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
— False Claims Act defense attorneys have been warning government contractors, particularly Medicare and Medicaid providers, of increased risks and a reduced ability to defend against whistleblower complaints since the passage of the Fraud Enforcement Recovery Act of 2009 (“FERA”). The greatest risk comes from FERA’s addition of a new... Continue Reading →Tags: False Claims Act, FCA, Keltner, Lakeshore, Milwaukee, overpayment, qui tam, retained, whistleblower, Wisconsin
By David B. Honig and Andrew B. Howk In U.S. v. MedQuest, the Sixth Circuit held that violations by a provider of conditions of participation in Medicare were insufficient as a matter of law to “trigger the hefty fines and penalties created by the FCA.” This case was a reaffirmation... Continue Reading →Tags: 6th Circuit, condition of participation, condition of payment, Dalse C, express false certification, false certification, False Claims Act, FCA, implies certification, MedQuest, sixth Circuit, summary judgment
The recent amendments to the False Claims Act, the Fraud Enforcement Recovery Act of 2009 (“FERA”), the Patient Protection and Affordable Care Act of 2010 (“PPACA”) and the Dodd-Frank Wall Street Reform and Consumer Protection Act (“Dodd-Frank”) continue to generate new rules and guidance. Effective 2007, Congress created incentives for states to pass... Continue Reading →Tags: Dodd-Frank, False Claims Act, FCA, FERA, HHS, OIG, PPACA
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
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)