Articles and Blogs

False Claims Act

Are You In or Are You Out? Inpatient Admission Status Is a Key Risk Area for Medicare Providers

[04/26/18]

Posted on April 26, 2018 in Health Law News

Published by: Hall Render

In the continually evolving world of Medicare coverage and payment rules, hospital compliance personnel must look broadly to identify potential risk areas to be addressed within their organization. Based on the facts alleged in two recent False Claims Act qui tam cases, with one of those cases currently proceeding through the federal courts, hospitals... READ MORE

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A Timely Split – Eleventh Circuit Strays from Common Application of the False Claims Act’s Statute of Limitations

[04/17/18]

Posted on April 17, 2018 in False Claims Act Defense

Published by: Hall Render

On April 11, 2018, the Eleventh Circuit Court of Appeals split from the Fourth and Tenth Circuits when it issued an order effectively granting relators in qui tam actions an additional three years to file. The court ruled that § 3731(b)(2)’s three-year limitation, which has traditionally only been applied when the United States is... READ MORE

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“Constructive Discharge” Retaliation Claims Under the False Claims Act: What Form of Intent Must the Employer Have?

[04/09/18]

Posted on April 9, 2018 in HR Insights for Health Care

Published by: Hall Render

A critical element in any claim for retaliation under the False Claims Act is an adverse employment action. Most commonly, FCA retaliation claims rest on an employee’s involuntary termination due to lawful actions taken by the employee in reporting or opposing the submission of false claims to the government. In certain cases, an employee... READ MORE

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Government Traps, Zaps and Zingers

[01/15/18]

Posted on January 15, 2018 in False Claims Act Defense

Published by: Hall Render

In an opinion loaded with linguistic hooks, the United States District Court for the Middle District of Florida recently reinforced the Supreme Court’s holding in Escobar, enthusiastically highlighting the importance of materiality and scienter in FCA cases. Background In U.S. ex rel. Ruckh v. Salus Rehabilitation, LLC, et al., Relators were successful in a... READ MORE

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Fifth Circuit Addresses Pre-Suit Disclosure and Causation Requirements for FCA Theories of Liability

[10/17/17]

Posted on October 17, 2017 in False Claims Act Defense

Published by: Hall Render

The Fifth Circuit recently addressed pre-suit disclosure and causation requirements for FCA theories of liability in United States ex rel. King v. Solvay Pharmaceuticals Inc., 871 F.3d 318 (5th Cir. 2017). Two former employees (“Relators”) of Solvay Pharmaceuticals, Inc. filed a qui tam suit claiming that Solvay induced false Medicaid claims through a variety... READ MORE

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Fourth Circuit Says Attorney General Holds “Unreviewable Veto Power” Over Qui Tam Settlements and Sends Statistical Sampling Issue Back to the Trial Court

[02/17/17]

Posted on February 17, 2017 in False Claims Act Defense

Published by: Hall Render

The Attorney General of the United States has an unreviewable veto power over qui tam settlements, according to the Fourth Circuit’s recent published decision in United States ex rel. Michaels v. Agape Senior Community.[1] In the same decision, the court declined to decide an issue raised by the relators over the trial court’s refusal... READ MORE

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Trial Court Pushes Back on “Fraud with Particularity” Requirement

[01/26/17]

Posted on January 26, 2017 in False Claims Act Defense

Published by: Hall Render

The Federal District Court for the Middle District of Florida appears  to have rejected recent direction from the Eleventh Circuit Court of Appeal to deny a motion to dismiss in a False Claims Act case. In United States ex rel. Napoli et al. v. Premier Hospitalists PL, et al. the whistle-blowers alleged a hospitalist... READ MORE

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OIG Final Rule Significantly Expands Exclusion Authority

[01/19/17]

Posted on January 19, 2017 in Health Law News

Published by: Hall Render

On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE

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DOJ Issues Holiday Blockbuster on Annual FCA Recoveries

[12/27/16]

Posted on December 27, 2016 in Health Law News

Published by: Hall Render

On December 14, 2016, the Department of Justice (“DOJ”) released a report on fraud statistics regarding recovery amounts for False Claims Act (“FCA”) violations in fiscal year 2016 (“Report”). Reaching $4.7 billion from settlements and judgments, this year’s recovery is the third highest annual recovery in FCA history. Health care fraud accounts for a... READ MORE

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Massive Penalty Spike Darkens the FCA Landscape

[06/30/16]

Posted on June 30, 2016 in False Claims Act Defense

Written by: David B. Honig

In November 2015, the Bipartisan Budget Act of 2015 went into effect. One aspect of that act was the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. The new law required that the Program Fraud Civil Remedies Act and the False Claims Act (“FCA”) penalties be “corrected” to adjust for inflation since... READ MORE

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