When is a new qui tam lawsuit derivative of a lawsuit in which the government has already intervened? The US Court of Appeals for the Ninth Circuit answered that question on December 1, 2017, when it decided United States ex
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 7
Dismissed in Florida: Former Compounding Pharmacy Sales Representative’s FCA Whistleblower Suit
On November 8, 2017, the US District Court for the Middle District of Florida dismissed a relator’s non-intervened claims in United States ex rel. Stepe v. RS Compounding LLC for failure to satisfy the particularity requirement of Federal Rule of…
DOJ Announces Significant Shift Towards Affirmative Dismissal Of “Frivolous” Qui Tam Complaints: A New Exit Strategy For Defendants?
Attendees at the Health Care Compliance Association’s Health Care Enforcement Compliance Institute are reporting that, Michael Granston, Director, Civil Frauds, Commercial Litigation Branch of the Civil Division of the US Department of Justice (DOJ), announced a significant shift in policy…
Seventh Circuit Reevaluates and Adopts More Stringent FCA Causation Standard
On October 23, 2017, the US Court of Appeals for the Seventh Circuit reversed itself by determining that proximate cause—and not the “but-for” causation test that the court adopted 25 years ago—is the appropriate standard to determine causation in a…
DOJ Settlement with Florida Medical Practice Serves as a Reminder: Delayed Repayment to Federal Programs Can Have Significant Consequences
While medical practices are generally aware that relators and the government pursue allegations of false or duplicative claims to federal health care programs, a recent settlement reflects a growing trend of False Claims Act (FCA) allegations concerning the failure to…
Another State Alleges False Claims Act Violation to Combat Opioid Crisis
On October 5, 2017, the State of New Jersey sued Insys Therapeutics, Inc. (Insys), alleging that the company improperly marketed and promoted the opioid-fentanyl painkiller drug, Subsys. The civil complaint (Complaint) follows a series of federal indictments (and in some…
DOJ Settlement with Home Health Providers Underscores Strategic Considerations for Self-Disclosure
Eventually, any health care organization with an effective compliance program is very likely to discover an issue that raises potential liability and requires disclosure to a government entity. While we largely discuss False Claims Act (FCA) litigation and defense issues…
Breaking Down the 2017 DOJ and OIG Compliance Guides
By Tony Maida
Earlier this year, DOJ and OIG independently issued guides focused on evaluating compliance program effectiveness. The guides approach the topic from different perspectives but cover overlapping themes and work well in tandem. We reviewed the guides and compiled the reference…
Tenth Circuit Expands First-to-File Rule, Dismissing Complaint after Substitution of Parties
On September 18, 2017, the Tenth Circuit reversed a decision of the US District Court for the District of Utah in United States ex rel. Little v. Triumph Gear Sys., Inc. In doing so, the Tenth Circuit concluded that the…
Recent Developments on the Fair Market Value Front – Part 1
Over the last several months, a handful of federal court decisions—including two rulings this summer on challenges to the admissibility of proposed expert testimony—serve as reminders of the importance of (and parameters around) fair market value (FMV) issues in the…