Courts Affirm Constitutionality of FCA Qui Tam Provision

On September 30, 2024, Judge Kathryn Mizelle in the Middle District of Florida granted a defense motion for judgment on the pleadings and dismissed an FCA case after concluding that the FCA’s qui tam provision is unconstitutional.   U.S. ex rel. Zafirov v. Fla. Medical Assoc. LLC, No. 19-cv-1236, Dkt. No. 346 (M.D. Fla. Sept. 30, 2024). Judge Mizelle […]

High Court False Claims Ruling Underscores Communication Is Key

Federal contractors should avoid taking unjustifiable risks when interpreting regulations—and then submitting bills to the US government— if they want to stay out of False Claims Act trouble. That’s one of the takeaways from Justice Clarence Thomas’ June 1 opinion in United States ex rel. Schutte v. SuperValu Inc., which reinstated FCA suits alleging the SuperValu and […]

CLE: The Art of Drafting and Responding to Effective Demand Letters

Telephone Seminar, 6/21/2023, Noon – 1:30 | Learn the latest on The Art of Drafting and Responding to Effective Demand Letters CLE with this convenient, telephonic seminar with visual access to written materials. Register to obtain CLE and MCLE credit, receive access to complete course and reference materials, and attend this telephonic seminar. Benefits: The […]

On Demand CLE: Pretrial False Claims Act Litigation

Federal Bar Association Webinar – Recorded May 3, 2023 The False Claims Act, which dates back to the Lincoln Administration, provides the government the right to pursue individuals or entities that file or cause to be filed false or fraudulent claims for payment or approval with the Government. The statute has “qui tam” provisions that […]

Whistleblowers accuse Erlanger of illegal billing for concurrent surgeries that left patients unsupervised

A federal whistleblower lawsuit filed against Erlanger Health System accuses hospital leaders of illegal billing practices by knowingly overlapping surgeries and allowing trainees to operate on patients without physician supervision, among other patient safety and compliance issues. The complaint, brought under the federal False Claims Act and Tennessee Medicaid False Claims Act and filed in […]

UPMC, head of cardiothoracic surgery will pay $8.5M to feds to settle lawsuit

“Patients don’t know their doctors are serving two masters.” UPMC, a renowned cardiothoracic surgeon there and a physicians group will pay the federal government $8.5 million to settle a lawsuit accusing them of knowingly submitting hundreds of false claims to Medicare, failing to follow medical standards for surgery and knowingly placing patients at risk. he […]

CLE: Demand Letters and Pre-Complaint Settlement

This CLE program will outline the types of cases susceptible to pre-complaint resolution and the various methods that may be employed to bring the parties to a point where they can resolve their disputes.

Demanding more impact from impact litigation: lessons to be learned from multi-state opioid settlements

In the 1990s, state Attorneys General learned how to leverage their resources when they retained private counsel to sue the tobacco industry. The private attorneys worked on contingency, meaning they did not get paid unless money was recovered from the tobacco industry. For their part, the states were able to take on novel litigation and draw from private investments in legal innovation without putting taxpayer dollars at risk.

Whistleblowers and fears of losing funds key to enforcing U.S. vaccine rules

Workplace whistleblowers and a fear of losing federal funds are expected to play vital roles in ensuring compliance with COVID-19 vaccine mandates ordered by President Joe Biden’s administration for U.S. businesses, nursing homes and hospitals, according to experts. Biden announced last Thursday that his administration will enforce the vaccine mandates starting on Jan. 4. The […]

Book: New Pretrial Advocacy Book Addresses New Norms in Transformed Field of Litigation

A new book on pretrial advocacy, published this week by the National Institute for Trial Advocacy (NITA) and Wolters Kluwer, takes on a world of litigation that has been radically transformed in recent years by remote proceedings and other practice norms that often deliver resolution long before litigants face off in the courtroom. (Available in print […]

Oglethorpe Inc. Agrees to Pay $10.25 Million to Resolve False Claims Act Lawsuit

Florida based Oglethorpe Inc. and it’s three Ohio treatment facilities will pay $10.25 million to settle allegations of illegal patient kickback provisions, unnecessary inpatient admission, and the resulting submission of false claims to Medicare. The suit alleged that Oglethorpe’s treatment centers, which include two inpatient psychiatric hospitals and one substance abuse treatment facility, provided free […]

Insitu Inc. to Settle False Claims Allegations for $25 million

Washington State company Insitu Inc., an unmanned aerial vehicle contractor, has agreed to pay $25 million to settle allegations that it submitted false cost and pricing data for determination of contract value with the U.S. Special Operations Command and Navy. The lawsuit was built upon evidence that between 2009 and 2017 Insitu entered into multiple […]

Texas Heart Hospital to Pay $48 million to Resolve Allegations of False Claims

The DOJ has announced that Texas Heart Hospital of the Southwest LLP and its subsidiary THHBP Management Company, LLC have agreed to pay the US $48 million to settle allegations that the hospital submitted claims to Medicare that were in violation of the Physician Self-Referral Law and the Anti-kickback Statute of the False Claims Act. […]

Biogen Inc. and Advanced Care Scripts Inc. to Pay $23.4 Million in False Claims Settlement

One of the world’s largest pharmaceutical companies, Biogen, Inc., and a large specialty pharmacy, Advanced Care Scripts, Inc. (ACS), will pay a combined $23.4 million to settle allegations under the Federal False Claims Act that kickbacks were used to induce the sale of drugs used to treat multiple sclerosis. Biogen will pay $22 million and ACS will pay $1.4 million. […]

Home Healthcare Agency Settles Whistleblower Suit for $5.8m

Doctor’s Choice Home Care, Inc. and former executives have agreed to pay $5.8 million to settle allegations that the home health agency engaged in a variety of conduct in violation of the False Claims Act, including providing illegal remunerations or bonuses for referring physicians. Doctor’s Choice, which provides medical services to Medicare patients in their […]

Kaiser Foundation Health Plan to Settle False Claims Act Allegations

Oakland, CA based Kaiser Foundation Health Plan has agreed to pay $6.3 million to settle allegations that it submitted false Medicare Advantage patient diagnoses in order to receive inflated payments from Medicare. Under the Medicare Advantage program, Medicare pays private insurers based on the cost of providing care for all recipients enrolled in their plans. […]

Peer Review Doesn’t Apply in False Claims Act Suit

Massachusetts General Hospital could not assert the medical peer review privilege to block production of documents sought by a whistleblower in her False Claims Act suit over the hospital’s alleged double and triple booking of surgeries, a U.S. magistrate judge has ruled. . . . During discovery, Wollman (relator) moved to compel production of medical […]

Medtronic USA Inc. Agrees to $9.2 Million Settlement

Minnesota-based Medtronic USA Inc. has agreed to pay $9.2 million to resolve allegations that it violated the anti-kickback provision of the False Claims Act. The company was accused of illegally paying Wilson Asfora, M.D., a South Dakota neurosurgeon, to induce use of it’s SynchroMed II infusion pumps, which are implantable drug delivery devices. For a […]

DOJ Announces $24.9 million Settlement with Guild Mortgage Company

San Diego based Guild Mortgage Company, participant in the Federal Housing Administration insurance program, has agreed to pay $24.9 million to resolve allegations that it caused the submission of false claims for recovery of defaulted home loans. Guild was accused of violating the False Claims Act by knowingly approving ineligible home ownership loans then recovering […]

Santee Christian College to Pay $225,000 Over Federal Violations on Recruiting

San Diego Christian College in Santee will pay $225,000 to resolve allegations that it compensated a student recruiting company in violation of a federal ban on incentive-based compensation, the Department of Justice announced Monday. The university’s settlement resolves allegations that it hired student recruiting company Joined Inc. between 2014 and 2016 to recruit prospective students to SDCC and […]

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