News & Analysis as of November 17, 2024

Anti-Kickback Statute › Dismissals

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The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -

Petition for Certiorari Filed in Supreme Court in False Claims Act Case Seeking Review of Whether “Willful” Under the...

Mintz - Health Care Viewpoints on 7/9/2024

The Supreme Court now has the opportunity to define “willfulness” under the federal criminal Anti-Kickback Statute (AKS). In a declined qui tam case filed against McKesson Corporation, a pharmaceutical wholesaler, the...more

Recent False Claims Act Decisions to Know

Bass, Berry & Sims PLC on 5/1/2023

In this post, we summarize noteworthy False Claims Act (FCA) decisions so far from 2023. Each of the three circuit court opinions discussed here ruled in favor of the defendants on different aspects of the FCA: the Sixth...more

Public Disclosure Bar Applies – Court Dismisses Whistleblower’s False Claims Complaint

Stevens & Lee on 3/30/2023

A recent U.S. District Court decision provides a good example of how federal courts will apply the public disclosure/original source rules in whistleblower cases alleging that health care providers violated the False Claims...more

Second Circuit Holds False Claims Act Complaint Is Barred by SEC Filings

Bass, Berry & Sims PLC on 12/29/2022

In July 2021, the U.S. District Court for the Eastern District of New York dismissed a False Claims Act complaint filed by CKD Project, LLC, an entity created for the purpose of filing the lawsuit, which alleged that...more

False Claims Act - 2021 Year in Review

Bradley Arant Boult Cummings LLP on 2/3/2022

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

Judge Dismisses Pfizer’s Lawsuit Over HHS Limits on Drug Copay Assistance

Goodwin on 10/4/2021

In a previous post published on the Washington Legal Foundation’s Legal Pulse blog, Goodwin Partners Matt Wetzel and William Jackson discussed the potential implications of a high-profile recent lawsuit lodged by Pfizer...more

D.C. District Court Upholds HHS’s 2013 Policy of Including Part C Days in the Medicare Fraction of the DSH Calculation

King & Spalding on 7/16/2021

On July 7, 2021, the U.S. District Court for the District of Columbia ruled in favor of HHS and upheld HHS’s 2013 rule readopting its policy of including Part C days in the Medicare fraction of the disproportionate share...more

Fifth Circuit Affirms Government’s Unilateral Dismissal of FCA Claims Despite Initially Declining to Intervene

King & Spalding on 7/15/2021

On July 7, 2021, a Fifth Circuit panel upheld a decision by the U.S. District Court for the Eastern District of Texas to grant the government’s dismissal of two qui tam actions under the False Claims Act (FCA) in Texas,...more

Healthcare Management Services Organizations Get The Green Light In California

King & Spalding on 7/1/2021

Healthcare management services organizations (MSO), also known as a medical management company, have become critical to managing healthcare operations. The structure of the MSO and the MSO ownership, however, carry risk and...more

Biogen Inc. Wins Some, Loses Some, in Delaware Chancery Court Corporate Records Suit

Goodwin on 4/23/2021

Biogen Inc. Wins Some, Loses Some, In Delaware Chancery Court Corporate Records Suit; Southern District of Florida Dismisses Securities Fraud Class Action Against Norwegian Cruise Lines Stemming From Alleged Impacts of...more

Healthcare Law Update: February 2021

Holland & Knight LLP on 2/5/2021

To date, there has been little consistency in how Health Insurance Portability and Accountability Act (HIPAA) requirements are enforced by the U.S. Department of Health and Human Services (HHS), or the amount of settlements...more

Escobar in Action: Physician-owners’ fraud claims against hospital defeated in Fifth Circuit appeal for lack of materiality

Dorsey & Whitney LLP on 12/11/2019

Following the passage of the Affordable Care Act (“ACA”), which placed new limits on physician-owned hospitals, St. Luke’s Health System (“System”) took action to change one of its hospital’s ownership structures through a...more

The Granston Memo in 2019: Recent Cases Highlight the Granston Memo’s Effectiveness as a Tool to Dismiss False Claims Act Cases

Sheppard Mullin Richter & Hampton LLP on 12/5/2019

The “Granston Memo” has proven to be a boon again in 2019 for False Claims Act (“FCA”) defendants. In a January 15, 2019 Sheppard Mullin FCA Defense Blog article, we highlighted a growing movement by the Department of Justice...more

Healthcare Law Update: October 2019

Holland & Knight LLP on 10/15/2019

In recent years, the healthcare industry has been turning greater attention to the need to engage or involve patients in developing new technologies and systems to improve healthcare delivery. These patient engagement...more

Post-Granston Memo, DOJ Can Use Its Dismissal Authority, but Not Without Limits

Foley & Lardner LLP on 5/16/2019

In a memo leaked last year (the Granston Memo), the U.S. Department of Justice (DOJ) instructed its prosecutors to more seriously consider dismissing meritless whistleblower False Claims Act (FCA) cases when it is in the...more

District Courts Hold that DOJ Lacks “Unfettered” Discretion to Preemptively Dismiss Qui Tam Actions

Bass, Berry & Sims PLC on 4/30/2019

In two recent decisions, federal district courts in the Eastern District of Pennsylvania and the Southern District of Illinois, respectively, considered the Government’s motions to dismiss False Claims Act (FCA) lawsuits...more

Judge Dismisses FCA Claims Against Compounding Pharmacy and Private Equity Firm Owner but Allows the Government to Amend

Mintz - Health Care Viewpoints on 3/15/2019

Last week, a U.S. district court judge in the Southern District of Florida upheld a magistrate judge’s decision to dismiss False Claims Act (FCA) allegations against a compounding pharmacy, its private equity firm owner, and...more

Mintz Levin Health Care Qui Tam Update - February 2019

Mintz on 2/25/2019

Overview of Qui Tam Activity - We identified 49 health care-related qui tam cases that were unsealed in September and October 2018. The government intervened in whole or in part in 10 of those 49 unsealed cases, which...more

K&L Gates Triage: Triage in 2019: Health Care Topics to Watch in the New Year

K&L Gates LLP on 1/31/2019

As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more

Health Care Enforcement Quarterly Roundup - Q4 | January 2019

McDermott Will & Emery on 1/29/2019

This latest installment of the Health Care Enforcement Quarterly Roundup reflects on trends that persisted in 2018 and those emerging trends that will carry us into 2019 and beyond. Leading off with the US Department of...more

False Claims Act: 2018 Year in Review

Bradley Arant Boult Cummings LLP on 1/18/2019

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

Upswing in DOJ Qui Tam Dismissals

Sheppard Mullin Richter & Hampton LLP on 1/16/2019

The Department of Justice (DOJ) appears to be taking to heart the policy articulated in what has come to be called the Granston Memo, as it has recently sought dismissal of 11 False Claims Act (FCA) cases in various federal...more

Department of Justice Moves to Dismiss FCA Cases Involving Patient Support Services

Jones Day on 12/26/2018

Exercising the government's discretion to dismiss meritless FCA cases, DOJ argues patient support services are "appropriate and beneficial to federal healthcare programs and their beneficiaries." This week, the Department...more

Eleventh Circuit Affirms Vitality of the Employee Exemption to the Anti-Kickback Statute

Holland & Knight LLP on 8/23/2018

On Aug. 7, 2018, the 11th Circuit Court of Appeals affirmed the dismissal of a whistleblower case brought under the federal False Claims Act. The principal grounds for affirmance was a finding that the employee exemption to...more

Amended FCA Complaint Cannot Cure A First-to-File Violation

Mintz - Health Care Viewpoints on 8/20/2018

The Second Circuit Court of Appeals recently held that a False Claims Act (FCA) relator could not evade the FCA’s first-to-file bar by filing an amended complaint after two earlier-filed FCA suits alleging similar conduct had...more

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Anti-Kickback Statute › Dismissals

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