The Western District of New York recently allowed the government to intervene in an FCA action brought months after the government’s initial notice of declination and more than seven years after the government initiated its investigation. U.S. ex rel. Teresa
The FCA Insider
Insights and updates on False Claims Act Litigation
The FCA Insider, published by McGuireWoods LLP, focuses on legal developments and compliance issues related to healthcare fraud and abuse, particularly under statutes like the False Claims Act, Anti-Kickback Statute, and the Eliminating Kickbacks in Recovery Act (EKRA). The blog covers enforcement actions, regulatory guidance, and court decisions affecting healthcare providers, payors, and related entities. Topics include Medicare and Medicaid billing practices, fraud investigations, compliance risks in remote patient monitoring, marketing and referral arrangements, and settlements involving healthcare providers. It also addresses the implications of government audits and whistleblower actions in the healthcare sector.
Latest from The FCA Insider - Page 11
Fifth Circuit Orders Return of Privileged Property After Government Seizure
The Fifth Circuit recently reversed a district court’s dismissal of a motion to return property after the government’s seizure of protected attorney-client information in Harbor Healthcare Sys., L.P. v. United States, 5 F.4th 593 (July 15, 2021). Harbor Healthcare System,…
District Court Embraces Expansive View of “Referrals” to include Accessing Records
By Timothy Fry & Brett Barnett
In Stop Illinois Health Care Fraud, LLC v. Sayeed, No. 12-CV-09306, 2021 WL 2331338 (N.D. Ill. June 8, 2021), an Illinois district court issued an order after a recent bench trial finding that the defendants violated the False Claims Act…
Tide Is Turning Against FCA Case Dismissals
According to a July 28 article in Law360 by McGuireWoods lawyers Michael J. Podberesky, John S. Moran, Todd R. Steggerda, David Pivnick and Cassandra M. Burns, the U.S. Supreme Court’s recent decision declining to review an…
New Georgia Statute Prohibits Patient Brokering for Substance Abuse Providers
A new Georgia anti-kickback statute seeks to halt a recently identified pattern of substance abuse treatment centers seeking patient referrals from healthcare providers in exchange for fees.
Read on for details about this law, which prohibits such “patient brokering.” Violations…
Increasing OIG and DOJ Telehealth Fraud Enforcement Likely on Horizon
Three McGuireWoods’ attorneys, partners Andrea Lee Linna and Michael Podberesky, and associate Amanda Ray, have co-authored an article on the likely forthcoming increase in OIG and DOJ telehealth fraud enforcement that was published in the July issue of Compliance…
Sixth Circuit Affirms Dismissed FCA Case against Walmart involving Opiate Prescription Allegations
The U.S. Court of Appeals for the Sixth Circuit dismissed a relator-pharmacist’s False Claim Act (FCA) case, holding that the pharmacist claims, largely based on a stolen Medical Expenses Summary, lacked merit. In U.S. ex. rel. Sheoran v. Wal-Mart Stores…
District Court Greenlights Potential Pro Tanto FCA Liability Offset
On June 18, 2021, the United States District Court for the District of Columbia certified an interlocutory appeal in favor of Honeywell in a case involving FCA common liability. The appeal will concern the question of whether the court properly…
2021’s First-Half Notable Themes on The FCA Insider
No FCA Liability Where Fraudulently Obtained Contract Did Not Concern the United States
In U.S. ex rel. Freedman v. Bayada Home Health Care, Inc., No. 3:19-cv-18753-FLW-ZNQ, 2021 WL 1904735 (D.N.J. May 12, 2021), a New Jersey District Court found that the relator failed to plead a cognizable theory of liability under the FCA…