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False Claims Act (FCA) Medicaid Federal Contractors

Fox Rothschild LLP

FCA 101: Falsity

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To prove a False Claim under the False Claims Act (FCA), the government or relator must establish three elements: 1.Falsity; - 2.Knowledge; and - 3.Materiality. In this blog post, we will explore the Falsity element. ...more

Cozen O'Connor

Are You Secure? DOJ’s Cyber-Fraud Initiative and Heightened FCA Enforcement

Cozen O'Connor on

False Claims Act (FCA) enforcement has routinely targeted false information supplied to Medicare and Medicaid. A new trend in false-reporting cases is emerging under the FCA’s broad authority — cybersecurity enforcement....more

PilieroMazza PLLC

Settlements and Judgments from FCA and Fraud Matters Top $2.68 Billion in 2023

PilieroMazza PLLC on

On February 22, 2024, the Department of Justice (DOJ) released its annual statistical report (Annual Report) regarding settlements and judgments obtained in the False Claims Act (FCA) and fraud matters for Fiscal Year (FY)...more

Hogan Lovells

The False Claims Act Guide: 2023 and the road ahead

Hogan Lovells on

In the latest edition of our False Claims Act Guide: 2023 and the road ahead, we analyze the key developments from 2023 and discuss how the most important cases and issues are shaping FCA enforcement now and in the year to...more

Manatt, Phelps & Phillips, LLP

False Claims Act 2023: What Every Health Care Entity Working with the Government Needs to Know

In our July 18, 2023, webinar titled “False Claims Act 2023: What Every Health Care Entity Working with the Government Needs to Know,” Manatt posed the following hypothetical and asked three questions about it in our live...more

Jackson Lewis P.C.

U.S. Supreme Court: False Claims Act Liability Depends on Defendant’s Subjective Beliefs

Jackson Lewis P.C. on

Liability in False Claims Act (FCA) suits depends on whether a defendant subjectively believed its claims were false, not on whether it can offer an objectively reasonable basis for its claims, the U.S. Supreme Court has held...more

McGuireWoods LLP

Supreme Court Clarifies the False Claims Act’s Knowledge Requirement, Eliminating a Potential Defense for Government Contractors...

McGuireWoods LLP on

On June 1, 2023, the Supreme Court unanimously ruled in favor of whistleblower plaintiffs (referred to as “relators”) in consolidated False Claims Act (“FCA”) cases in a decision that clarified the application of the FCA’s...more

Schwabe, Williamson & Wyatt PC

Supreme Court FCA Decision and NLRB GC Memo on Non-Competes

Two important decisions, one by the United States Supreme Court and one by the General Counsel for the National Labor Relations Board (“NLRB”), were issued this week and may be of interest to government contractors and...more

Goodwin

The Supreme Court Holds that the False Claims Act’s Scienter Element Turns on Defendant’s Subjective Beliefs, Rejecting Seventh...

Goodwin on

The Supreme Court recently issued a significant decision clarifying what it means to “knowingly” submit a false claim under the False Claims Act. At issue in United States ex rel. Schutte v. SuperValu Inc. were allegations...more

WilmerHale

High Court Hears Important Case on False Claims Act’s Scienter

WilmerHale on

On April 18, the Supreme Court heard oral argument and what has been billed as the most important False Claims Act (FCA) case in a decade. Since the FCA was enacted in the Civil War era, it has been the primary tool for the...more

McCarter & English Blog: Government Contracts...

Knowing IS the Battle: Supreme Court to Address the FCA’s Scienter Standard

Scenario 1: A pharmacy chain hires a value consultant to review its Medicare and Medicaid billing practices for ways to optimize the coding of drug reimbursements to maximize profits. Drugs that had historically been charged...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Dorsey & Whitney LLP

Eighth Circuit Analyzes Scope of FCA Liability Under Anti-Kickback Statute

Dorsey & Whitney LLP on

​​​​​​​On July 26, 2022, the Eighth Circuit Court of Appeals issued an opinion interpreting the standard for the causal link the government must show to establish that a “false or fraudulent” claim under the False Claims Act...more

Manatt, Phelps & Phillips, LLP

The Fourth Circuit Raises the Bar for Proving Scienter Under the False Claims Act

On January 25, 2022, the U.S. Court of Appeals for the Fourth Circuit issued an important opinion for companies trying to navigate the complex statutory scheme in heavily regulated areas like Medicare and Medicaid....more

Foley Hoag LLP - Medicaid and the Law

‘Objective Falsity’ and the FCA: An Ongoing Circuit Split

The False Claims Act (“FCA”) is a Federal statute originally enacted in 1863 as a response to fraud from defense contractors during the American Civil War. Under the FCA (31 U.S.C. §§ 3729 – 3733), it is a crime for any...more

Proskauer - Minding Your Business

Professional Relators Under False Claims Act Find No Friends in Federal Government or Seventh Circuit

Qui tam cases in American jurisprudence rely on a simple premise: help prevent nefarious actors from defrauding the government and Uncle Sam will compensate you for your efforts. With its roots in English law, the American...more

Miles & Stockbridge P.C.

Federal False Claims Act Wrap-Up - August 2020

A look at selected soon-to-be-reported decisions on various False Claims Act issues. This month we can glean three quick lessons...more

Sheppard Mullin Richter & Hampton LLP

Guard Against False Claims as Massive Government Spending Rolls Out to Combat COVID-19

Federal and state governments are ready to roll out over one trillion dollars in funding in response to the novel coronavirus (COVID-19) pandemic. As past is often prologue, we expect this new round of massive government...more

Bass, Berry & Sims PLC

Recent Developments in False Claims Act Pleading Standards

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The Department of Justice (DOJ) recently released its report detailing the settlements and judgments obtained in 2019 from civil cases involving fraud and abuse claims. As in years past, the substantial majority of these...more

Foley Hoag LLP - White Collar Law &...

White Collar Year in Preview: False Claims Act Trends in 2020

Editors’ Note: This is the fourth in our start-of-year series examining important trends in white collar law and investigations in the coming year. Our previous entry discussed anti-corruption trends in 2020. Up next: a look...more

ArentFox Schiff

Investigations Newsletter: Defense Vehicle Manufacturer Accused of Defrauding the Government by $1.2 Billion

ArentFox Schiff on

Defense Vehicle Manufacturer Accused of Defrauding the Government by $1.2 Billion - On Tuesday, December 3, the United States District Court for the District of Columbia unsealed a six-year-old False Claims Act complaint...more

Baker Donelson

False Claims Act Liability Without Submitting False Claims? Yes, That's a Thing

Baker Donelson on

Most health care providers recognize that submitting a knowingly false claim to a federally funded health care program violates the False Claims Act (FCA). However, it is less well known that indirectly "causing" someone else...more

Foley Hoag LLP - White Collar Law &...

Latest FCA Settlement Involving Massachusetts Lab Highlights Federal/State Cooperation

Late last month the U.S. Attorney’s Office for the District of Connecticut issued a press release regarding the latest False Claims Act (FCA) settlement involving the healthcare industry in New England.  According to the...more

Morgan Lewis

Ninth Circuit Panel: Escobar Test for Implied Certification Liability Is Mandatory

Morgan Lewis on

Unless and until the US Court of Appeals for the Ninth Circuit, “en banc, interprets Escobar differently,” a Ninth Circuit panel, relying on past case law, has ruled that relators seeking to establish False Claims Act...more

The Volkov Law Group

Rolling Along with False Claims Act Enforcement Actions (Part III of IV)

The Volkov Law Group on

Despite the controversial impact of the Supreme Court’s Escobar decision, the Justice Department’s False Claims Act prosecutions and settlements are continuing at a consistent rate – heading towards another multi-billion...more

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