News & Analysis as of

Motion to Dismiss False Claims Act (FCA) Healthcare Fraud

Epstein Becker & Green

Eleventh Circuit Addresses Rule 9(b) Heightened Pleading Standard in False Claims Act Case

Epstein Becker & Green on

The U.S. Court of Appeals for the Eleventh Circuit has concluded that a successful False Claims Act (FCA) claim should “allege not just a scheme, but a scheme that actually led to false claims being submitted to the...more

Sheppard Mullin Richter & Hampton LLP

Inferential Leaps and Conclusory Kickback Allegations Remain Verboten in False Claims Act Complaints

Last month, the Eleventh Circuit (the “Court”) issued a decision in a False Claims Act (“FCA”) case against a medical supplier that offers welcome clarity for companies facing whistleblower allegations. In Vargas ex rel....more

King & Spalding

Second Circuit Holds No FCA Violation Where Defendant Relied on Favorable OIG Advisory Opinions

King & Spalding on

On April 14, 2025, the Second Circuit issued a summary order holding that the relator failed to plead scienter, a necessary element under the Anti-Kickback Statute (AKS) and the False Claims Act (FCA), where the defendant...more

Bradley Arant Boult Cummings LLP

Eleventh Circuit Further Clarifies its “Reliable Indicia” Pleading Standard Under the False Claims Act

It has long been the law of the Eleventh Circuit that, under the False Claims Act (FCA) and Federal Rule of Civil Procedure 9(b), a relator must provide sufficient “indicia of reliability … to support the allegation of an...more

ArentFox Schiff

Investigations Newsletter: Jury Acquitted Lab Owners in Nearly $40 Million COVID-19 Fraud Case

ArentFox Schiff on

Jury Acquitted Lab Owners in Nearly $40 Million COVID-19 Fraud Case - On March 27, a Florida jury acquitted two testing lab co-owners of conspiracy, health care fraud, and wire fraud charges. Innovative Genomics, LLC...more

Zuckerman Spaeder LLP

The Supreme Court Confirms the Government’s Essentially Unfettered Authority to Dismiss False Claims Act Cases

Zuckerman Spaeder LLP on

On Friday, June 16, 2023, I (sort of) lost my bet that the Supreme Court would follow the path charted in Borzilleri v. Bayer Healthcare Pharmaceuticals, 24 F.4th 32 (1st Cir. 2022) to determine the government’s False Claims...more

BakerHostetler

SCOTUS Majority Affirms the DOJ's Ability to Dismiss Whistleblower Cases Under the False Claims Act - But Dissent Raises Suspicion...

BakerHostetler on

On June 16, 2023, the United States Supreme Court issued an 8-1 decision in the case of United States, ex rel. Polansky v. Executive Health Resources, Inc., which held that the Department of Justice (DOJ) can move to dismiss...more

Cozen O'Connor

It’s (Not) About Time - Government May Move to Dismiss FCA Suit at Any Point During its Pendency

Cozen O'Connor on

On Friday, June 16, 2023, the United States Supreme Court (SCOTUS or the Court) upheld prior decisions by the trial court and Third Circuit in U.S. ex rel. Polansky v. Executive Health Resources, Inc. Polansky involves the...more

Wiley Rein LLP

Supreme Court Clarifies DOJ’s FCA Dismissal Authority

Wiley Rein LLP on

WHAT: On June 16, 2023, the U.S. Supreme Court ruled 8–1 that the Government has broad authority to intervene and dismiss False Claims Act (FCA) suits litigated by relators. U.S. ex rel. Polansky v. Executive Health Resources...more

Stevens & Lee

Supreme Court Grants Government Broad Dismissal Rights in Qui Tam Cases

Stevens & Lee on

The U.S. Supreme Court, in an 8-1 decision written by Justice Kagan, held on June 16 that the United States (“Government”), having initially chosen not to intervene in a False Claims Act (“FCA”) qui tam case, but having...more

Epstein Becker & Green

The United States Is the FCA Party in Interest, Not the Relator – SCOTUS Today

Epstein Becker & Green on

It should come as no surprise to constitutionalists, practitioners under the Federal False Claims Act (31 U.S.C. §§3729–3733) (FCA), and auditors of the oral argument in the case that the Supreme Court has held that the...more

ArentFox Schiff

Investigations Newsletter: Amici Seek Dismissal of Qui Tam Suit From High Court

ArentFox Schiff on

Headlines that Matter for Companies and Executives in Regulated Industries- Amici Seek Dismissal of Qui Tam Suit From High Court - Various medical, business and legal organizations are asking the US Supreme Court to...more

Polsinelli

SCOTUS to Determine Key Aspects of Government Dismissal Authority in FCA Cases

Polsinelli on

The United States Supreme Court recently agreed to hear a case interpreting the False Claims Act (“FCA”) that may affect the government’s involvement in pending and future matters. To resolve a circuit split, the Court will...more

Akerman LLP - Health Law Rx

SCOTUS May Resolve Circuit Split on the Specificity Required of False Claims Act Claims: Relief or More FCA Grief for Providers?

Currently, providers have different risks of potential False Claims Act (“FCA”) liability depending on where they are geographically located due to the difference in the standards required by the U.S. Courts of Appeals...more

The Volkov Law Group

2021 False Claims Act Year in Review: Judicial and Congressional Developments (II of II)

The Volkov Law Group on

As for the Judiciary, the U.S. Supreme Court did not issue any relevant decisions nor grant certiorari in any notable FCA cases in FY21. To the contrary, they denied petitions to review appellate cases of potential...more

Morgan Lewis

Seventh Circuit Creates Third Standard in FCA Dismissal Authority Circuit Split

Morgan Lewis on

The Seventh Circuit’s novel statutory interpretation of the government’s dismissal authority under 31 USC § 3730(c)(2)(A) may have unintended consequences. ...more

Morgan Lewis

Senator Grassley Drafting Legislation to Potentially Limit DOJ Dismissal Power in FCA Cases

Morgan Lewis on

Senator Chuck Grassley plans to propose legislation that would require the US Department of Justice to state its reasons for dismissal of qui tam cases over the objection of the relator. ...more

The Volkov Law Group

False Claims Act 2019 Year in Review

The Volkov Law Group on

Jessica Sanderson, Of Counsel at The Volkov Law Group rejoins us for her annual review of False Claims Act enforcement. 2020 marks the 150th anniversary of the Department of Justice (“DOJ”), and it unwrapped a nice gift:...more

Seyfarth Shaw LLP

In Case You Missed It: Guidance on Health Care Fraud Enforcement and Compliance

Seyfarth Shaw LLP on

The Houston Bar Association and the University of Houston Law Center Health Law & Policy Institute partnered to host the “Guidance on Health Care Fraud Enforcement and Compliance - A Conversation with HHS Counsel and Other...more

Hogan Lovells

FCA Alert: Decision Opens Door to Challenge of Agency Guidance in False Claims Cases

Hogan Lovells on

On November 5, 2019, the United States District Court for the Eastern District of Pennsylvania ruled on a motion to dismiss a False Claims Act (FCA) qui tam suit filed by the United States Department of Justice, long after it...more

McDermott Will & Emery

Remuneration? Not If It’s Fair Market Value, Says Eleventh Circuit

McDermott Will & Emery on

Bingham v. HCA, Inc., a recent Eleventh Circuit case, highlights the centrality of fair market value to Anti-Kickback Statute (AKS) analyses. This decision is significant for several reasons and we expect to see Bingham cited...more

K&L Gates LLP

Qui Tam Quarterly: The Department of Justice False Claims Act Policy Issue

K&L Gates LLP on

In this second installment of Qui Tam Quarterly, K&L Gates breaks down two policy statements by the U.S. Department of Justice ("DOJ"), providing an analysis of both (1) the 2018 "Granston Memo" and related case law; as well...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

Bass, Berry & Sims PLC

Government Files Amended FCA Complaint Against Private Equity Firm and its Portfolio Company

On March 18, 2019, the Department of Justice (DOJ) filed an amended complaint-in-intervention in the False Claims Act (FCA) case against Diabetic Care Rx, LLC d/b/a Patient Care America (PCA); two of PCA’s executives; and the...more

Troutman Pepper Locke

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

Troutman Pepper Locke on

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

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