News & Analysis as of

Healthcare Fraud Motion to Dismiss Health Care Providers

King & Spalding

Second Circuit Holds No FCA Violation Where Defendant Relied on Favorable OIG Advisory Opinions

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On April 14, 2025, the Second Circuit issued a summary order holding that the relator failed to plead scienter, a necessary element under the Anti-Kickback Statute (AKS) and the False Claims Act (FCA), where the defendant...more

Akerman LLP - Health Law Rx

SCOTUS May Resolve Circuit Split on the Specificity Required of False Claims Act Claims: Relief or More FCA Grief for Providers?

Currently, providers have different risks of potential False Claims Act (“FCA”) liability depending on where they are geographically located due to the difference in the standards required by the U.S. Courts of Appeals...more

Oberheiden P.C.

Indicted on Healthcare Fraud Charges? 5 Things to Expect & 3 Potential Outcomes

Oberheiden P.C. on

The U.S. Department of Justice (DOJ) is cracking down on healthcare fraud, and many providers are finding themselves facing serious allegations. This includes criminal allegations in many cases. If these allegations lead to a...more

The Volkov Law Group

False Claims Act 2019 Year in Review

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Jessica Sanderson, Of Counsel at The Volkov Law Group rejoins us for her annual review of False Claims Act enforcement. 2020 marks the 150th anniversary of the Department of Justice (“DOJ”), and it unwrapped a nice gift:...more

Seyfarth Shaw LLP

In Case You Missed It: Guidance on Health Care Fraud Enforcement and Compliance

Seyfarth Shaw LLP on

The Houston Bar Association and the University of Houston Law Center Health Law & Policy Institute partnered to host the “Guidance on Health Care Fraud Enforcement and Compliance - A Conversation with HHS Counsel and Other...more

Hogan Lovells

FCA Alert: Decision Opens Door to Challenge of Agency Guidance in False Claims Cases

Hogan Lovells on

On November 5, 2019, the United States District Court for the Eastern District of Pennsylvania ruled on a motion to dismiss a False Claims Act (FCA) qui tam suit filed by the United States Department of Justice, long after it...more

McDermott Will & Schulte

Remuneration? Not If It’s Fair Market Value, Says Eleventh Circuit

Bingham v. HCA, Inc., a recent Eleventh Circuit case, highlights the centrality of fair market value to Anti-Kickback Statute (AKS) analyses. This decision is significant for several reasons and we expect to see Bingham cited...more

K&L Gates LLP

Qui Tam Quarterly: The Department of Justice False Claims Act Policy Issue

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In this second installment of Qui Tam Quarterly, K&L Gates breaks down two policy statements by the U.S. Department of Justice ("DOJ"), providing an analysis of both (1) the 2018 "Granston Memo" and related case law; as well...more

Mintz - Health Care Viewpoints

Health Care Fraud Investigations and Litigation Offer Unexpected Lessons for Bankruptcy Counsel

WHAT’S INSIDE - Who Decides How Bankruptcy Laws Are Applied? PROMESA: An Experiment Doomed to Fail - The Role of Alter Ego in Restructuring - SPECIAL FRAUD SECTION - Don’t Depend on a Handshake - Health...more

Bass, Berry & Sims PLC

Government Files Amended FCA Complaint Against Private Equity Firm and its Portfolio Company

On March 18, 2019, the Department of Justice (DOJ) filed an amended complaint-in-intervention in the False Claims Act (FCA) case against Diabetic Care Rx, LLC d/b/a Patient Care America (PCA); two of PCA’s executives; and the...more

Seyfarth Shaw LLP

Management Alert: DOJ Files Motion To Dismiss Eleven False Claims Act Suits

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Seyfarth Synopsis: The United States Department of Justice recently filed a seismic motion to dismiss in a series of healthcare fraud-related cases. ...more

Arnall Golden Gregory LLP

Tenth Circuit Reverses Dismissal of Complaint Alleging False Claims Act Liability for Unnecessary Surgical Procedures

On July 9, 2018, in United States ex rel. Polukoff v. St. Mark’s Hosp., the Tenth Circuit Court of Appeals added to the debate over the role of the False Claims Act in policing medical necessity. ...more

Cadwalader, Wickersham & Taft LLP

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

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

Troutman Pepper Locke

Lessons From a Year of Escobar

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It has been one year since the U.S. Supreme Court’s landmark ruling in Universal Health Services v. United States ex rel. Escobar, which resolved a circuit split as to the validity of the implied false certification theory...more

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