Articles and Blogs

In a recent case out of Kansas, the Tenth Circuit reiterated the importance of the FCA’s materiality and scienter requirements that the Supreme Court set forth in Escobar: FCA claims must satisfy materiality and knowledge requirements—both of which are rigorous and strictly enforced. A whistleblower must prove knowledge in an implied certification case—it cannot... READ MORE

In a partial affirmation, the Fourth Circuit weeded out False Claims Act (“FCA”) claims made without particularity, requiring relators to “connect the dots” between the alleged false claims and government payment and highlighted the FCA’s recently amended “objective reasonableness” standard in reviewing retaliation claims. Background In 2010, the FCA was amended to include any... READ MORE

The Department of Justice (“DOJ”) reported it collected more than $2.8 billion in False Claims Act (“FCA”) settlements and verdicts in 2018.¹ This is significantly down from the record $5.69 billion recovered in 2014 and from the $3.6 billion – $4.7 billion in 2015 through 2017. This can primarily be explained by the absence... READ MORE

The DOJ plans to dismiss 11 FCA lawsuits involving the new theory that patient assistance services supplied by drugmakers are unlawful kickbacks.¹ These lawsuits were brought by shell company whistleblowers backed by the National Healthcare Analysis Group (“NHCA”), a company that specializes in generating FCA cases. The 11 cases were essentially the same complaints with a different... READ MORE

Joining the other circuit courts, the Fifth Circuit extends the time to appeal a civil case if the United States was a party. As long as the United States was actively involved in the case prior to the appeal, any party has 60 days to appeal. Background In United States v. Ronald Conner, [1]... READ MORE

The Fifth Circuit ruled that a whistleblower’s voluntary dismissal with prejudice cannot affect the Government’s ability to pursue related litigation. When the Government has not yet intervened, and thus is not a yet a party, a case cannot be dismissed with prejudice as to the Government by a whistleblower. Background In Vaughn, ex rel.... READ MORE

The Eleventh Circuit recently held that a qui tam relator cannot intervene in criminal forfeiture proceedings when the Government chooses to criminally prosecute fraud rather than intervene in a qui tam action. In United States v. Couch,[1] a former employee (“Relator”) of a pain management clinic in Alabama tried to recover amounts she believed... READ MORE

The past several years have seen a trend of attorneys now taking on the role of relator as well as counsel. This raises a new question: how are relators who act as counsel to be rewarded? By the relator’s share? By attorneys’ fees? By both? That question was answered recently by the Illinois Supreme Court, interpreting... READ MORE

Nearly a decade has passed since the U.S. Congress enacted the Patient Protection and Affordable Care Act (the “ACA”). Since March 2010, we have seen federal court rulings on numerous challenges to the ACA itself and the executive branch’s efforts to enforce the ACA. One such challenge resulted on September 7, 2018 in the... READ MORE

Most health care providers caring for federal health care program beneficiaries are familiar with the False Claims Act[1] (“FCA”) and its qui tam provision,[2] which grants private citizens the right to sue health care providers on behalf of the federal government. The seemingly routine 6+ figure FCA settlements garner much-deserved attention. After all, providers... READ MORE