News & Analysis as of

Relators False Claims Act (FCA) Healthcare

Sheppard Mullin Richter & Hampton LLP

DOJ Civil Rights Fraud Initiative Will Use the False Claims Act to Target Antisemitism and DEI Programs

At the end of May, the Department of Justice (DOJ) announced the formation of a Civil Rights Fraud Initiative to “utilize the False Claims Act to investigate and, as appropriate, pursue claims against any recipient of federal...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

Health Care Compliance Association (HCCA)

Private-pay “crime stoppers”: Digesting the Corporate Whistleblower Awards Pilot Program

The U.S. Department of Justice’s (DOJ) Criminal Division launched its Corporate Whistleblower Awards Pilot Program (“Criminal Whistleblower Program”) in August of 2024 to encourage tips for various types of fraud, including...more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Private Equity Throws FCA Enforcement Off-Kilter

Over the last 15 years, private equity (“PE”) firms have invested hundreds of billions of dollars in the healthcare sector, infiltrating every corner of the industry from emergency rooms and labs to billing providers and...more

Perkins Coie

False Claims Act Qui Tam Lawsuits Increased to 979 in FY 2024—the Highest Ever

Perkins Coie on

Whistleblowers filed 979 qui tam lawsuits under the False Claims Act (FCA) in Fiscal Year 2024—the highest number in a single year and 35% more than in the prior year—the U.S. Department of Justice (DOJ) announced. Overall,...more

Bass, Berry & Sims PLC

DOJ Releases Annual Civil Fraud Recovery Statistics and Results… Our Look Behind the Numbers

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On January 15, the Department of Justice (DOJ) released its annual report on civil fraud recoveries for FY2024 along with a press release highlighting DOJ’s civil enforcement efforts....more

Pietragallo Gordon Alfano Bosick & Raspanti,...

Second Circuit Expands Anti-Kickback Statute Liability: “At Least One Purpose” is Enough

In a significant ruling, the Second Circuit Court of Appeals recently expanded the scope of the Anti-Kickback Statute (AKS).The Court joined other circuit courts across the country in adopting, for the first time, the...more

Foley Hoag LLP - White Collar Law &...

Hospital Avoids Admissions in False Claims Act Settlement, While Repeat Relator and Government Cash in on Medical Necessity...

There was a noteworthy False Claims Act (FCA) settlement made public yesterday out of the Eastern District of California involving Oroville Hospital. The government accused the Hospital of submitting false claims to Medicare...more

Akerman LLP - Health Law Rx

Zafirov Decision Sets Stage for Appellate Showdown Over Constitutionality of FCA’s Qui Tam Provision

For the first time ever, a judge has ruled that the qui tam provision of the False Claims Act (FCA), which whistleblowers have used to recover $52 billion on behalf of the government since 1986, is unconstitutional....more

PilieroMazza PLLC

Florida Federal Court Strikes Major Blow to FCA Whistleblowers: Key Takeaways for FCA Defendants

PilieroMazza PLLC on

In a prior blog, PilieroMazza discussed the Supreme Court’s decision in United States ex rel. Polansky v. Executive Health Resources, Inc. In that case, in his dissenting opinion, Justice Clarence Thomas referred to the qui...more

Sheppard Mullin Richter & Hampton LLP

FCA Whistleblowers – No More?

Yesterday, a federal district court in the Middle District of Florida issued a decision that threatens the federal government’s continued reliance on the False Claims Act (“FCA”) as the most powerful weapon in the Department...more

Health Care Compliance Association (HCCA)

The compliance lessons in the wake of the Supreme Court decision in U.S. ex rel Schutte v. SuperValu, Inc.

The False Claims Act (FCA) permits private individuals to bring lawsuits in the name of the United States—called qui tam—against those they believe have defrauded the federal government: 31 U.S.C. § 3730(b). The FCA thereby...more

Bass, Berry & Sims PLC

Second Circuit Clarifies Anti-Kickback Statute’s Scienter Requirement

Bass, Berry & Sims PLC on

On March 12, the U.S. Court of Appeals for the Second Circuit issued an important decision that sheds light on the test for determining scienter under the federal Anti-Kickback Statute (AKS). The Second Circuit reasoned that...more

Cozen O'Connor

Whistleblower Watch - A quarterly update on FCA Enforcement and Qui Tam Litigation - Winter 2024

Cozen O'Connor on

Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

Bass, Berry & Sims PLC

DOJ Releases Annual Civil Fraud Recovery Statistics and Results…A Look Behind the Numbers

Bass, Berry & Sims PLC on

On February 22, the Department of Justice (DOJ) released its annual report of civil fraud recoveries for FY2023, along with a press release highlighting DOJ’s civil enforcement efforts.  Our top ten observations from...more

Bass, Berry & Sims PLC

Second Circuit Rejects Insufficient Service-of-Process Argument, Adopts Relator-Friendly Rule

Bass, Berry & Sims PLC on

On November 28, the U.S. Court of Appeals for the Second Circuit held that the service-of-process clock for a False Claims Act (FCA) qui tam complaint begins to run when the district court orders the complaint to be served,...more

PilieroMazza PLLC

The FCA at the Supreme Court, Part 4 of 4: Government Intervention and Dismissal of FCA Cases

PilieroMazza PLLC on

The False Claims Act (FCA) saw quite a bit of action at the Supreme Court in its most recent completed term. In this fourth and final installment of PilieroMazza’s blog series “The FCA at the Supreme Court,” we examine active...more

Bass, Berry & Sims PLC

False Claims Act Decisions to Know from Q3 2023

Bass, Berry & Sims PLC on

Below are noteworthy False Claims Act (FCA) decisions from the third quarter of 2023. The main issues in the cases are: Materiality. The Fourth Circuit held that a pharmacist’s efforts to falsify patient eligibility...more

Arnall Golden Gregory LLP

Gamesmanship No More: How the Government’s Dawdling Cut a False Claims Act Verdict in Half

After a substantial jury verdict following a lengthy trial, the United States Court of Appeals for the Fifth Circuit declined to accept the defendants’ invitation to throw out the government’s complaint in intervention as a...more

Proskauer - Health Care Law Brief

Recent Supreme Court Case Affirms Government’s Power to Dismiss Qui Tam Suits

On June 16, 2023, the Supreme Court (the “Court”) in United States ex rel. Polansky v. Executive Health Resources affirmed the federal government’s power to dismiss a False Claims Act (“FCA”) action brought under the qui tam...more

Zuckerman Spaeder LLP

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

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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

Bradley Arant Boult Cummings LLP

Supreme Court Affirms Government Dismissal Power — Subject to Minor Limits — in FCA Qui Tam Cases

On June 16, 2023, the Supreme Court in United States ex rel. Polanksy v. Executive Health Resources, affirmed the Third Circuit’s deferential standard regarding the government’s ability to dismiss False Claims Act (FCA)...more

King & Spalding

U.S. Supreme Court Allows Justice Department to Dismiss Whistleblower Cases

King & Spalding on

On June 16, 2023, the U.S. Supreme Court affirmed that the DOJ properly secured a dismissal of a whistleblower suit accusing Executive Health Resources Inc. of violating the False Claims Act by improperly billing Medicare....more

ArentFox Schiff

US Supreme Court Rules 8-1 in Favor of Government FCA Dismissal Authority

ArentFox Schiff on

On June 16, 2023, in United States, ex rel. Polansky v. Executive Health Resources, Inc., the US Supreme Court addressed the government’s authority to dismiss a qui tam False Claims Act (FCA) suit over a relator’s objection...more

Jones Day

The U.S. Supreme Court Affirms the Government's Authority to Dismiss FCA Qui Tam Cases After Declining to Intervene

Jones Day on

The False Claims Act's ("FCA") use of qui tam relators (private individuals bringing suit on behalf of the government) has long raised both procedural and substantive challenges....more

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