News & Analysis as of

Motion to Dismiss Physicians

Foley & Lardner LLP

The Northern District of Illinois Endorses “But For” Causation Standard for AKS-Premised False Claims Act Cases

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A circuit split over the causation standard under the federal Anti-Kickback Statute (AKS) could grow wider after a recent Northern District of Illinois (NDIL) decision. In United States ex rel. Jeffrey Wilkerson & Larry...more

King & Spalding

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

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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

Marshall Dennehey

Pennsylvania Superior Court Affirms Dismissal of Medical Negligence Claims Due to Insufficient Evidence

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Vandever v. Stair, 2025 WL 523863 (Pa. Super. Ct. 2025) - The Pennsylvania Superior Court upheld the dismissal of a medical negligence claim against a physician, finding that the plaintiff failed to present sufficient...more

Greenbaum, Rowe, Smith & Davis LLP

New Jersey Supreme Court Opinion Refines Affidavit of Merit Requirements for Malpractice Case Against Physician Certified in...

In another in the seemingly endless series of decisions parsing the interpretation of the statutory requirements for an affidavit of merit in medical liability claims, on January 22, 2025 the New Jersey Supreme Court issued...more

Husch Blackwell LLP

False Claims Act Update: A Mid-Year Review (2023)

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The Supreme Court issued a number of headline-grabbing decisions this term on topics like religious accommodation, LGBTQ protections, and consideration of race in college admissions. These decisions are wide-reaching and...more

Pullman & Comley - Connecticut Health Law

CT Supreme Court Issues Important Decision Regarding Med Mal Opinion Letters

Health care providers should take note of a recent decision of the Connecticut Supreme Court that may make it easier for individuals to bring medical malpractice actions. In Carpenter v. Daar, 346 Conn. 80 (2023), the court...more

Weber Gallagher Simpson Stapleton Fires &...

NJ Appellate Court Rules that a Settling Defendant Cannot Pursue Contribution from Third-Party Defendant Without a Judgment...

Upon settlement between the estate of a plaintiff, who suffered injuries which resulted in amputation, and a defendant physician, the trial court denied a third-party defendant’s motion to dismiss the joinder complaint...more

McGuireWoods LLP

Court Allows Superseding Indictment Twelve Days Before Trial, Failing to Find Prosecutorial Vindictiveness

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In U.S. v. Georges, 2021 WL 3887183 (S.D. Oh. Aug. 30, 2021), a federal court recently dismissed a defendant’s motion to dismiss a superseding indictment, denying her claim of prosecutorial vindictiveness related to multiple...more

Dorsey & Whitney LLP

SCOTUS Denies Review of Dismissal at DOJ’s Request; Circuit Split Remains

Dorsey & Whitney LLP on

On June 28, 2021, the United States Supreme Court denied review of a Seventh Circuit decision affirming the Department of Justice (“DOJ”)-requested dismissal of a False Claims Act (“FCA”) suit alleging a drug kickback scheme....more

Oberheiden P.C.

Indicted on Healthcare Fraud Charges? 5 Things to Expect & 3 Potential Outcomes

Oberheiden P.C. on

The U.S. Department of Justice (DOJ) is cracking down on healthcare fraud, and many providers are finding themselves facing serious allegations. This includes criminal allegations in many cases. If these allegations lead to a...more

McDermott Will & Emery

2020 Health Antitrust Litigation Update for Providers

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In 2019, the total number of antitrust cases filed against providers dropped to 20 after the 2018 bump (27 cases). In the latest Health Antitrust Litigation Update for Providers, we discuss what kinds of cases were brought...more

Morrison & Foerster LLP - Left Coast Appeals

This Week at The Ninth: Employees, Independent Contractors, and ERISA

This week, this Ninth Circuit once again issued a number of opinions arising from the employment relationship. Here, we focus on two of particular interest. In the first, the Court sought to unravel whether an emergency room...more

Morgan Lewis

Seventh Circuit Creates Third Standard in FCA Dismissal Authority Circuit Split

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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

Troutman Pepper Locke

Employers Beware: Federal Court Upholds Aggressive Law Enforcement Tactics When Investigating False Claims Act Allegations

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Before the government decides whether to intervene in a qui tam action, it is obligated by statute to investigate a whistleblower’s allegations. See 31 U.S.C §?3730(a). But, in the course of that investigation, may the...more

The Volkov Law Group

False Claims Act 2019 Year in Review

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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

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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

McDermott Will & Emery

Third Circuit Perpetuates Tuomey’s Controversial Stark Law “Volume or Value” Standard

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The US Court of Appeals for the Third Circuit endorsed two controversial interpretations of the Stark Law’s “volume or value” standard, known as the correlation theory and the practice “loss” theory in U.S. ex rel. J. William...more

Baker Donelson

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

Baker Donelson on

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

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

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

Bricker Graydon LLP

DOJ moves to dismiss 11 False Claims Act cases

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On December 17, 2018, the Department of Justice (DOJ) moved to dismiss 11 False Claims Act (FCA) cases brought by whistleblowers against pharmaceutical manufacturers and their commercial outsourcing vendors, alleging that...more

Pillsbury Winthrop Shaw Pittman LLP

Can Association Membership Be Tied to Professional Certification?

Talone settlement highlights the continuing risk nonprofit organizations face if they link membership to credentialing. - Antitrust class action targeted American Osteopathic Association’s practice of requiring physicians...more

Holland & Knight LLP

EMTALA as a Basis for a Qui Tam Case?

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The Emergency Medical Treatment & Labor Act (EMTALA) requires a hospital with an emergency department (ED) to provide "an appropriate medical screening examination" when an individual comes to the ED and a request is made on...more

Mintz - Health Care Viewpoints

Tenth Circuit Revives FCA Claim Based on Alleged Lack of Medical Necessity

The Tenth Circuit Court of Appeals has issued a significant decision, finding that a physician’s medical judgment about the medical necessity of heart procedures can be “false or fraudulent” under the federal False Claims Act...more

Jones Day

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

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The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

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