News & Analysis as of

Fraud Federal Contractors Health Care Providers

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Fox Rothschild LLP

FCA Enforcement Remains Fixed on Healthcare and Cybersecurity

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On February 22, 2024, the U.S. Department of Justice (“DOJ”) released its Fiscal Year 2023 False Claims Act (“FCA”) statistics showing recoveries of almost $2.7 billion. Last year’s recoveries exceeded 2022’s $2.2 billion...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

BCLP

U.S. Health Care Industry: Risk Mitigation Tips in the Post-Supervalu FCA Landscape

BCLP on

As we predicted, the Supreme Court held that a business could be exposed to substantial damages under the False Claims Act (FCA) if it incorrectly applies ambiguous rules or regulations. The unanimity of the opinion—which we...more

Maynard Nexsen

The DOJ’s Heightened Focus on the False Claims Act and Cybersecurity: Six Steps for Healthcare Providers to Implement to Stave Off...

Maynard Nexsen on

In October 6, 2021, the Deputy General for the United States Department of Justice (“DOJ”) announced a new “Civil Cyber-Fraud Initiative” (the “Cyber-Fraud Initiative”) as part of the DOJ’s ongoing efforts to combat new and...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Reverse False Claims

Previous False Claims Act (FCA) Fundamentals posts have examined how violations of certain federal laws can potentially expose entities to FCA liability when they receive money from the government. This post focuses on how...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Self-Disclosures

Bass, Berry & Sims PLC on

When healthcare providers and other government contractors are subject to scrutiny for bills submitted to the government, it is often the result of a whistleblower complaint filed under the qui tam provisions of the False...more

Foley Hoag LLP - White Collar Law &...

Health Care Enforcement – A Look Ahead

This is the first post in this year’s series examining important trends in white collar law and investigations. Join us in the weeks ahead as we provide updates on new developments and emerging trends in a number of white...more

Wiley Rein LLP

2021 FCA Recoveries Bounce Back from Decade-Low . . . Maybe

Wiley Rein LLP on

On February 1, the U.S. Department of Justice (DOJ) announced the second-largest annual total recoveries in the history of the False Claims Act (FCA)—$5.6 billion—for FY 2021 (October 2020 – September 2021)...more

Steptoe & Johnson PLLC

Federal Authorities Ramping Up COVID-19 Related Health Care Fraud Prosecutions

Steptoe & Johnson PLLC on

Recently announced Department of Justice (DOJ) priorities include a reinvigoration of health care fraud prosecutions. The COVID-19 crisis created fertile ground for not only fraud related to the Paycheck Protection Program...more

Sheppard Mullin Richter & Hampton LLP

Using “Prospective Hindsight” To Identify And Mitigate Risks During A Crisis

In 1657, mathematician Blaise Pascal commented in a letter to his church leaders “I have made this longer than usual because I did not have time to make it shorter.” More than 100 years later, another Frenchman, Napoleon...more

Alston & Bird

Implied False Certification Liability Under the False Claims Act: How the Materiality Standard Offers Protection after Escobar

Alston & Bird on

The False Claims Act (FCA), initially enacted in 1863 during the Civil War, was sponsored by the Lincoln administration to curtail the rampant fraud and excessive profiteering being perpetuated by government contractors, who,...more

Bass, Berry & Sims PLC

FCA Deeper Dive: Original Sources under the FCA’s Public Disclosure Bar

Bass, Berry & Sims PLC on

The FCA continues to be the federal government’s primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we...more

Troutman Pepper

Materiality Is the New Condition of Payment: The Implied False Certification Theory After Escobar

Troutman Pepper on

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

McAfee & Taft

Supreme Court ruling potentially expands false claims liability for healthcare providers

McAfee & Taft on

In a much-anticipated decision, the U.S. Supreme Court ruled recently that the implied false certification theory may form the basis for liability under the False Claims Act (FCA), resolving a split of among the federal...more

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