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False Claims Act

Last Week in the FCA

[10/14/14]

Posted on October 14, 2014 in False Claims Act Defense

Written by: David B. Honig

From October 1 through October 12, 2014, there were 14 federal cases reported that mentioned the False Claims Act. One was previously discussed in the September 2014 FCA Update. Eight more only tangentially discussed the False Claims Act. Five cases might be of interest to parties and counsel in a False Claims Act suit. US... READ MORE

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September 2014 FCA Update

[10/12/14]

Posted on October 12, 2014 in False Claims Act Defense

Written by: David B. Honig

Only one FCA case of interest was decided by a U.S. Circuit Court in September. In US ex rel Parikh v Brown, the Court found that a county hospital and its administrator’s participation in a “simple, brazen kickback scheme” could not be shielded by qualified immunity. The hospital and its administrator split pain center revenues with... READ MORE

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Qui Tam Complaints to Be Reviewed by Criminal Division

[10/01/14]

Posted on October 1, 2014 in False Claims Act Defense

Written by: David B. Honig

Leslie R. Caldwell, Assistant Attorney General for the Criminal Division, announced recently that all new qui tam complaints would be “shared by the Civil Division with the Criminal Division as soon as the cases are filed.” Fraud prosecutors will now review all qui tam complaints to determine whether to open a parallel criminal investigation. READ MORE

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False Claims Act Update, May 2013

[05/15/13]

Posted on May 15, 2013 in False Claims Act Defense

Written by: David B. Honig

Three new FCA cases of interest were reported in the last few weeks. One was discussed previously on FCADefense.com in Toumey Loses Stark/FCA Case Again by Drew Howk. Another, Ulysses, Inc. v. United States is yet another example of the growing trend of failed FCA counter-claims by the Government in response to contract litigation. The Third, Fresenius... READ MORE

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Retained Overpayments Change the FCA Ball Game

[05/05/13]

Posted on May 5, 2013 in False Claims Act Defense

Written by: David B. Honig

False Claims Act defense attorneys have been warning government contractors, particularly Medicare and Medicaid providers, of increased risks and a reduced ability to defend against whistleblower complaints since the passage of the Fraud Enforcement Recovery Act of 2009 (“FERA”). The greatest risk comes from FERA’s addition of a new kind of reverse false claim:... READ MORE

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April False Claims Act Update

[04/15/13]

Posted on April 15, 2013 in False Claims Act Defense

Written by: David B. Honig

Introduction Three cases are addressed in a review of the False Claims Act decisions of the past month. The first, US v. Anchor Mortage Corp., is a significant Seventh Circuit case addressing the proper treble damages calculation under the statute. The second, US ex rel. Carter v. Halliburton, considers the application of the Wartimes Suspension... READ MORE

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Sixth Circuit: Violations of Conditions of Participation Insufficient Basis for FCA Claims

[04/02/13]

Posted on April 2, 2013 in False Claims Act Defense

Written by: David B. Honig and Andrew B. Howk

By David B. Honig and Andrew B. Howk In U.S. v. MedQuest, the Sixth Circuit held that violations by a provider of conditions of participation in Medicare were insufficient as a matter of law to “trigger the hefty fines and penalties created by the FCA.” This case was a reaffirmation by the Sixth Circuit... READ MORE

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CMS Publishes Administrative Ruling and Proposed Rule Providing Additional Part B Payment to Hospitals Denied Inpatient Payment

[03/18/13]

Posted on March 18, 2013 in False Claims Act Defense

Written by: David B. Honig

Executive Summary On March 13, 2013, CMS concurrently released an immediately effective administrative ruling (“CMS Ruling 1455-R” or “Ruling”) and a proposed rule (“Proposed Rule”) reversing CMS policy precluding hospitals from billing on an outpatient basis for inpatient services denied payment on grounds the services should have been provided on an outpatient basis.  Under... READ MORE

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OIG Issues New Guidelines for Review of State FCA Statutes

[03/15/13]

Posted on March 15, 2013 in False Claims Act Defense

Published by: Hall Render

The recent amendments to the False Claims Act, the Fraud Enforcement Recovery Act of 2009 (“FERA”), the Patient Protection and Affordable Care Act of 2010 (“PPACA”), and the Dodd-Frank Wall Street Reform and Consumer Protection Act (“Dodd-Frank”) continue to generate new rules and guidance. Effective 2007, Congress created incentives for States to pass and enforce mirror FCA statutes... READ MORE

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False Claims Act Update

[02/27/13]

Posted on February 27, 2013 in False Claims Act Defense

Written by: David B. Honig

Appellate Court Cases Three appellate-level FCA cases were reported in January and February 2013. Only one, U.S. ex rel. Nathan v. Takeda Pharmaceuticals North America, Inc., was selected for publication. All three cases addressed Rule 9(b)’s requirement that allegations of fraud be lead “with particularity.” The cases, read together, highlight the differences among Circuits... READ MORE

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