[04/09/18]
Posted on April 9, 2018 in HR Insights for Health Care
Published by: Hall Render
A critical element in any claim for retaliation under the False Claims Act is an adverse employment action. Most commonly, FCA retaliation claims rest on an employee’s involuntary termination due to lawful actions taken by the employee in reporting or opposing the submission of false claims to the government. In certain cases, an employee... READ MORE
Tags: Constructive Discharge, False Claims Act, Retaliation Claims
[01/15/18]
Posted on January 15, 2018 in False Claims Act Defense
Published by: Hall Render
In an opinion loaded with linguistic hooks, the United States District Court for the Middle District of Florida recently reinforced the Supreme Court’s holding in Escobar, enthusiastically highlighting the importance of materiality and scienter in FCA cases. Background In U.S. ex rel. Ruckh v. Salus Rehabilitation, LLC, et al., Relators were successful in a... READ MORE
Tags: analysis, False Claims Act, FCA, Litigation, qui tam
[10/17/17]
Posted on October 17, 2017 in False Claims Act Defense
Published by: Hall Render
The Fifth Circuit recently addressed pre-suit disclosure and causation requirements for FCA theories of liability in United States ex rel. King v. Solvay Pharmaceuticals Inc., 871 F.3d 318 (5th Cir. 2017). Two former employees (“Relators”) of Solvay Pharmaceuticals, Inc. filed a qui tam suit claiming that Solvay induced false Medicaid claims through a variety... READ MORE
Tags: analysis, False Claims Act, FCA, Litigation, qui tam
[01/26/17]
Posted on January 26, 2017 in False Claims Act Defense
Published by: Hall Render
The Federal District Court for the Middle District of Florida appears to have rejected recent direction from the Eleventh Circuit Court of Appeal to deny a motion to dismiss in a False Claims Act case. In United States ex rel. Napoli et al. v. Premier Hospitalists PL, et al. the whistle-blowers alleged a hospitalist... READ MORE
Tags: Clausen, False Claims Act, FCA, fraud, Fraud with Paricularity, Jallali, Mastej, Napoli, Premier Hospitalists, Rule 9
[01/19/17]
Posted on January 19, 2017 in Health Law News
Published by: Hall Render
On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE
Tags: abuse, ACA, Affirmative, Affordable Care Act, Authority, Changes, DOJ, Early reinstatement, exclusion, Expand, False Claims Act, FCA, final rule, fraud, hhs, oig, Permissive, regulation, Reinstatement, Revisions, update
[12/27/16]
Posted on December 27, 2016 in Health Law News
Published by: Hall Render
On December 14, 2016, the Department of Justice (“DOJ”) released a report on fraud statistics regarding recovery amounts for False Claims Act (“FCA”) violations in fiscal year 2016 (“Report”). Reaching $4.7 billion from settlements and judgments, this year’s recovery is the third highest annual recovery in FCA history. Health care fraud accounts for a... READ MORE
Tags: False Claims Act, FCA
[06/30/16]
Posted on June 30, 2016 in False Claims Act Defense
Written by: David B. Honig
In November 2015, the Bipartisan Budget Act of 2015 went into effect. One aspect of that act was the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. The new law required that the Program Fraud Civil Remedies Act and the False Claims Act (“FCA”) penalties be “corrected” to adjust for inflation since... READ MORE
Tags: adjustment, Case Analysis, Damages, Department of Justice, False Claims Act, FCA, fines, government, inflation, maximum, minimum, penalties, Statutes and Regulations
[05/31/16]
Posted on May 31, 2016 in False Claims Act Defense
Written by: David B. Honig
A recent whistleblower case could have a significant impact on Medicare Part D charge limits and corresponding reimbursement and could have ripple effects for aspects of other Medicare programs. The Seventh Circuit Court of Appeals ruled that reduced prescription prices offered by a large retail pharmacy (here Kmart) to participants enrolled in a popular discount... READ MORE
Tags: Case Analysis, False Claims Act, FCA, Garbe, Kmart, materiality, pharmacy, pricing, usual and customary
[05/30/16]
Posted on May 30, 2016 in False Claims Act Defense
Written by: David B. Honig
Releases of FCA claims my only be effective in very limited circumstances, the Second Circuit Court of Appeals ruled in a decision this week. In US ex rel. Ladas v. Exelis, Inc, et al., the court ruled that a pre-filing release is unenforceable as a matter of public policy – the encouragement of qui... READ MORE
Tags: Case Analysis, Employment, Exelis, False Claims Act, FCA, Lados, Release, Second Circuit, Settlement
[04/07/16]
Posted on April 7, 2016 in False Claims Act Defense
Published by: Hall Render
An Indiana Federal District Court just published an opinion on an issue of first impression in the Seventh Circuit, the ability of the government to reject or approve a settlement in a case in which they did not intervene. The court also opined on the ability of a whistleblower to enter into a settlement that... READ MORE
Tags: False Claims Act, FCA, Howze, Settlement, Sleep Centers, whistleblower