As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA).
We start with the numbers: The Department...more
2/28/2024
/ Causation ,
Damages ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Materiality ,
Objective Falsity ,
Penalties ,
Qui Tam ,
Relators ,
Retaliation ,
Scienter ,
Settlement ,
Sovereign Immunity ,
Whistleblowers
Genetic testing is a burgeoning area of preventative and predictive medicine. Such testing enables greater insight into a patient's unique genetic makeup and, in turn, more tailored and individualized medical decisions....more
In 2022, the False Claims Act (FCA) continued to be the federal government’s chief tool for combatting fraud. Many trends in recent years were likewise present in 2022: robust FCA enforcement generally, healthcare as the...more
On December 6, 2022, the Supreme Court heard oral argument in United States ex rel. Polansky v. Executive Health Resources, Inc. As previously reported, this case raises whether the government has the authority to dismiss a...more
The year 2021 marks the 10th anniversary of the Bradley False Claims Act Year in Review. In that decade, much has remained the same in FCA enforcement. To start with the obvious: It continues to result in billions of dollars...more
2/3/2022
/ Alternate Remedy ,
Anti-Kickback Statute ,
CARES Act ,
Causation ,
Class Action ,
Cybersecurity ,
Damages ,
Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud ,
Government Investigations ,
Healthcare ,
Local Coverage Determination (LCD) ,
Materiality ,
Overpayment ,
Pleading Standards ,
Public Disclosure Bar ,
Request for Equitable Adjustment ,
Scienter ,
Settlement
This year saw substantial activity in FCA settlements and litigated court cases. Although no single case or development dominated the discourse this year, several important court decisions were issued, including two that may...more
2/1/2021
/ Ambiguous ,
Anti-Kickback Statute ,
Damages ,
Deficit Reduction ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Department of Veterans Affairs ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Aviation Administration (FAA) ,
Fee-Shifting ,
First-to-File ,
Fraud ,
Materiality ,
Medicaid ,
Medicare ,
Qualified Immunity ,
Reasonable Interpretations ,
Retaliation ,
Speaker Programs ,
Statute of Limitations
This week, the Department of Justice (DOJ) formalized and expanded its guidance for how defendants can earn cooperation credit in False Claims Act (FCA) cases and thereby reduce settlement amounts. New section 4-4.112 of the...more
5/13/2019
/ Compliance ,
Cooperation ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Government Agencies ,
Government Investigations ,
New Guidance ,
Remedial Actions ,
Risk Mitigation ,
Voluntary Disclosure
INTRODUCTION -
Unlike some recent years, 2018 was somewhat short on headline grabbing news related to the False Claims Act (FCA). There were, to be sure, significant developments in the courts and within the Department of...more
1/18/2019
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Dismissals ,
Enforcement Actions ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Qui Tam ,
Relators ,
Retaliation ,
Statute of Limitations ,
Universal Health Services Inc v United States ex rel Escobar ,
Whistleblowers ,
Yates Memorandum
It’s Time to Review Your Compliance, Data and Auditing Plans -
As we near the end of 2018, healthcare providers and companies are understandably focused on 2019 and the trends ahead. In planning for next year, however,...more
12/17/2018
/ Audits ,
Criminal Prosecution ,
Data Management ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Fraud ,
Medicare ,
Medicare Fraud Strike Force ,
Opioid ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Prescription Drugs ,
Risk Mitigation
The opioid crisis in America is now well known, affecting a staggering number of people directly or indirectly and occupying a regular place in media reports and political discussions. In addition to potential public health...more
7/19/2018
/ Civil Liability ,
Criminal Prosecution ,
DEA ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Drug & Alcohol Abuse ,
Enforcement Actions ,
False Claims Act (FCA) ,
Federal Agency Taskforce ,
Health Care Providers ,
Investigations ,
Law Enforcement ,
OIG ,
Opioid ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Prescription Drugs ,
Public Health ,
Regulatory Oversight ,
Supply Chain