The False Claims Act (FCA) is the federal government’s chief weapon to combat false or fraudulent claims made to the government and has resulted in billions of dollars of recoveries. In recent years, broad interpretation of...more
The Supreme Court’s decision in Universal Health Services v. United States ex rel. Escobar reframes when falsity may be implied under the False Claims Act (FCA) and raises the bar for materiality under the statute. Though the...more
On Monday, the Second Circuit overturned a jury verdict and $1.27 billion penalty against Bank of America imposed under the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 (FIRREA), 12 U.S.C. § 1833a....more
5/25/2016
/ Bank of America ,
Breach of Contract ,
Burden of Proof ,
Countrywide ,
False Claims Act (FCA) ,
Fannie Mae ,
FIRREA ,
Fraud ,
Intent ,
Jury Verdicts ,
Penalties
Today, the Second Circuit affirmed the dismissal of False Claims Act (“FCA”) claims against Wells Fargo, finding a general certification of compliance with “any laws or regulations” too broad to support an FCA action and...more
Last week, in U.S. ex rel. Advocates for Basic Legal Equality, Inc. (ABLE) v. U.S. Bank, the Sixth Circuit affirmed the dismissal of a False Claims Act (FCA) suit against U.S. Bank because the conduct alleged by the qui tam...more
Liability under the False Claims Act (FCA) is premised on the submission of a claim for money or property either to a federal government “officer, employee, or agent” or, under certain circumstances, to a nongovernmental...more
On February 12, 2016, the Centers for Medicare and Medicaid Services (CMS) published its long-awaited final rule (the “Final Rule”) governing the requirement that healthcare providers report and return Medicare overpayments...more
This year continued the trend of aggressive False Claims Act (FCA) enforcement by the Department of Justice (DOJ) and high volumes of qui tam lawsuits brought by whistleblowers. In fiscal year 2015, the DOJ marked the fourth...more
12/22/2015
/ Anti-Kickback Statute ,
Certiorari ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
False-Certification of Conformance ,
Federal Contractors ,
First-to-File ,
Implied Certification ,
Public Disclosure ,
Qui Tam ,
SCOTUS ,
Split of Authority ,
Stark Law ,
Whistleblowers
On August 3, 2015, Judge Edgardo Ramos of the United States District Court for the Southern District of New York issued the first judicial opinion addressing when a health care provider has “identified” a Medicare or Medicaid...more
8/14/2015
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
FERA ,
Hospitals ,
Intervenors ,
Medicaid ,
Medicare ,
Motion to Dismiss ,
Overpayment ,
Overpayment Recovery Time Limits ,
Qui Tam
In what is becoming an annual refrain, 2014 marked another year of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and mushrooming qui tam lawsuits by whistleblowers. Indeed, fiscal year 2014...more
1/19/2015
/ Bank of America ,
Banking Sector ,
Banks ,
BNP Paribas ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Janssen Pharmaceuticals ,
JPMorgan Chase ,
KBR (formerly Kellogg Brown & Root) ,
Qui Tam ,
Settlement Agreements ,
SunTrust ,
US Bank ,
Wartime Suspension of Limitations Act ,
Whistleblower Awards ,
Whistleblowers
Each year brings significant changes and challenges in the laws governing the health care industry, and 2014 proved to be no exception. What the year may have lacked in the high drama that accompanies comprehensive health...more
12/31/2014
/ ACOs ,
Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
CMP Law ,
Cybersecurity ,
Ebola ,
Enforcement ,
Enforcement Actions ,
False Claims Act (FCA) ,
Halbig v Burwell ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
King v Burwell ,
Medicare Shared Savings Program ,
OIG ,
Patient Confidentiality Breaches ,
PHI ,
Popular ,
Stark Law ,
Tax Credits
Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more
1/15/2014
/ Calculation of Damages ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Federal Contractors ,
FERA ,
Fines ,
First-to-File ,
Fraud ,
Halliburton ,
Healthcare ,
Medicare ,
Off-Label Use ,
Overpayment ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Prescription Drugs ,
Public Disclosure ,
Qui Tam ,
Wells Fargo ,
Whistleblowers ,
WSLA
On August 16, 2013, Judge Jed S. Rakoff of the Southern District of New York issued a ruling in in United States v. Countrywide Financial Corp., No. 12 Civ. 1422, that will likely be relevant to any financial institution...more