On Feb. 18, in U.S. v. Regeneron Pharmaceuticals, the First Circuit Court of Appeals joined the Sixth Circuit and the Eighth Circuit in holding that, for purposes of establishing that a claim for payment of items or services...more
2/21/2025
/ Anti-Kickback Statute ,
Appeals ,
Appellate Courts ,
Causation ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Government Agencies ,
Healthcare Fraud ,
Medicare ,
Pharmaceutical Industry ,
Qui Tam ,
Regeneron ,
Summary Judgment ,
Whistleblowers
Last week, the U.S. Supreme Court denied the request of qui tam relators that it review the Sixth Circuit’s recent decision in United States of America ex rel. Martin v. Hathaway, No. 22-1463 (6th Cir.). In so doing, the...more
10/10/2023
/ Anti-Kickback Statute ,
But For Causation ,
Denial of Certiorari ,
False Claims Act (FCA) ,
Health Care Providers ,
Patient Referrals ,
Physicians ,
Qui Tam ,
Relators ,
Remuneration ,
SCOTUS
The False Claims Act’s (FCA) materiality requirement as articulated by the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel. Escobar, 579 U.S. 176 (2016) was again front and center, this time in a...more
On the heels of the Sixth Circuit’s recent decision in Martin v. Hathaway, previously discussed on Health Law Observer, a critical issue in that case, i.e., the meaning of the term “remuneration” for purposes of the federal...more
The U.S. Supreme Court, in an 8-1 decision written by Justice Kagan, held on June 16 that the United States (“Government”), having initially chosen not to intervene in a False Claims Act (“FCA”) qui tam case, but having...more
Two recently decided federal court cases hone in on the proper interpretation and application of three critical components of the Anti-Kickback Statute (“AKS”), namely:
•the requirement that a violation of the AKS must...more
4/17/2023
/ Affordable Care Act ,
Anti-Kickback Statute ,
Bribery ,
Causation ,
False Claims Act (FCA) ,
Federal Health Care Programs (FHCP) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Patient Referrals ,
Qui Tam ,
Rebates ,
Remuneration
A recent U.S. District Court decision provides a good example of how federal courts will apply the public disclosure/original source rules in whistleblower cases alleging that health care providers violated the False Claims...more
An important threshold question in qui tam cases under the False Claims Act is whether the relator-whistleblower is the original source of the information forming the basis for the claim. This is because qui tam actions under...more