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
The Seventh Circuit Court of Appeals just issued its decision in US ex rel. Nelson v. Sanford-Brown, Ltd.. This decision is sure to find its way into briefs and arguments for years to come in False Claims Act (“FCA”) cases. It touched upon many of the different ways a qui tam relator can... Continue Reading →Tags: 7th Cir, conditions of participation, False Claims Act, FCA, implied certification, Nelson, original source, PPA, public disclosure, Sanford-Brown, Seventh Circuit
On May 26, 2015, the United States Supreme Court issued its decision in Kellog Brown & Root Service, Inv. et al. v. United States ex rel. Carter, 575 U.S. ____ (2015), Case No. 12-1497. Most of the commentary on the case centers around the Court’s decision on the Wartime Suspension... Continue Reading →Tags: bar, Brown, Carter, False Claims Act, FCA, first to file, Kellogg, original source, prejudice, public disclosure, qui tam, Root, settlement, whistleblower
Today the Sixth Circuit Court of Appeals joined several other Circuit Courts in finding that an administrative review, and even a repayment to the appropriate government oversight entity, did not qualify as a “public disclosure” under the False Claims Act’s public disclosure bar.... Continue Reading →Tags: Chattanooga-Hamilton County Hospital Authority, David Honig, Erlanger, False Claims Act, Farmington, FCA, public disclosure, Ritu Cooper, sixth Circuit, Whipple
A recent case out of the Northern District of Illinois Federal Court, US ex rel. Oughatiyan v. IPC the Hospitalist Company, Inc., demonstrates the high risk inherent in evaluation and management (E&M) coding for health care providers.... Continue Reading →Tags: 9(b), E&M, evaluation and management, False Claims Act, FCA, hospitalist, Illinois, IPC, Northern District of Illinois, Oughatiyan, Seventh Circuit
Written by David B. Honig and Delphine P. O’Rourke Assertion of affirmative defenses creates risk for clients, attorneys and law firms. Treating False Claims Act litigation like any other litigation will lead to the unnecessary expenditure of time and money and potentially sanctions. A recent decision out of the Southern District of Texas, United States ex rel. King v Solvay... Continue Reading →Tags: affirmative defenses, comparative fault, contributory fault, Damages, failure to mitigate, False Claims Act, FCA, laches, learned intermediary, mitigation, third parties, unclean hands
Written by David B. Honig and Ritu Kaur Cooper. On February 3, 2015, the Fourth Circuit Court of Appeals ruled that disclosures to the public officials responsible for managing the subject of a False Claims Act lawsuit did not qualify as “public disclosures” for the purpose of the FCA’s public disclosure bar. US... Continue Reading →Tags: audit, Bank of Farmington, compliance, David B. Honig, False Claims Act, FCA, Graham County, original source, public disclosure, qui tam, Rita Kaur Cooper, self-disclosure, whistleblower
with Drew B. Howk On Monday, February 2, well-respected Federal District Court Judge Jed S. Rakoff awarded costs to the prevailing Defendant in US ex rel. Associates Against Outlier Fraud v. Huron Consulting, Case No. 09 Civ. 1800(JSR). The case had a long history. The Complaint was originally filed in February 2009. It... Continue Reading →Tags: costs, expenses, False Claims Act, FCA, fees, Huron Consulting, Rakoff
Written by David B. Honig and Steven H. Pratt. On February 2, the Sixth Circuit Court of Appeals ruled on a case from the Southern District of Ohio, US ex rel American Systems Consulting, Inc. v Mantech Advanced Systems International. At issue was whether a court may determine whether a knowingly false... Continue Reading →Tags: Colorado, DITCO, False Claims Act, FCA, healthcare, ManTech, materiality, Medicaid, Medicare, RFP
Relator Thulin was a pharmacist in Idaho working for Shopko, a Wisconsin company. He filed an FCA claim alleging Shopko defrauded Medicaid by failing to pass along private insurance plan prices to Medicaid for dual-eligible patients. The court rejected Shopko’s claim, affirming the trial court’s grant of a motion to... Continue Reading →Tags: assignment, False Claims Act, FCA, Medicaid, pharmacy, Shopko, Thulin