Articles and Blogs

False Claims Act

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

Tags: , , , , , , , , ,

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

Tags: , , , , , , , , ,

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

Tags: , , , , , , , , , , , , , , , , , , , ,

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

Tags: ,

Massive Penalty Spike Darkens the FCA Landscape

[06/30/16]

Posted on June 30, 2016 in False Claims Act Defense

Written by:

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

Tags: , , , , , , , , , , , ,

7th Circuit Rules “Usual and Customary Pricing” Can Include Discount Programs

[05/31/16]

Posted on May 31, 2016 in False Claims Act Defense

Written by:

A recent whistleblower case could have a significant impact on Medicare Part D charge limits and corresponding reimbursement and could have ripple effects for aspects of other Medicare programs. The Seventh Circuit Court of Appeals ruled that reduced prescription prices offered by a large retail pharmacy (here Kmart) to participants enrolled in a popular discount... READ MORE

Tags: , , , , , , , ,

Enforceability of FCA Releases Questioned

[05/30/16]

Posted on May 30, 2016 in False Claims Act Defense

Written by:

Releases of FCA claims my only be effective in very limited circumstances, the Second Circuit Court of Appeals ruled in a decision this week. In US ex rel. Ladas v. Exelis, Inc, et al., the court ruled that a pre-filing release is unenforceable as a matter of public policy – the encouragement of qui... READ MORE

Tags: , , , , , , , ,

Massive Spike in FCA Penalties

[05/04/16]

Posted on May 4, 2016 in False Claims Act Defense

Written by:

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 their... READ MORE

Tags: , , , , , ,

Government Approval and Percentage in FCA Cases

[04/07/16]

Posted on April 7, 2016 in False Claims Act Defense

Published by: Hall Render

An Indiana Federal District Court just published an opinion on an issue of first impression in the Seventh Circuit, the ability of the government to reject or approve a settlement in a case in which they did not intervene. The court also opined on the ability of a whistleblower to enter into a settlement that... READ MORE

Tags: , , , , ,

Sixth Circuit Rejects HITECH FCA Complaint

[03/14/16]

Posted on March 14, 2016 in False Claims Act Defense

Written by:

The Sixth Circuit Court of Appeals, in US ex rel. Sheldon v. Kettering Health Network, affirmed the dismissal of a False Claims Act (“FCA”) suit alleging fraud based upon certifications of compliance with the HITECH Act and a data breach. The HITECH Act, or Health Information Technology for Economic and Clinical Health Act, encourages the... READ MORE

Tags: , , , , ,