United States ex rel. Polansky v. Executive Health Resources, Inc. (S. Ct. June 16, 2023) -
The vast majority of False Claims Act cases are initiated by private parties, known as relators, not the government. In fact,...more
6/28/2023
/ Department of Justice (DOJ) ,
EHR ,
False Claims Act (FCA) ,
Federal Jurisdiction ,
FRCP 41 ,
Healthcare Fraud ,
Medicare ,
Qui Tam ,
Relators ,
SCOTUS ,
United States ex rel Polansky v Executive Health Resources Inc
In 2021, the Department of Justice (DOJ) obtained more than $5.6 billion in False Claims Act settlements and judgments — the largest amount since 2014 and the second largest amount recorded. This number is inflated by the...more
The Supreme Court denied a closely watched petition to review the Third Circuit’s decision in United States ex rel. Druding v. Care Alternatives, a False Claims Act (FCA) case that created a circuit split around whether and...more
Before the government decides whether to intervene in a qui tam action, it is obligated by statute to investigate a whistleblower’s allegations. See 31 U.S.C §?3730(a). But, in the course of that investigation, may the...more
3/5/2020
/ Anti-Kickback Statute ,
Audio Recording ,
Discovery ,
Distributors ,
Evidence ,
False Claims Act (FCA) ,
Government Investigations ,
Internal Communications ,
Intervening Acts ,
Kickbacks ,
Motion to Dismiss ,
Physicians ,
Qui Tam ,
Rules of Professional Conduct ,
Secret Recordings ,
Statutory Violations ,
Whistleblowers
On September 9, in a setback for AseraCare but an overall win for hospice providers, the Eleventh Circuit affirmed a Northern District of Alabama decision to grant a new trial in a False Claims Act (FCA) case against...more
9/13/2019
/ Bifurcation ,
Department of Justice (DOJ) ,
Enforcement Actions ,
Expert Witness ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospice ,
Insurance Fraud ,
Life Sciences ,
Medicare ,
Objective Falsity ,
Physician Medicare Reimbursements ,
Physicians ,
Professional Liability ,
Remand ,
Scienter ,
Statistical Analysis ,
Sua Sponte ,
Terminal Illness Treatments ,
Whistleblowers
In an unanimous decision in Cochise Consultancy, Inc. v. United States ex rel. Hunt, the U.S. Supreme Court settled a circuit split and gave qui tam relators more time to file actions alleging violations of the False Claims...more
6/11/2019
/ Appeals ,
Cochise Consultancy Inc v United States ex rel Hunt ,
False Claims Act (FCA) ,
First-to-File ,
Government Officials ,
Intervenors ,
Oral Argument ,
Qui Tam ,
Relators ,
SCOTUS ,
Split of Authority ,
Statute of Limitations
The Supreme Court has made it clear that, even at the pleadings stage, relators (or the government) must plead facts to support materiality with plausibility and particularity.
For False Claims Act (FCA) defendants who...more
7/11/2016
/ Conditions of Payment ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
Fraud ,
Health Care Providers ,
Implied Certification ,
Material Misrepresentation ,
Materiality ,
Medicaid ,
Mental Health ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar ,
Unlicensed Medical Providers