Appellate Court Cases Three appellate-level FCA cases were reported in January and February 2013. Only one, U.S. ex rel. Nathan v. Takeda Pharmaceuticals North America, Inc., 1 was selected for publication. All three cases addressed Rule 9(b)’s requirement that allegations of fraud be lead “with particularity.” The cases, read together,... Continue Reading →Tags: Abbott, Bender, Conn, Conrad, Deck, False Claims Act, FCA, Griffith, Jajdelski, Kaplan, Miami Jacobs, Nathan, North American Communications, qui tam, relator, Takeda, whistleblower
by David B. Honig Can the False Claims Act be used by the government or whistleblowers in quality of care cases? The Department of Justice seems to think so, based in significant part on the retention of overpayments amendments to the FCA by FERA and the PPACA. 1 If... Continue Reading →Tags: False Claims Act, FERA, health, health care, hospital, liability, malpractice, overpayment, peer review, PPACA
by David B. Honig Federal regulations are an enormous morass of complex, confusing, and often contradictory rules. The 2009 Code of Federal Regulations was 163,333 pages in 226 individual books. The 2010 Federal Register, which contains new regulations proposed rules, and presidential papers, contained an additional 81,305 pages. Intended... Continue Reading →Tags: Advice of Counsel, attorney-client privilege, CFR, Code of Federal Regulations, False Claims Act, Federal Register, knowledge, mens rea, Regulations, waiver
This Thursday, June 28, 2012, the United States Supreme Court will decide the fate of the Patient Protection and Affordable Care Act, aka “Obamacare.” In so doing, it may also make significant changes in one of the newest and most complicated amendments the False Claims Act, with results that are... Continue Reading →Tags: 60, ACA, deadline, False Claims Act, FCA, FERA, grace period, Obamacare, pleading, PPACA, retention of overpayments, sixty, Supreme Court
290 F.3d 1301, (11th Cir. 2002). To adequately plead a False Claims Act case under Fed.R.Civ.P. 9(b), a whistleblower may not merely plead a scheme to defraud. Rather, they whistleblower must plead and identify actual claims which are false. For more information, please contact David B. Honig at dhonig@hallrender.com or... Continue Reading →Tags: actual claim, Clausen, False Claims Act, FCA, Federal Rules of Civil Procedure, fraud with particularity, Laboratory Corporation of America, Rule 9(b)
314 F.3d 995, 1002 (9th Cir. 2002), the court ruled the relator, an insider, “must show ‘an actual false claims for payment being made to the Government.’” (emphasis in original). The court based its ruling upon the simple fact “(e)vidence of an actual false claim is ‘the sine qua non... Continue Reading →Tags: claim, False Claims Act, FCA, pleading, sine qua non
Pleading a False Claims Act case can be a tricky exercise, and in defending an FCA case, it is important to know just what the rules are for a whistleblower, and how they can fail to meet them. One of the most common mistakes made by whistleblowers is failing to “plead fraud... Continue Reading →Tags: Camillo, False Claims Act, FCA, Fowler, fraud with particularity, Gross, Nayak, Rolls-Royce, Rule 9(b), whistleblower
570 F.3d 849, 844 (7th Cir. 2009). The Court of Appeals ruled that a whistleblower met Fed.R.Civ.P. 9(b)’s requirement to plead fraud “with particularity,” even where he did not produce actual invoices submitted to the government, where the contract required submission of invoices and the whistleblower alleged false certification of compliance... Continue Reading →Tags: False Claims Act, FCA, fraud wtih paticularity, Lusby, Rolls-Royce, Rule 9(b)
2002 WL 1066745 (E.D.La. Case No. Civ.A. 99-1767, May 28, 2002). The False Claims Act whistleblower attempted to identify fraudulent schemes with enough detail to meet Fed.R.Civ.P. Rule 9(b)’s requirement that all averments of fraud be plead “with particularity.” However, his complaint identified actions taken by “the defendants,” and did... Continue Reading →Tags: False Claims Act, FCA, fraud with particularity, Rule 9(b), Stewart, The Louisiana Clinic
2005 WL 1926559 (S.D.Ill. Case No. 03 CV 0024 DRH, Aug. 8, 2005) Defendant Kenneth Hall Regional Hospital, Inc., moved to dismiss the whistleblower’s amended complaint, as it was not an original defendant. As a result, the government had never reviewed the claims against it and made an intervention decision,... Continue Reading →Tags: Ancilla, Andy Martone, Camillo, David Honig, False Claims Act, FCA, fraud with parciularity, Hall, Heath & Lyman, Killian, Martone Hesse, Render, Rule 9(b)