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fraud

D.C. Court of Appeals Shuts Down Recycled Fraud Claims Under Public Disclosure Bar

[03/24/25]

Posted on March 24, 2025 in False Claims Act Defense, Litigation Analysis

Published by: Hall Render

In United States ex rel. O’Connor v. USCC Wireless Investment, Inc., relators filed a qui tam action under the False Claims Act (“FCA”). On February 11, 2025, the D.C. Court of Appeals (the “Court”) affirmed a district court’s ruling that (1) a previous lawsuit had raised substantially the same allegations, triggering the FCA’s public... READ MORE

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DOJ Recouped $2.9 Billion Under FCA in 2024

[01/17/25]

Posted on January 17, 2025 in Health Law News

Published by: Hall Render

On January 15, 2025, the Department of Justice (“DOJ”) announced that it recovered over $2.9 billion in False Claims Act (“FCA”) related settlements and judgments in the fiscal year ending September 30, 2024 (“FY2024”). The 2024 recovery amount exceeds the previous year’s recovery of $2.68 billion, with the number of settlements and judgments coming in at 558. Whistleblowers... READ MORE

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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

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Protected Activity Under the FCA Requires Both a Subjectively and an Objectively Reasonable Belief of Fraud

[09/12/22]

Posted on September 12, 2022 in False Claims Act Defense, Health Law News, HR Insights for Health Care

Published by: Hall Render

Recently, Simon et al, v. Healthsouth of Sarasota Limited Partnership, et al, the Eleventh Circuit held that for a plaintiff to qualify as engaging in “protected activity,” the plaintiff must demonstrate that they had both a subjectively reasonable belief of fraud and an objectively reasonable belief of fraud. Background The plaintiff in this action... READ MORE

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Former Texas Hospital Settles Fraud Case over $170 Million Loan

[11/06/20]

Posted on November 6, 2020 in Health Law News

Published by: Hall Render

Recently, a former Texas hospital (the “Hospital”) settled a multi-million dollar False Claims Act civil lawsuit involving the acquisition and use of funds from the largest Federal Housing Administration-backed mortgage for a for-profit hospital. The Hospital settled for $13.6 million and three top executives of the hospital, along with the development company, will collectively... READ MORE

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Trial Court Pushes Back on “Fraud with Particularity” Requirement

[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

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OIG Final Rule Significantly Expands Exclusion Authority

[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

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Eleventh Circuit: “Worthless Services” Claim Constitutional in Criminal Fraud Case

[06/24/14]

Posted on June 24, 2014 in False Claims Act Defense

Written by: Drew B. Howk

The Eleventh Circuit ruled last week that a conviction for criminal health care fraud against the owner of nursing home facilities was constitutional. The Court held that the government’s “worthless service” theory of fraudulent billing was not unconstitutional. In United States vs. George Houser, the government alleged that the defendant conspired to defraud the... READ MORE

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CMS Extends and Expands Home Health Enrollment Moratoria

[02/11/14]

Posted on February 11, 2014 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

Effective January 31, 2014, the Centers for Medicare & Medicaid Services (“CMS”) has issued a temporary moratoria for the enrollment of home health agencies in Fort Lauderdale, Florida; Detroit, Michigan; Dallas, Texas; and Houston, Texas.  CMS also announced it is extending the current enrollment moratoria in Chicago, Illinois and Miami, Florida for another six... READ MORE

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April False Claims Act Update

[04/15/13]

Posted on April 15, 2013 in False Claims Act Defense

Written by: David B. Honig

Introduction Three cases are addressed in a review of the False Claims Act decisions of the past month. The first, US v. Anchor Mortage Corp., is a significant Seventh Circuit case addressing the proper treble damages calculation under the statute. The second, US ex rel. Carter v. Halliburton, considers the application of the Wartimes Suspension... READ MORE

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