Recently, the Department of Justice (“DOJ”) announced it had entered into a $42 million settlement (“Settlement”)[1] with the owners of a California acute care hospital (“Parent Company”) to resolve allegations that the Parent Company had violated the False Claims Act by submitting false claims to Medicare and MediCal (California Medicaid)... Continue Reading →Tags: AKS, False Claims Act, FCA, Medical Director, referrals, settlement, Stark
A recent court decision had highlighted two issues on the cutting edge of health care and False Claims Act (“FCA”) law. Both address what happens in the transition from health care advice to health care litigation. The first is the application of the attorney client privilege and the advice of counsel... Continue Reading →Tags: Advice of Counsel, CMS, commentary, False Claims Act, FCA, jury, Stark
Last week, the 11th Circuit Court of Appeals issued its unpublished ruling in US ex rel. Mastej v. Health Management Associates, Inc. At issue was whether the relator’s Third Amended Complaint adequately pled fraud with particularity, as required by Fed.R.Civ.Pro. 9(b). Mastej was an Health Management Associate (“HMA”) executive from 2001 to... Continue Reading →Tags: 11th Circuit, 9(b), AKS, Anti-Kickback, Eleventh Circuit, False Claims Act, FCA, fraud with particularity, Health Management Systems, HMS, Mastej, Stark
Only one FCA case of interest was decided by a U.S. Circuit Court in September. In US ex rel Parikh v Brown, the Court found that a county hospital and its administrator’s participation in a “simple, brazen kickback scheme” could not be shielded by qualified immunity. The hospital and its administrator... Continue Reading →Tags: AKS, Anti-Kickback, Brown, False Claims Act, FCA, Fifth Circuit, Parikh, qualified immunity, Stark
Jury verdicts in False Claims Act litigation are rare. Two in the same case are rarer still. On May 8, 2013, after just over four hours of deliberation, a jury in the Federal District Court of South Carolina returned a verdict for the Government, finding that the Tuomey Healthcare System... Continue Reading →Tags: FCA, South Carolina, Stark, Toumey, verdict