In a partial affirmation, the Fourth Circuit weeded out False Claims Act (“FCA”) claims made without particularity, requiring relators to “connect the dots” between the alleged false claims and government payment and highlighted the FCA’s recently amended “objective reasonableness” standard in reviewing retaliation claims. Background In 2010, the FCA was... Continue Reading →Tags: False Claims Act, FCA, fraud with particularity, Grant, Rule 9(b)
The courts appear to be walking back their trend toward loosening False Claims Act (“FCA”) pleading requirements. The FCA is a fraud statute, and lawsuits alleging FCA violations must be pled under Rule 9(b) of the Federal Rules of Civil Procedure: Fraud or Mistake; Conditions of Mind. In alleging fraud or mistake,... Continue Reading →Tags: Bledsoe, Clausen, False Claims Act, fraud with particularity, Hirt, Jallali, Mastej, Prather, Rule 9(b), Walgreen
The False Claims Act[1] is a fraud statute; therefore, False Claims Act complaints must be pled with particularity,[2] identifying “the who, what, when, where, and how of an actual false claim” submitted to the government.[3] Whistleblowers without evidence of specific claims have tried to circumvent the rule with statistics, showing... Continue Reading →Tags: Booker, fraud with particularity, Neurontin, Pfizer, Rule 9(b), statistics
The Federal District Court for the Middle District of Florida appears to have rejected recent direction from the Eleventh Circuit Court of Appeal to deny a motion to dismiss in a False Claims Act case. In United States ex rel. Napoli et al. v. Premier Hospitalists PL, et al. the... Continue Reading →Tags: Clausen, False Claims Act, FCA, fraud, fraud with particularity, Jallali, Mastej, Napoli, Premier Hospitalists, Rule 9
Last week, the Seventh Circuit Court of Appeals handed down its decision in US ex rel. Presser v. Acacia Mental Health Clinic, LLC. [1] The FCA case was brought by a nurse practitioner whistleblower who alleged that services being provided were not medically necessary. The court affirmed dismissal under Rule 9(b)... Continue Reading →Tags: Acacia, False Claims Act, FCA, fraud with particularity, medical necessity, Presser, reasonable and necessary
Last week, the 11th Circuit Court of Appeals issued its unpublished ruling in US ex rel.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
From October 1 through October 12, 2014, there were 14 federal cases reported that mentioned the False Claims Act. One was previously discussed in the September 2014 FCA Update. Eight more only tangentially discussed the False Claims Act. Five cases might be of interest to parties and counsel in a False... Continue Reading →Tags: attorney, Boeing, Cephalon, Cestra, conspiracy, deposition, FAA, False Claims Act, FCA, first to file, fraud with particularity, Graves, individual defendants, jurisdiction, Kelly, May, Plaza Medical Centers, privilege, Purdue Pharma, regulatory compliance, Serco, Smith, specific claims
US ex rel Graves v Plaza Medical Centers Corp Case No. 10-23382-CIV-MORENO (S.D.Fla. Oct. 8, 2014) Defendants filed a Motion to Dismiss for failure to plead fraud with particularity. The trial court dismissed without prejudice, finding: While Relator alleged specific conduct as to 28 patients, it did not offer a... Continue Reading →Tags: actual claim, conspiracy, False Claims Act, FCA, fraud with particularity, Graves, individual defendants, motion to dismiss, Plaza Medical Centers, specific allegations
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)
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