Articles and Blogs

FCA

Seventh Circuit Clarifies “Authoritative Guidance” for the False Claims Act

[04/06/22]

Posted on April 6, 2022 in Health Law News, Litigation Analysis

Published by: Hall Render

Recently, the Seventh Circuit, in Proctor v. Safeway, Inc., clarified what it means to act with reckless disregard in respect to claims brought under the False Claims Act (“FCA”). ­__ F.4th ­__, No. 3:11-CV-3406, 2022 WL 1012256, (7th Cir. 2022). In doing so, the court stated that authoritative guidance must be truly authoritative in... READ MORE

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What You Should Know About Health Systems and the Attorney-Client Privilege

[03/21/22]

Posted on March 21, 2022 in False Claims Act Defense, Health Law News

Published by: Hall Render

A federal district court affirmed this guidance in a careful analysis of the attorney-client privilege and its application to protect separate legal entities within a larger corporate structure. Affirming that member entities are not treated as “one client,” the Court in U.S. ex rel Behnke v. CVS Caremark Corp., et al. denied a whistleblower’s... READ MORE

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Your Standard Liability Policy Doesn’t Cover FCA Claims

[11/20/20]

Posted on November 20, 2020 in False Claims Act Defense

Published by: Hall Render

In health care, actions under the False Claims Act (“FCA”) typically allege conduct that is knowingly in violation of one or more of Medicare’s conditions of payment—part of an amorphous contract between a government agency and a provider—that results in a fraudulently obtained overpayment to the provider for services rendered. Last week, the Ninth... READ MORE

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Eleventh Circuit Reaffirms Need for Counsel to Pursue Qui Tam Claims Under the False Claims Act

[09/02/20]

Posted on September 2, 2020 in Health Law News, Litigation Analysis

Published by: Hall Render

The United States Court of Appeals, Eleventh Circuit, recently issued an opinion reaffirming the need for counsel in qui tam cases under the False Claims Act (“FCA”). In particular, pro se plaintiffs, or individuals proceeding without attorney representation, filed suit against multiple defendants alleging qui tam claims under the FCA as well as 21... READ MORE

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Improper Real Estate Arrangements Alleged as Part of $72.3 Million FCA Settlement

[07/29/20]

Posted on July 29, 2020 in Health Law News

Published by: Hall Render

On July 8, 2020, the Department of Justice announced it settled a qui tam action[1] involving alleged violations of the federal and state False Claims Act (“FCA”) for $72.3 million against an Oklahoma surgical specialty hospital, its managers, a physician group and two individual physicians. Part of the factual allegations underpinning the FCA claims... READ MORE

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False Claims Cost More: DOJ Increases Civil Penalties for False Claims Act Violations

[07/01/20]

Posted on July 1, 2020 in False Claims Act Defense, Health Law News

Published by: Hall Render

On June 19, 2020, the Department of Justice (the “DOJ”) announced its Final Rule[1] increasing the penalties assessable under the False Claims Act (“FCA”). The DOJ raised the minimum penalty for a single false claim from $11,181 to $11,665; the maximum penalty from $22,363 to $23,331. Under the False Claims Act,[2] any person who... READ MORE

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Ninth Circuit Shuts Down “Objective Falsehood” Pleading Requirement Under the FCA

[04/02/20]

Posted on April 2, 2020 in False Claims Act Defense

Published by: Hall Render

An accepted doctrine of FCA pleading requires whistleblowers or the Government to assert an “objective falsehood” in their complaints. Last week, the Ninth Circuit nixed the requirement. The Ninth Circuit reversed a district court’s dismissal tied to a failure to plead an objective falsehood under FCA. The Court held that whistleblowers or the Government... READ MORE

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One Is Not Enough: Court Clarifies Whistleblower’s Burden in High Volume FCA Action

[03/25/20]

Posted on March 25, 2020 in False Claims Act Defense

Published by: Hall Render

The Southern District of Indiana recently held that a whistleblower must present sufficient evidence to support each alleged false claim, not just one, to survive summary judgment.[1] This holding is a win for FCA defendants that deal in a high volume of claims submitted to the government—like hospitals—and requires whistleblowers to identify every claim... READ MORE

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Second Circuit Affirms Dismissal of Piggybacked FCA Complaint

[03/24/20]

Posted on March 24, 2020 in False Claims Act Defense

Published by: Hall Render

Earlier this week, the Second Circuit in Vierczhalek v. MedImmune, Inc.[1] affirmed the dismissal of a relator’s amended complaint, finding she was not an “original source” of new allegations that piggybacked on a public disclosure. Facts of the Case Relator Susan Vierczhalek, M.D., filed a qui tam action in 2009 alleging that drug manufacturer... READ MORE

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Third Circuit Emphasizes Distinction Between Falsity and Scienter in FCA Cases

[03/05/20]

Posted on March 5, 2020 in False Claims Act Defense

Published by: Hall Render

In a matter of first impression, the Third Circuit yesterday held that conflicting medical opinions can create a genuine dispute of material fact as to the element of falsity in a False Claims Act action.[1] Facts of the Case In U.S. v. Care Alternatives, relators alleged that Care Alternatives, a hospice facility, “admitted patients... READ MORE

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