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Qui Tam Fraud Healthcare Fraud

Oberheiden P.C.

A Guide to Qui Tam Lawsuits for Whistleblowers

Oberheiden P.C. on

One avenue for whistleblowers to take to report fraud against the government is to file a qui tam lawsuit under the federal False Claims Act. These lawsuits are complex because they have not two, but three parties to them –...more

Morrison & Foerster LLP

DOJ Releases 2024 COVID-19 Fraud Enforcement Task Force Report

On April 9, 2024, the United States Department of Justice (DOJ) released a report on the COVID-19 Fraud Enforcement Task Force (“Task Force”), by far DOJ’s most comprehensive review of the Task Force since its creation in...more

K&L Gates LLP

The False Claims Act and Health Care: 2022 Recoveries and 2023 Outlook

K&L Gates LLP on

On 7 February 2023, the US Department of Justice (DOJ) publicly reported the statistics for federal civil fraud recoveries in Fiscal Year (FY) 2022. While the DOJ emphasized in its accompanying press release that “the...more

Nelson Mullins Riley & Scarborough LLP

DOJ Releases Civil Fraud Recovery Statistics for 2022

Last week the Department of Justice (DOJ) issued its annual report of civil fraud recoveries and statistics under the civil False Claims Act (FCA). The Report can be found, and the accompanying DOJ Press Release can be found....more

Jenner & Block

Client Alert: Future Implications of Low Dollar False Claims Act Recoveries for FY2022

Jenner & Block on

The Department of Justice (DOJ) has released its summary of False Claims Act (FCA) recoveries for Fiscal Year 2022. At $2.2 billion, financial recoveries were significantly lower than the $5.7 billion collected the year...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

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Self-Disclosures

Bass, Berry & Sims PLC on

When healthcare providers and other government contractors are subject to scrutiny for bills submitted to the government, it is often the result of a whistleblower complaint filed under the qui tam provisions of the False...more

ArentFox Schiff

Investigations Newsletter: DOJ Attorneys Comment on the Rise of Telehealth Fraud During the COVID-19 Pandemic

ArentFox Schiff on

DOJ Attorneys Comment on the Rise of Telehealth Fraud During the COVID-19 Pandemic - During the 2022 Qui Tam Conference of the Federal Bar Association, DOJ attorneys commented on the dramatic rise in the use of remote...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

The Volkov Law Group

2021 False Claims Act Year in Review: Enforcement Statistics (Part I of II)

The Volkov Law Group on

Worth the Wait? DOJ finally released its Fraud Statistics for FY 2021 and announced the “second largest amount recorded” since 1986: FCPA Settlement and judgment exceed $5.6 billion...more

McGuireWoods LLP

Analysis of DOJ’s 2021 FCA Statistics and the Trends Therein

McGuireWoods LLP on

Last week, the U.S. Department of Justice (DOJ or Department) announced that it recovered over $5.6 billion under the False Claims Act (FCA) in Fiscal Year 2021. That is a massive headline haul that is second only to the...more

McGuireWoods LLP

Seventh Circuit Clarifies Pleading Standard for Anesthesiologist’s False Claims Action

McGuireWoods LLP on

The Seventh Circuit recently reversed a lower court’s ruling that an amended complaint in a qui tam lawsuit filed under the False Claims Act (FCA) alleging fraudulent anesthesiology billing practices failed to meet the...more

Wiley Rein LLP

2021 FCA Recoveries Bounce Back from Decade-Low . . . Maybe

Wiley Rein LLP on

On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more

Baker Donelson

Déjà Vu All Over Again: Pandemic Renews Focus on Ongoing False Claims Act Enforcement Priorities

Baker Donelson on

There are few areas that the pandemic has not touched, directly or indirectly. The Department of Justice Civil Division knows no different, as is reflected in its current statements regarding priorities for False Claims Act...more

ArentFox Schiff

Investigations Newsletter: Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act

ArentFox Schiff on

Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act - On February 22, 2021, the United States Supreme Court denied petitions for certiorari in a case that could have addressed the issue of...more

ArentFox Schiff

Investigations Newsletter: Investment Bank To Pay Over $130 Million To Resolve Foreign Corrupt Practices Act and Fraud Allegations

ArentFox Schiff on

Deutsche Bank to Pay Over $130 Million to Resolve Foreign Corrupt Practices Act and Fraud Allegations - Deutsche Bank Aktiengesellschaft (Deutsche Bank) has agreed to pay more than $130 million to resolve the government’s...more

ArentFox Schiff

Investigations Newsletter: Russian National Sentenced to Prison for $100 Million Cyber Fraud Conspiracy

ArentFox Schiff on

Russian National Sentenced to Prison for $100 Million Cyber Fraud Conspiracy - On October 30, 2020, a Russian national was sentenced to eight years in prison for his role in a scheme to illicitly obtain and use sensitive...more

Epstein Becker & Green

False Claims Act Enforcement During the COVID-19 Pandemic and Beyond

Epstein Becker & Green on

Earlier this summer, Ethan P. Davis, Principal Deputy Assistant Attorney General for the Civil Division of the U.S. Department of Justice (DOJ) delivered remarks addressing DOJ’s top priorities for enforcement actions related...more

King & Spalding

Ninth Circuit Holds That Medical Opinions Do Not Automatically Preclude FCA Liability at the Pleading Stage

King & Spalding on

In late March, the United States Court of Appeals for the Ninth Circuit revived a whistleblower lawsuit under the False Claims Act (FCA) in which a former employee accused a healthcare provider of submitting reimbursement...more

Bass, Berry & Sims PLC

Recent Developments in FCA Pleading Standards – Part One

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

Blank Rome LLP

What DOJ’s FY 2018 False Claims Act Recovery Statistics Reveal

Blank Rome LLP on

The Department of Justice (“DOJ”) recently released its annual fraud statistics for FY 2018. The statistics reveal that False Claims Act (“FCA”) recoveries reached their lowest level since FY 2009. However, although total...more

Morgan Lewis

US Attorney’s Office in Chicago Announces Creation of Health Care Fraud Unit

Morgan Lewis on

Acting US Attorney Joel Levin says the new dedicated unit aims to bring “even greater focus, efficiency, and impact to our efforts in this important area.”...more

McGuireWoods LLP

Mitigating FCA Whistleblower Risk When Employees Leave

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Over the past decade, efforts to enforce health care fraud regulations have been bolstered significantly with increased government funding and a dramatic increase in whistleblower claims filed under the False Claims Act’s qui...more

Cooley LLP

Blog: Key Takeaways from Government Enforcement Panel at ACI Sunshine Conference

Cooley LLP on

Recently, representatives from the United States Attorney’s Office for the Northern District of Georgia, United States Attorney’s Office for the District of New Jersey, and Medicaid Fraud Control Unit (MFCU) for the Office of...more

Faegre Drinker Biddle & Reath LLP

Government Joins Lawsuit Against Florida Doctor Alleging Fraud and Kickbacks

In a move demonstrating the government’s continued aim to combat health care fraud through its Health Care Fraud Prevention and Enforcement Action Team (HEAT), the Department of Justice announced today that the government has...more

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