Articles and Blogs

FCA

California Central District Court Compels Government Disclosure of Non-Sealed Documents Withheld Pursuant to Law Enforcement Privilege

[08/08/24]

Posted on August 8, 2024 in Health Law News, Litigation Analysis

Published by: Hall Render

A Special Master for the Central District Court of California granted a motion to compel the disclosure of investigative documents that are no longer under seal in the course of an ongoing False Claims Act claim. UnitedHealth Group, Inc., et al. (“United”) filed a motion to compel the United States (“government”) to produce documents... READ MORE

Tags: , ,

Eighth Circuit Declares $7.5M FCA Award Unconstitutional and Affirms Statistical Sampling in Bench Trials

[08/01/24]

Posted on August 1, 2024 in Health Law News, Litigation Analysis

Published by: Hall Render

On July 5, 2024, the Eighth Circuit Court of Appeals (“the Court”) ruled that a $7.5 million award of treble damages and civil penalties in an Iowa FCA case was unconstitutional due to the Eighth Amendment’s prohibition against “excessive fines.” The Court also examined other matters, including the acceptability of statistical sampling and the... READ MORE

Tags: , , ,

DOJ Announces $2.68 Billion in False Claims Act Recoveries

[02/23/24]

Posted on February 23, 2024 in False Claims Act Defense, Health Law News

Published by: Hall Render

On February 22, 2024, the Department of Justice (“DOJ”) announced that it recovered over $2.68 billion in False Claims Act (“FCA”) settlements and judgments during the 2023 federal fiscal year. Notably, this amount stems from the highest number of settlements and judgments in a single year, including 543 settlements and judgments during this last... READ MORE

Tags: , , , ,

False Claims Act Retaliation Decision Calls into Question the Heightened Burden for Employees Whose Duties Include Compliance and Fraud Investigation

[11/21/23]

Posted on November 21, 2023 in False Claims Act Defense, Health Law News, HR Insights for Health Care

Published by: Hall Render

The United States District Court for the Eastern District of Wisconsin recently issued a decision involving protections for employees whose jobs involve the investigation of fraud. The case, brought under the anti-retaliation provision of the False Claims Act (“FCA”), is available here. Since 2009, the FCA’s anti-retaliation provision,(codified at 31 U.S.C. § 3730(h)(1)), has provided... READ MORE

Tags: , ,

FCA Penalties Are to Be Awarded per Each Violation Rather than Each Line Item

[08/22/23]

Posted on August 22, 2023 in False Claims Act Defense, Health Law News

Published by: Hall Render

The Ninth Circuit recently held in Hendrix ex rel. United States v. J-M Manufacturing Company, Inc. that in False Claims Act (“FCA”) cases, one penalty per project or FCA violation is proper, rather than one penalty per line item contained within the project or violation. Background In this case, the plaintiff brought suit against the... READ MORE

Tags: , , ,

False Information Is Material Regardless of the Validity of Underlying Eligibility Requirements

[08/22/23]

Posted on August 22, 2023 in False Claims Act Defense, Health Law News

Published by: Hall Render

The Fourth Circuit recently held that providers may not defend a False Claims Act (“FCA”) lawsuit by arguing that eligibility requirements violate the Medicaid Act. Rather, liability under the FCA may still be established if any misrepresentations made by a provider influenced decision-makers and resulted in the submission of false claims to the government.... READ MORE

Tags: , ,

SCOTUS Upholds Government Dismissal of FCA Actions When It Determines Costs Outweigh Benefits

[06/16/23]

Posted on June 16, 2023 in Health Law News

Published by: Hall Render

On June 16, 2023, the U.S. Supreme Court decided United States ex rel. Polansky v. Executive Health Resources, Inc. The Court’s opinion settles two outstanding questions about the authority of the Government to dismiss FCA actions in which it first declines to intervene but that whistleblowers continue to pursue on the Government’s behalf. First,... READ MORE

Tags: , , ,

SCOTUS Tosses Objective FCA Scienter Standard 

[06/07/23]

Posted on June 7, 2023 in Health Law News

Published by: Hall Render

On June 1, 2023, the U.S. Supreme Court in U.S. ex rel. Schutte v. SuperValu, Inc. held that the mental state required by the False Claims Act (“FCA”) refers to the defendant’s actual knowledge and subjective beliefs about the truth of claims for payment submitted to federal payors. This decision overturns the growing body of... READ MORE

Tags: , , ,

DOJ Recouped $2.2 Billion Under FCA in 2022

[02/27/23]

Posted on February 27, 2023 in Health Law News

Published by: Hall Render

On February 7, 2023, the Department of Justice (“DOJ”) announced that it recovered over $2.2 billion in False Claims Act (“FCA”) related settlements and judgments in the federal fiscal year 2022. While this is less than half of the previous year’s recovery of $5.6 billion, the number of cases settled was the second highest... READ MORE

Tags: , , , ,

CMS Proposes to Drastically Change Overpayment Refund Rule

[01/12/23]

Posted on January 12, 2023 in Health Law News

Published by: Hall Render

On December 27, 2022, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that could potentially have a significant impact on enrollees’ obligations under the “60-day” overpayment rule. The original overpayment rule, which was signed into law in 2014 with the Affordable Care Act and expanded to Medicare Parts A and... READ MORE

Tags: , , ,