On December 23, 2016, the US Court of Appeals for the First Circuit issued an opinion in United States ex rel. D’Agostino v. ev3, Inc. (Case No. 16-1126), affirming the US District Court for the District of Massachusetts’s denial of
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 11
Relying on Escobar, Ninth Circuit Tosses Implied Certification Case
On January 12, 2017, the US Court of Appeals for the Ninth Circuit affirmed a district court’s grant of summary judgment in favor of a government contractor, where a relator had asserted that the contractor had violated material contractual requirements.…
OIG Issues Report on Medicare’s ‘2-Midnight Hospital Rule’
On December 19, 2016, the US Department of Health and Human Services Office of Inspector General (OIG) posted a report examining the Centers for Medicare & Medicaid Services’ (CMS’s) “2-Midnight Rule.” The OIG concluded that although the number of inpatient…
First Circuit Affirms Dismissal of Former Sales Representative’s False Claims Act Claims Against Medical Device Manufacturer
On December 16, 2016, the US Court of Appeals for the First Circuit issued an opinion in United States ex rel. Hagerty v. Cyberonics, Inc. (Case No. 16-1304) affirming the US District Court for the District of Massachusetts’ dismissal of…
OIG Revises Safe Harbors under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements
On December 7, 2016, the Office of Inspector General of the US Department of Health and Human Services published a final rule containing revisions to both the federal Anti-Kickback Statute safe harbors and the beneficiary inducement prohibition in the civil…
A Closer Look at Rigsby and the Supreme Court’s Rejection of Mandatory Dismissal for Seal Violations
In light of the rising civil monetary penalties under the False Claims Act (FCA) and the looming threat of bank-breaking treble damages, avenues to dismissal are paramount to defendants operating in industries vulnerable to FCA claims, including health care. The…
‘Tis the Season for Giving: OIG Updates Policy on Gifts of Nominal Value to Medicare and Medicaid Beneficiaries
On December 7, 2016, the Office of the Inspector General (OIG) of the US Department of Health and Human Services (HHS) issued a policy statement increasing its thresholds for gifts that are considered “nominal” for purposes of the patient inducement…
District Court Lets Insurer off the Hook from Defending FCA Suit
On November 15, the US District Court for the Northern District of California granted Scottsdale Insurance Company’s motion for judgment on the pleadings in Hotchalk, Inc. v. Scottsdale Insurance Co. (Case No. 4:16-CV-03883), ruling that Scottsdale is not required to…
Supreme Court Determines that Seal Violation Does Not Mandate Dismissal
On December 6, 2016, the Supreme Court of the United States decided State Farm Fire and Casualty Co. v. United States ex rel. Cori Rigsby and Kerri Rigsby. At issue was whether a qui tam relator’s violation of the seal…
Split Sixth Circuit Panel Affirms Dismissal of Reverse False Claims Case Involving Fracking Leases
Last week, a 2-1 split panel on the US Court of Appeals for the Sixth Circuit affirmed the lower court’s dismissal of U.S. ex rel. Harper, et al. v. Muskingum Watershed Conservancy District, Case No. 15-4406 (6th Cir. Nov.…