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Settlement Relators

Pietragallo Gordon Alfano Bosick & Raspanti,...

Private Equity Throws FCA Enforcement Off-Kilter

Over the last 15 years, private equity (“PE”) firms have invested hundreds of billions of dollars in the healthcare sector, infiltrating every corner of the industry from emergency rooms and labs to billing providers and...more

Perkins Coie

False Claims Act Qui Tam Lawsuits Increased to 979 in FY 2024—the Highest Ever

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Whistleblowers filed 979 qui tam lawsuits under the False Claims Act (FCA) in Fiscal Year 2024—the highest number in a single year and 35% more than in the prior year—the U.S. Department of Justice (DOJ) announced. Overall,...more

Miles Mediation & Arbitration

Mediating False Claims Act Cases: Issues for Attorneys to Keep in Mind

When I started practicing law in 1981, I focused on labor and employment law. My practice involved management and union matters such as unfair labor practice charges and breaches of collective bargaining agreements. As a...more

Foley Hoag LLP - White Collar Law &...

Hospital Avoids Admissions in False Claims Act Settlement, While Repeat Relator and Government Cash in on Medical Necessity...

There was a noteworthy False Claims Act (FCA) settlement made public yesterday out of the Eastern District of California involving Oroville Hospital. The government accused the Hospital of submitting false claims to Medicare...more

Bass, Berry & Sims PLC

False Claims Act Decisions to Know from Q3 2024

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Courts have addressed multiple False Claims Act (FCA) issues in the third quarter of this year. Below is a summary of top cases involving the constitutionality of the FCA’s qui tam provisions, the FCA’s scienter requirement,...more

Lathrop GPM

Now is Not the Time to Relax: Record Settlements in Stark Law and False Claims Cases

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In early May 2024, the University of Pittsburgh Medical Center (UPMC) agreed to pay $38 million to resolve a False Claims Act case based on alleged Stark Law violations. The size of the settlement in United States ex rel. J....more

Bradley Arant Boult Cummings LLP

False Claims Act - 2023 Year in Review

As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA). We start with the numbers: The Department...more

Bass, Berry & Sims PLC

False Claims Act Decisions to Know from Q2 2023

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In this post, we summarize noteworthy False Claims Act (FCA) decisions from the second quarter of 2023. U.S. Supreme Court Decisions. The second quarter was particularly noteworthy because the Supreme Court decided two...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

Holland & Knight LLP

DOJ's Annual False Claims Act Statistics: Relators Forging Ahead with Success

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The U.S. Department of Justice (DOJ) on Feb. 7, 2023, released its annual statistics for its civil False Claims Act (FCA) and fraud cases from the 2022 fiscal year (FY). Up front, we see the following key takeaways ...more

Perkins Coie

The Number of False Claims Act Cases Reach Record High, But DOJ’s Recoveries Drop to $2.2 Billion in Fiscal Year 2022

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The U.S. Department of Justice (DOJ) obtained more than $2.2 billion in civil False Claims Act (FCA) judgments and settlements in fiscal year (FY) 2022, the lowest such annual total since 2008 and a significant drop from a...more

Bass, Berry & Sims PLC

First False Claims Act Settlement under DOJ’s Cyber-Fraud Initiative

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On March 8, the Department of Justice (DOJ) announced the first settlement under its Civil Cyber-Fraud Initiative, as Comprehensive Health Services, LLC (CHS), a global medical services provider, agreed to pay $930,000 in...more

Bass, Berry & Sims PLC

False Claims Act Decisions and Settlements to Know from Q4 2021

The final months of 2021 saw a flurry of noteworthy False Claims Act (FCA) activity. Among other developments, appellate courts issued important decisions concerning materiality, the government’s qui tam dismissal authority,...more

Bass, Berry & Sims PLC

Recent Developments in False Claims Act Pleading Standards

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The Department of Justice (DOJ) recently released its report detailing the settlements and judgments obtained in 2019 from civil cases involving fraud and abuse claims. As in years past, the substantial majority of these...more

ArentFox Schiff

Investigations Newsletter: Inpatient Rehabilitation Company Agrees to Pay $48 Million to Resolve FCA

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DOJ News - Inpatient Rehabilitation Company Agrees to Pay $48 Million to Resolve FCA Allegations - DOJ announced that Encompass Health Corporation (f/k/a HealthSouth Corporation), the nation’s largest operator of...more

Dorsey & Whitney LLP

An Ambulance Provider’s Long Road to Settlement

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On June 20, 2019, more than six years after the case was first set into motion by the Relator, the U.S. Attorney’s Office for the District of Maryland announced in a press release that Hart to Heart Ambulance Services, Inc....more

King & Spalding

California Federal Judge Rules Insurer Not Obligated to Pay Los Angeles Hospital’s $42 Million Settlement and Investigation Costs...

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On February 12, 2019, U.S. District Court Judge Stephen V. Wilson dismissed a suit brought by Pacific Alliance Medical Center (PAMC) alleging, among other counts, breach of contract against its insurer for failure to cover...more

Bass, Berry & Sims PLC

FCA Deeper Dive: Judicial Review of Settlements

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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...more

Baker Donelson

Court Puts the Brakes on Whistleblower's FCA Parking Claims

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The Department of Justice (DOJ) reports that, in fiscal year 2016 ending September 30, it obtained more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims. More than half of this...more

Bass, Berry & Sims PLC

A Striking EHR Settlement: The DOJ pursues an EHR Vendor for "Causing the Submission" of False EHR Incentive Payment Claims

On May 31, 2017, the U.S. Department of Justice (DOJ) announced a $155 million settlement with eClinical Works (ECW), a nationally-known electronic health records (EHR) software vendor. The settlement arises out of a lawsuit,...more

Bass, Berry & Sims PLC

FCA Issues to Watch: FCA Claims Concerning Physician Compensation

Physician employment arrangements with hospitals have remained a significant area of regulatory scrutiny in recent months with the announcement of several high profile settlements and decisions in key FCA cases involving...more

Dorsey & Whitney LLP

Court Examines Standard for Approval of Settlement of Qui Tam Over a Relator’s Objection

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The False Claims Act (FCA) allows plaintiffs/relators to bring qui tam actions, in which the government may then elect to intervene. The FCA also provides that “[t]he Government may settle a [qui tam] action with the...more

Bass, Berry & Sims PLC

Fourth Circuit Takes a Pass on Statistical Sampling, Finds DOJ's Settlement Veto Authority Unreviewable

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After granting the relators’ petition for an interlocutory review of the district court’s rejection of the use of statistical sampling to establish FCA liability, the Fourth Circuit ultimately declined to reach that issue in...more

Baker Donelson

Update on First 60-Day Case

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A settlement was reached on August 23, 2016, in U.S. ex rel. Kane v. Healthfirst, Inc., et al., No. 11 CIV. 2325 (ER) (SDNY), a little over one year after the judge in that case issued the first judicial interpretation of the...more

Saul Ewing Arnstein & Lehr LLP

When Government Walks in Industry’s Shoes, FCA May Not Apply (and Vice Versa)

In November, an Illinois federal judge blocked a former bank employee from collecting his claimed relator’s share of a potential settlement between the FDIC (acting as the bank’s receiver) and the bank’s former directors. In...more

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