News & Analysis as of

Healthcare Motion to Dismiss False Claims Act (FCA)

Paul Hastings LLP

The Verdict Is In: SuperValu Wins at Trial Despite Knowingly Submitting False Claims

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In 2023, we wrote about the Supreme Court’s decision in United States ex. rel. Schutte v. SuperValu Inc. interpreting the False Claims Act’s (FCA) scienter standard to require inquiry into a defendant’s subjective knowledge....more

Epstein Becker & Green

Eleventh Circuit Addresses Rule 9(b) Heightened Pleading Standard in False Claims Act Case

Epstein Becker & Green on

The U.S. Court of Appeals for the Eleventh Circuit has concluded that a successful False Claims Act (FCA) claim should “allege not just a scheme, but a scheme that actually led to false claims being submitted to the...more

Sheppard Mullin Richter & Hampton LLP

Inferential Leaps and Conclusory Kickback Allegations Remain Verboten in False Claims Act Complaints

Last month, the Eleventh Circuit (the “Court”) issued a decision in a False Claims Act (“FCA”) case against a medical supplier that offers welcome clarity for companies facing whistleblower allegations. In Vargas ex rel....more

King & Spalding

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

King & Spalding on

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

Bradley Arant Boult Cummings LLP

Eleventh Circuit Further Clarifies its “Reliable Indicia” Pleading Standard Under the False Claims Act

It has long been the law of the Eleventh Circuit that, under the False Claims Act (FCA) and Federal Rule of Civil Procedure 9(b), a relator must provide sufficient “indicia of reliability … to support the allegation of an...more

ArentFox Schiff

Investigations Newsletter: Jury Acquitted Lab Owners in Nearly $40 Million COVID-19 Fraud Case

ArentFox Schiff on

Jury Acquitted Lab Owners in Nearly $40 Million COVID-19 Fraud Case - On March 27, a Florida jury acquitted two testing lab co-owners of conspiracy, health care fraud, and wire fraud charges. Innovative Genomics, LLC...more

McDermott Will & Emery

This Week in 340B: March 13 – 18, 2024

Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick...more

Zuckerman Spaeder LLP

The Supreme Court Confirms the Government’s Essentially Unfettered Authority to Dismiss False Claims Act Cases

Zuckerman Spaeder LLP on

On Friday, June 16, 2023, I (sort of) lost my bet that the Supreme Court would follow the path charted in Borzilleri v. Bayer Healthcare Pharmaceuticals, 24 F.4th 32 (1st Cir. 2022) to determine the government’s False Claims...more

Polsinelli

Nursing Home Providers Suffer Blow as District Court Denies Motion to Dismiss in “Worthless Services” FCA Action Based on...

Polsinelli on

On March 31, 2023, the United States District Court for the Eastern District of Pennsylvania dealt a blow to a trio of nursing home providers by denying their motion to dismiss a False Claims Act (FCA) claim brought by the...more

Sheppard Mullin Richter & Hampton LLP

SCOTUS to Decide Whether the Government has the Authority to Dismiss an FCA Suit After Initially Declining to Intervene and, if...

Arguments were heard in the case of United States ex rel. Polansky v. Executive Health Resources, Inc., No. 21-1052 to determine whether and on what statutory grounds, the government, after initially declining to intervene,...more

Bradley Arant Boult Cummings LLP

Supreme Court Declines to Clarify FCA Pleading Standard

How much detail must a plaintiff allege to meet the heightened pleading standards that apply in an FCA case? Appellate courts have taken different approaches but given a chance to address a seeming circuit split, the Supreme...more

Polsinelli

SCOTUS to Determine Key Aspects of Government Dismissal Authority in FCA Cases

Polsinelli on

The United States Supreme Court recently agreed to hear a case interpreting the False Claims Act (“FCA”) that may affect the government’s involvement in pending and future matters. To resolve a circuit split, the Court will...more

Farrell Fritz, P.C.

Supreme Court To Decide Standard For Government Dismissal Of False Claims Act Cases

Farrell Fritz, P.C. on

The Supreme Court granted certiorari in a case that will decide two important questions under the False Claims Act (FCA).  In United States ex rel. Polansky v. Executive Health Resources, Inc., the Relator asks the Court to...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

Jones Day

Department of Justice Moves to Dismiss FCA Cases Involving Patient Support Services

Jones Day on

Exercising the government's discretion to dismiss meritless FCA cases, DOJ argues patient support services are "appropriate and beneficial to federal healthcare programs and their beneficiaries." This week, the Department...more

Lowndes

Recent Cases Involving 60-Day Overpayment Rule Should Put Healthcare Providers on Alert

Lowndes on

Two recent federal court cases show that the federal government intends to vigorously enforce the so-called “60-day Rule” for the return of overpayments enacted as part of the Affordable Care Act (the “ACA”) even though the...more

Ballard Spahr LLP

The 60 Day Rule — Identification and Knowing Avoidance

Ballard Spahr LLP on

On August 3, 2015, the United States District Court for the Southern District of New York issued an opinion and order in Kane v. Healthfirst, Inc., et al.[1] that provides the first judicial interpretation of the requirement...more

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