Our 13th annual Healthcare Fraud & Abuse Review, compiled by the Bass, Berry & Sims Healthcare Fraud & Abuse Task Force, is now available, providing an in-depth look at the key enforcement trends, legal decisions, and settlements shaping
Inside the False Claims Act
Latest from Inside the False Claims Act - Page 2
Supreme Court Clarifies “Claim” Definition Under False Claims Act
In Wisconsin Bell, Inc. v. United States ex rel. Heath, the Supreme Court clarified the definition of “claim” under the FCA. The case resolves a split between the Fifth and Seventh Circuits on whether a request for reimbursement under the…
First Circuit Adopts “But-For” Causation Standard for Proving Kickback FCA Violations
In a closely watched appeal, the U.S. Court of Appeals for the First Circuit ruled on February 18 that to satisfy the causation requirement in False Claims Act (FCA) actions based on alleged Anti-Kickback Statute (AKS) violations, the government or…
The Surge in FCA Whistleblower Lawsuits: What’s Driving the Trend and What Comes Next?
By Matt Curley
Whistleblower-driven False Claims Act (FCA) lawsuits are on the rise, raising critical questions about the factors fueling this trend and its potential impact on enforcement.…
Fourth Circuit Holds that Violation of CIA Can Support Reverse False Claims and Adopts Relaxed Rule 9(b) Presentment Requirement
On February 3, the U.S. Court of Appeals for the Fourth Circuit reversed a district court’s grant of a motion to dismiss, holding in relevant part that:…
Impact of Trump Administration’s Executive Order on DEI Programs and FCA Liability
As federal contractors and grant recipients navigate the changing landscape of diversity, equity, and inclusion (DEI) programs, the Trump administration’s rescinding of Executive Order No. 11246 (EO) raises new concerns about potential False Claims Act (FCA) liability for non-compliance.…
Executive Order on DEI Programs: Implications for Healthcare and False Claims Act Risks
The Trump administration’s recent executive order targeting diversity, equity, and inclusion (DEI) programs is reshaping the landscape for healthcare providers, with potential legal and regulatory implications that are still unfolding.…
HHS-OIG Year in Review 2024
Success of Repeat Whistleblower in Recent FCA Settlement
By Matt Curley
I commented on the success of serial whistleblower Cecilia Guardiola in her most recent False Claims Lawsuit (FCA) against a healthcare provider. Since 2007 she has secured at least four settlements totaling more than $43 million against healthcare companies; her…