[09/01/20]
Posted on September 1, 2020 in Health Law News
Published by: Hall Render
A recent decision by the Seventh Circuit Court of Appeals addressed the sometimes hostile relationship between the government and the whistleblowers it relies on to prosecute False Claims Act (“FCA”) actions. The resulting opinion was twofold: If the government wants to dictate FCA litigation it must intervene in the lawsuit; and The government has... READ MORE
Tags: False Claims Act, FCA litigation, Inc., LLC v. UCB, U.S. ex rel. CIMZNHCA, whistleblower
[07/29/20]
Posted on July 29, 2020 in Health Law News
Published by: Hall Render
On July 8, 2020, the Department of Justice announced it settled a qui tam action[1] involving alleged violations of the federal and state False Claims Act (“FCA”) for $72.3 million against an Oklahoma surgical specialty hospital, its managers, a physician group and two individual physicians. Part of the factual allegations underpinning the FCA claims... READ MORE
Tags: Anti-Kickback Statute, False Claims Act, FCA, Health Care Real Estate, qui tam, Stark law
[07/01/20]
Posted on July 1, 2020 in False Claims Act Defense, Health Law News
Published by: Hall Render
On June 19, 2020, the Department of Justice (the “DOJ”) announced its Final Rule[1] increasing the penalties assessable under the False Claims Act (“FCA”). The DOJ raised the minimum penalty for a single false claim from $11,181 to $11,665; the maximum penalty from $22,363 to $23,331. Under the False Claims Act,[2] any person who... READ MORE
Tags: DOJ, False Claims Act, FCA, penalties
[03/25/20]
Posted on March 25, 2020 in False Claims Act Defense
Published by: Hall Render
The Southern District of Indiana recently held that a whistleblower must present sufficient evidence to support each alleged false claim, not just one, to survive summary judgment.[1] This holding is a win for FCA defendants that deal in a high volume of claims submitted to the government—like hospitals—and requires whistleblowers to identify every claim... READ MORE
Tags: False Claims Act, FCA, whistleblower
[03/24/20]
Posted on March 24, 2020 in False Claims Act Defense
Published by: Hall Render
Earlier this week, the Second Circuit in Vierczhalek v. MedImmune, Inc.[1] affirmed the dismissal of a relator’s amended complaint, finding she was not an “original source” of new allegations that piggybacked on a public disclosure. Facts of the Case Relator Susan Vierczhalek, M.D., filed a qui tam action in 2009 alleging that drug manufacturer... READ MORE
Tags: False Claims Act, FCA
[03/05/20]
Posted on March 5, 2020 in False Claims Act Defense
Published by: Hall Render
In a matter of first impression, the Third Circuit yesterday held that conflicting medical opinions can create a genuine dispute of material fact as to the element of falsity in a False Claims Act action.[1] Facts of the Case In U.S. v. Care Alternatives, relators alleged that Care Alternatives, a hospice facility, “admitted patients... READ MORE
Tags: False Claims Act, FCA
[02/25/20]
Posted on February 25, 2020 in False Claims Act Defense
Published by: Hall Render
The United States Court of Appeals for the First Circuit issued an opinion creating a national divide on when a relator is an “original source” of an FCA claim, finding that a relator’s secondhand knowledge of fraud was “direct” knowledge. Facts of the Case In United States ex rel. Banigan v. PharMerica, Inc.[1], a... READ MORE
Tags: False Claims Act, FCA
[01/15/20]
Posted on January 15, 2020 in Compliance, Health Law News
Published by: Hall Render
On January 9, 2020, the Department of Justice (“DOJ”) announced that it collected over $3 billion in settlements and judgments under the False Claims Act (“FCA”) in the federal fiscal year 2019. The FCA has historically been the government’s primary tool for combatting perceived fraud, waste and abuse in the health care system, and... READ MORE
Tags: compliance, COMPLIANCE PROGRAM, False Claims Act, FCA, kickbacks, whistleblower
[10/03/19]
Posted on October 3, 2019 in Health Law News
Published by: Hall Render
The Eastern District of Texas affirmed the Government’s right to dismiss FCA actions over a whistleblower’s objections. The Court held that the Government may dismiss claims to avoid the costs of extended litigation. The United States Declined to Intervene Health Choice Alliance, LLC filed an FCA action alleging that the defendants defrauded the United... READ MORE
Tags: AKS, Anti-Kickback Statute, False Claims Act, FCA, Sequoia Orange standard, whistleblower
[08/16/19]
Posted on August 16, 2019 in Health Law News
Published by: Hall Render
On July 11, 2019, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services (“HHS”) released the new Grant Self-Disclosure Program Guidance (“Grant Guidance”) for HHS grant recipients and subrecipients. Through the Grant Guidance, OIG provides new self-reporting options for HHS grant recipients and subrecipients who determine that they... READ MORE
Tags: Civil Monetary Penalty Law, cmp, False Claims Act, FCA, Grant Guidance, Grantee Self-Disclosure, hhs, oig, SAM, self-disclosure, System for Award Management