Last month, the US District Court for the District of Columbia delivered another blow to the “tainted claims” theory of False Claims Act (FCA) damages frequently espoused by the government and qui tam relators.
From the 1990s through 2004, the
FCA Update
Exploring Recent Developments in False Claims Act Litigation, Enforcement and Compliance
The FCA Update blog, published by McDermott Will & Emery, focuses on legal developments related to the False Claims Act and enforcement issues impacting the healthcare industry. It covers topics such as healthcare compliance, government investigations, Medicare payment rules, Stark Law regulations, and litigation strategies. The blog also addresses regulatory guidance, policy changes, and practical implications for healthcare providers and organizations. It serves as a resource for updates on healthcare fraud and abuse laws, enforcement trends, and compliance best practices within the healthcare and life sciences sectors.
Latest from FCA Update - Page 10
Medicare Part B Provider Secures Dismissal of FCA Claims Under First-to-File Bar
On February 27, 2017, the US District Court for the Southern District of Mississippi granted a defense motion to dismiss False Claims Act (FCA) claims in United States ex rel. Dale v. Lincare Holdings, Inc., on the grounds that the…
SDNY Dismisses Sub-Prime Mortgage Crisis Complaint on Materiality Grounds Because Government Paid Claims Despite Notice of Alleged Fraud
By Laura McLane
On March 2, 2017, the US District Court for the Southern District of New York applied the materiality standard announced by the Supreme Court of the United States in Universal Health Services, Inc. v. United States ex rel. Escobar to…
New OIG Exclusion Regulations About to Go into Effect
The Office of Inspector General (OIG) recently published a final rule regarding its exclusion authorities. The final rule goes into effect March 21, 2017, and expands OIG’s authority to exclude certain individuals and entities from participating in federal health care…
Documents and Resources from the June 18, 2015 Medicare Fraud Strike Force Press Conference
DOJ Releases Detailed Criteria for Evaluating Compliance Programs
By Tony Maida
The Department of Justice (DOJ) doubled-down on emphasizing corporate compliance programs with new guidance from the Criminal Division Fraud Section with the “Evaluation of Corporate Compliance Programs” (Criteria). This document, released February 8 without much fanfare, contains a…
Fourth Circuit Declines to Address FCA Sampling Dispute as “Issue of Fact” While Affirming That United States Has “Unreviewable Veto Power” to Deny Settlements
On February 14, 2017, after nearly two years of appellate proceedings, the US Court of Appeals for the Fourth Circuit declined to address the substance of an appeal related to the use of statistical sampling to prove liability in…
The FCA and Medical Necessity: An Increasingly Tenuous Relationship
On January 19, 2017, another district court ruled that a mere difference of opinion between physicians is not enough to establish falsity under the False Claims Act. In US ex rel. Polukoff v. St. Mark’s et al., No. 16-cv-00304 (Jan.…
Court Rejects Criminal Defendant’s Attempt to Dismiss Indictment Based on Favorable Defense Verdict in Non-Intervened FCA Case
By Laura McLane
On January 26, 2017, the US District Court for the Western District of Virginia rejected a defendant’s attempt to invoke collateral estoppel principles to dismiss an indictment for fraud. In United States v. Whyte, the defendant, Whyte, argued that the…
Federal Health Care Fraud and Abuse Enforcement Made a Strong Showing in FY 2016
According to a report released last week, the Health Care Fraud and Abuse Control Program (HCFAC) returned over $3.3 billion to the federal government or private individuals as a result of its health care enforcement efforts in fiscal year (FY)…