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condition of payment

Incorporation by Reference Does Not Create a Material Condition of Payment

[10/18/22]

Posted on October 18, 2022 in Health Law News, Litigation Analysis

Published by: Hall Render

The Second Circuit Court of Appeals emphasized, in affirming a district court’s ruling on a motion to dismiss, that a contract merely incorporating a statutory or regulatory payment provision by reference, without more, does not make all terms of the statutory and regulatory scheme material, express conditions of payment in False Claims Act cases.... READ MORE

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Relator’s Damages and Documentation Theories Rejected in Halifax

[07/04/14]

Posted on July 4, 2014 in False Claims Act Defense

Written by: Drew B. Howk

This week a Court in the Middle District of Florida dealt a blow to a whistleblower’s allegations of fraud in U.S. ex rel. Baklid-Kunz v. Halifax Hospital Medical Center ruling that: (1) the Relator is barred from recovering damages even if it can prove its allegations and (2) the Relator is barred from arguing or... READ MORE

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Sixth Circuit: Violations of Conditions of Participation Insufficient Basis for FCA Claims

[04/02/13]

Posted on April 2, 2013 in False Claims Act Defense

Written by: David B. Honig and Andrew B. Howk

By David B. Honig and Andrew B. Howk In U.S. v. MedQuest, the Sixth Circuit held that violations by a provider of conditions of participation in Medicare were insufficient as a matter of law to “trigger the hefty fines and penalties created by the FCA.” This case was a reaffirmation by the Sixth Circuit... READ MORE

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