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Goodwin

Securities Litigation Against Life Sciences Companies 2024 Year in Review

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Welcome to our ninth annual report on US securities class actions filed against publicly traded life sciences companies, which include pharmaceutical, biotechnology, medical device, and healthcare companies....more

Health Care Compliance Association (HCCA)

The emerging battle over 'objective reasonableness' in False Claims Act cases

Health Care Compliance Association (HCCA) on

CT Magazine (June 2022) - The Medicare and Medicaid programs are exceedingly complex, and navigating the myriad statutes, regulations, rules, and guidance presents significant challenges for all healthcare providers and...more

Miles & Stockbridge P.C.

The Fourth Circuit Grants Potential Relief from FCA Claims to Medical Providers Struggling to Decipher Medicare Requirements

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Medical providers often are left confused by the incredibly complex statutory and regulatory body of law implemented by the Centers for Medicare and Medicaid Services (CMS). Without further administrative guidance, providers...more

Holland & Knight LLP

Healthcare Law Update: October 2021

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Kathryn Isted In Harbor Healthcare System, L.P. v. United States, 5 F.4th 593 (5th Cir. 2021), the court of appeals ruled that the district court abused its discretion in refusing to exercise its equitable jurisdiction over a...more

Mintz - Health Care Viewpoints

Third Circuit Rejects AseraCare’s “Objective Falsity” Requirement, Allows Scrutiny of Medical Opinions in Hospice False Claims Act...

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Last week, the Third Circuit joined several other appellate courts in finding that medical opinions related to medical necessity of hospice services can be subject to scrutiny and found to be “false” for purposes of proving a...more

Foley & Lardner LLP

Third Circuit Creates Budding Circuit Split in United States v. Care Alternatives, Ruling That “Objective Falsity” Is Not Required...

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The United States Court of Appeals for the Third Circuit ruled last week that whistleblower relators need not show “objective falsity” to prove their claims, and that a dispute among physician experts about a clinical...more

Akin Gump Strauss Hauer & Feld LLP

11th Circuit’s Decision in AseraCare: Important in Determining When Clinical Judgment Regarding Medical Necessity Can Result in an...

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• Reasonable disagreement among clinicians, by itself, does not result in a false claim. • Clinical judgment must be objectively false to constitute an FCA violation. • A clinical judgment may only be objectively false...more

Troutman Pepper Locke

Eleventh Circuit Says Difference Of Opinion Does Not Establish Falsity In False Claims Act Case

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On September 9, in a setback for AseraCare but an overall win for hospice providers, the Eleventh Circuit affirmed a Northern District of Alabama decision to grant a new trial in a False Claims Act (FCA) case against...more

Cadwalader, Wickersham & Taft LLP

Untimely Physician Certifications for Medicare Home Care Claims—Arguably a Technicality—Vulnerable to False Claims Act...

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On June 11, 2018, the United States Court of Appeals for the Sixth Circuit sustained a complaint against a home health care agency alleging that the agency had violated the False Claims Act (the “FCA”) by submitting numerous...more

Holland & Knight LLP

Reasonable Interpretation of Ambiguous Regulation May Not Preclude False Claims Act Liability

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A recent appellate court ruling governing all federal court cases in Florida, Georgia and Alabama establishes that a defendant in a False Claims Act (FCA) case cannot rely on a defense that there was no intent to defraud the...more

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