Articles and Blogs

FCA

A New Option for Grant Noncompliance: OIG Releases Grantee Self-Disclosure Program

[08/16/19]

Posted on August 16, 2019 in Health Law News

Published by: Hall Render

On July 11, 2019, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) released the new Grant Self-Disclosure Program Guidance (“Grant Guidance”) for HHS grant recipients and subrecipients. Through the Grant Guidance, OIG provides new self-reporting options for HHS grant recipients and subrecipients who determine that they... READ MORE

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Defendants Successful in FCA Action Alleging Donuts for Referrals

[08/06/19]

Posted on August 6, 2019 in Health Law News

Published by: Hall Render

Last week, a federal district court in Illinois entered judgment for Defendants in an FCA action against a self-proclaimed “one stop shop” health care referral management company, alleging anti-kickback and FCA violations for its arrangement with a care coordination organization for low-income seniors.[1] Originally filed in 2016, this case highlights how even an FCA... READ MORE

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E.D. Wisconsin: Boilerplate Defenses Insufficient; Challenges Wasteful

[07/31/19]

Posted on July 31, 2019 in False Claims Act Defense

Published by: Hall Render

Litigators and litigants should always be wary of templates, unconsidered boilerplate pleadings—and unnecessary motion practice. Last week, a federal court in Wisconsin struck boilerplate affirmative defenses that lacked “short and plain statement of the facts and…the necessary elements of the defenses.”[1] The ruling reinforced the Seventh Circuit’s standards for affirmative defenses—even though the judge... READ MORE

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Greed and Creative Pleading: A Formula for Dismissal Under the FCA

[07/11/19]

Posted on July 11, 2019 in False Claims Act Defense

Published by: Hall Render

On July 5, 2019, the United States Court of Appeals, District of Columbia Circuit issued an opinion enforcing Supreme Court precedent that the False Claims Act (“FCA”) should be reserved for true fraud against the government—not “garden-variety regulatory violations.” In U.S. ex rel. Kasowitz Benson Torres LLP v. BASF Corp.,[1] the D.C. Circuit reviewed... READ MORE

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Supreme Court Extends the FCA Statute of Limitations for Whistleblowers

[05/20/19]

Posted on May 20, 2019 in False Claims Act Defense

Published by: Hall Render

This week, the United States Supreme Court ruled that the government’s 10-year deadline to file FCA actions could be extended to whistleblowers. The Court’s decision in Cochise Consultancy, Inc. et al. v. United States ex rel. Hunt[1] resolved a circuit split that had dogged the courts, whistleblowers and defendants for decades. Health care providers... READ MORE

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DOJ Self-Disclosure and Cooperation Credit

[05/17/19]

Posted on May 17, 2019 in False Claims Act Defense

Published by: Hall Render

The DOJ’s recent revisions to its Justice Manual created a new path for self-disclosing potential fraud to the government – one which is unique in its ability to defray the costs of potential False Claims Act violations. In 2015, Deputy Attorney General Sally Quillian Yates released a memo entitled Individual Accountability for Corporate Wrongdoing, more... READ MORE

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Civil Investigative Demands: Broad, Unfair and Legal

[05/10/19]

Posted on May 10, 2019 in False Claims Act Defense

Published by: Hall Render

The U.S. government’s unilateral investigative powers under the False Claims Act were bolstered by a ruling from the U.S. District Court for the Eastern District of California last week. Ruling on a Petition for Summary Enforcement of a Civil Investigative Demand (“CID”), the court held: Settlement discussions with a person or entity involved in... READ MORE

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Critical Considerations of Implied Certification Under the FCA

[04/04/19]

Posted on April 4, 2019 in False Claims Act Defense

Published by: Hall Render

In a recent case out of Kansas, the Tenth Circuit reiterated the importance of the FCA’s materiality and scienter requirements that the Supreme Court set forth in Escobar: FCA claims must satisfy materiality and knowledge requirements—both of which are rigorous and strictly enforced. A whistleblower must prove knowledge in an implied certification case—it cannot... READ MORE

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A Closer Look at the FCA’s Particularity and Retaliation Requirements

[02/08/19]

Posted on February 8, 2019 in False Claims Act Defense

Published by: Hall Render

In a partial affirmation, the Fourth Circuit weeded out False Claims Act (“FCA”) claims made without particularity, requiring relators to “connect the dots” between the alleged false claims and government payment and highlighted the FCA’s recently amended “objective reasonableness” standard in reviewing retaliation claims. Background In 2010, the FCA was amended to include any... READ MORE

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The DOJ Is Not Backing Down: FCA Cases Recover More Than $2.8 Billion in 2018

[01/09/19]

Posted on January 9, 2019 in Health Law News

Published by: Hall Render

The Department of Justice (“DOJ”) reported it collected more than $2.8 billion in False Claims Act (“FCA”) settlements and verdicts in 2018.¹ This is significantly down from the record $5.69 billion recovered in 2014 and from the $3.6 billion – $4.7 billion in 2015 through 2017. This can primarily be explained by the absence... READ MORE

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