law Allegations

Mintz on

The Physician Self-Referral Law — known as the “Stark Law” — broadly prohibits physicians from profiting from self-referrals for “designated health services” (DHS) payable by Medicare or Medicaid. For example, the Stark Law...more

Snell & Wilmer

Scope of FCA Liability Illustrated In Recent Actions Against Higher Education Institutions

Snell & Wilmer on

In the past five years, the Federal Government and “Qui Tam” Realtors have ramped up False Claims Act (“FCA”) actions against higher education institutions. These actions highlight the scope and breadth of potential FCA...more

Arnall Golden Gregory LLP

Senate Introduces Bill Amending False Claims Act Materiality Element and Anti-Retaliation Provision Expanding Liability

On July 25, 2023, Sens. Chuck Grassley (R-IA), Dick Durbin (D-IL), John Kennedy (R-LA), and Roger Wicker (R-MS) introduced the False Claims Amendments Act of 2023. The proposed amendment to the False Claims Act does not...more

PilieroMazza PLLC

2022 FCA Year in Review and Emerging Trends for 2023

PilieroMazza PLLC on

The Department of Justice (DOJ) recovered approximately $2 billion in settlements and judgments from civil cases involving fraud and the False Claims Act (FCA) in Fiscal Year 2022, a sharp decline from 2021 and the lowest...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Reverse False Claims

Previous False Claims Act (FCA) Fundamentals posts have examined how violations of certain federal laws can potentially expose entities to FCA liability when they receive money from the government. This post focuses on how...more

Arnall Golden Gregory LLP

Government Investigations Team Insights - February 2023

AGG’s Government Investigations Team Insights provides periodic updates covering legal and regulatory topics. Our team, which includes former federal prosecutors, SEC enforcement attorneys, and federal agency attorneys, has...more

Arnall Golden Gregory LLP

Does “Objective Reasonableness” Matter? Supreme Court Poised to Address Scienter Standard Under the False Claims Act

On January 13, 2023, the Supreme Court of the United States granted a writ of certiorari in two cases, United States ex rel. Schutte v. SuperValu Inc., 9 F.4th 455 (7th Cir. 2021) and United States ex rel. Proctor v. Safeway,...more

Clark Hill PLC

United States To Address Important Standard Under False Claims Act

Clark Hill PLC on

Recently, the United States Supreme Court granted certiorari to two False Claims Act (“FCA”) cases to determine whether a defendant who acted with an “objectively reasonable” interpretation of the law can still be liable for...more

King & Spalding

Supreme Court to Determine Whether False Claims Act Requires Objective Scienter Standard

King & Spalding on

Last week, the Supreme Court granted review to clarify the scienter requirement in False Claim Act (31 U.S.C. §§ 3729 et seq.) (FCA) cases. This significant decision will affect the scope of FCA liability by addressing what...more

Mintz - Health Care Viewpoints

Supreme Court Justices Agree to Hear Second FCA Issue This Term

As many of our readers are likely aware, last week the Supreme Court agreed to hear a second False Claims Act (FCA) issue this term. Having previously accepted and heard argument on a case concerning the government’s...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Damages

Bass, Berry & Sims PLC on

Having previously examined the falsity, materiality, and scienter elements of the False Claims Act (FCA) in our FCA Fundamentals series, we now turn to what damages can arise from violations of the False Claims Act...more

ArentFox Schiff

Federal Contractors Beware: Firm-Fixed-Price Contract Negotiations & FCA Liability

ArentFox Schiff on

Federal Contractors Beware: Sixth Circuit Recognizes False Claims Act Exposure Based on Allegedly Inflated Labor Cost Estimates Leading To Firm-Fixed-Price Contract. On May 16, 2022, the US Court of Appeals for the Sixth...more

Jones Day

Fourth Circuit Limits Who Can Act "Knowingly" Under False Claims Act

Jones Day on

Health care industry participants frequently operate under nuanced legal frameworks that apply to the receipt of government funds. A breach of these regulations can open the door to draconian liability under the FCA even when...more

Bass, Berry & Sims PLC

Government Contractors Face False Claims Act Liability for Cybersecurity Non-Compliance

Last week, the District Court for the Eastern District of California denied the defendant’s motion for summary judgment of a False Claims Act (FCA) count against Aerojet Rocketdyne (Aerojet) for allegedly fraudulently...more

Foley & Lardner LLP

Health Care Fraud Self Disclosure Protocol: You Discovered Misconduct… Now What?

Foley & Lardner LLP on

When a company decides to self-disclose misconduct (or conduct that may be construed as such) to the government, that decision triggers a stream of additional questions. In the weighty deliberations about whether and what to...more

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