False Claims Act (FCA)

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Cybersecurity Compliance on U.S. Government Contracts and Subcontracts

By Karen Harbaugh and Richard Gibbon on Posted in cybersecurity, Department of Justice, False Claims Act (FCA), Fraud, ransomware, United States, US Department of Justice, Whistleblowing
The U.S. Department of Justice announced late last year that it would utilize the False Claims Act, the U.S. government’s primary civil tool to redress false claims for federal funds and property, to bring actions against U.S. government contractors and subcontractors who do not meet the cybersecurity requirements of a particular contract or grant. The … Continue Reading

Allocating Attorney Fees in a False Claims Act Settlement with Multiple Relators

By Benjamin Glassman on Posted in False Claims Act (FCA)
The United States Court of Appeals for the Sixth Circuit recently issued a published opinion regarding entitlement to attorney fees in a False Claims Act settlement that involved multiple relators, each of whom had filed a case in which the government intervened. Addressing arguments based on 31 U.S.C. s. 3730(d)(1), the first-to-file rule, and the … Continue Reading

DOJ Prioritizes Health Care Fraud in the Pandemic

By Chase Goldstein on Posted in bribery, Compliance Program, corruption, COVID-19, Department of Justice, False Claims Act (FCA), Fraud, Healthcare, Industry Investigations, telemedicine
The Department of Justice (“DOJ”) recently announced its largest ever health care fraud and opioid enforcement action.  In a coordinated effort, DOJ charged 345 defendants with more than $6 billion in fraud losses for submitting false and fraudulent claims to federal health care programs and private insurers.… Continue Reading

DOJ Civil Division Highlights False Claims Act Priorities for 2020

By Squire Patton Boggs on Posted in Department of Justice, False Claims Act (FCA), US Department of Justice
Joseph “Jody” Hunt, Assistant Attorney General for the Civil Division, provided a glimpse of current civil enforcement priorities of the Department of Justice (DOJ).  Speaking at the Federal Bar Association’s annual Qui Tam Conference on February 27, 2020, Hunt pledged that DOJ would pursue qui tam cases involving nursing homes, Medicare Advantage plans, and electronic … Continue Reading

False Claims Act Recoveries Back On The Rise

By Chase Goldstein on Posted in Anti-corruption, Department of Justice, False Claims Act (FCA), Fraud, US Department of Justice
After a dip in the 2018 fiscal year, False Claims Act (FCA) settlements and judgments are back and climbing. The Department of Justice (DOJ) recently announced that it had obtained more than $3.05 billion from FCA settlements and judgments for the 2019 fiscal year. 2018 may have just been an aberration after the 2010s saw … Continue Reading

DOJ Intervenes in False Claims Case Involving Copay Subsidies

By Rebecca Worthington on Posted in False Claims Act (FCA), Healthcare, U.S. Supreme Court
The Department of Justice (DOJ) recently intervened in a False Claims Act (FCA) lawsuit involving allegations of kickbacks for prescription drug copays. The DOJ says the lawsuit makes “clear that the Department will hold accountable drug companies that pay illegal kickbacks to facilitate increased drug prices.” The DOJ “will not allow drug companies to use … Continue Reading

DOJ Pursues More Electronic Health Records Cases

By Colin Jennings and Ayako Russell on Posted in corporate compliance, cybersecurity, Data Protection & Privacy, Department of Justice, False Claims Act (FCA), US Department of Justice
On May 31, 2019, the U.S. Attorney for the District of Kansas announced a $250,000 settlement with Coffey Health System, after two whistleblowers filed qui tam suit against Coffey for violations of the False Claims Act. The settlement resolved allegations that Coffey submitted false claims to Medicare and Medicaid pursuant to the Electronic Health Records … Continue Reading

New DOJ Guidance on Cooperation in False Claims Act Matters

By Rebecca Worthington on Posted in Compliance Program, corporate compliance, Department of Justice, False Claims Act (FCA), US Department of Justice
This week, the Civil Division of the U.S. Department of Justice released guidelines on cooperation credit in False Claims Act cases. The guidelines strongly emphasize voluntary disclosure, but also provide insight into other actions that could give rise to cooperation credit.… Continue Reading

DOJ 2018 Policy Shifts in Review

By Squire Patton Boggs on Posted in China, China enforcement actions, corporate compliance, Deferred Prosecution Agreement, Department of Justice, False Claims Act (FCA), FCPA Jurisdiction, Foreign Corrupt Practices Act, Foreign Corrupt Practices Act (FCPA), Government Investigation, Healthcare, US Department of Justice
In 2018, the US Department of Justice (DOJ) issued many important policy updates and rollouts that will have far-reaching impact. Our firm’s Alert provides an easily navigated yet detailed summary of developments. Policy Shifts at the Department of Justice – 2018 in Review focuses on government investigations and white collar prosecutions. The Alert covers:… Continue Reading

DOJ Recovers More Than $2.8 Billion for False Claims

By Rebecca Worthington on Posted in Department of Justice, False Claims Act (FCA), Fraud, Healthcare, US Department of Justice
The federal government’s recoveries for false claims during FY2018 topped $2.8 billion. The Department of Justice (DOJ) recently released this and other statistics for its civil False Claims Act recoveries since 1986. Although the most numerous and lucrative recoveries occurred in the health care industry, the DOJ reported 35 new qui tam cases involving the Department … Continue Reading

Third Circuit Clarifies Public Disclosure Bar in False Claims Act

By Rebecca Worthington on Posted in False Claims Act (FCA), Fraud, Healthcare
Third Circuit Clarifies Public Disclosure Bar in False Claims Act In United States v. Omnicare, Inc., the Third Circuit clarified the operation of the public disclosure bar in the False Claims Act (FCA). The court held that publicly available information “could not have reasonably or plausibly supported an inference” of fraud. This information included government … Continue Reading

CLOUD Act is Now Law

By Ericka Johnson on Posted in Data Protection & Privacy, Data provider, Department of Justice, U.S. Congress, U.S. Supreme Court, US Department of Justice
Buried on page 2,201 of the 2,232-page 2018 Omnibus Spending Bill, the CLOUD Act was signed into law on March 23, 2018. The bill allows U.S. law enforcement to obtain U.S. citizens’ private data from servers anywhere in the world, provided that an agreement exists with that country on data sharing. However, the CLOUD Act … Continue Reading

DOJ Reveals Data Team – Future of Enforcement

By Squire Patton Boggs on Posted in Department of Justice, False Claims Act (FCA), US Department of Justice
The 2017 Year in Review of the Department of Justice reveals a Data Analytics Team (the “Team”) for tracking healthcare fraud. The Healthcare Fraud Unit launched the Team in order to provide data mining expertise that efficiently detects healthcare fraud. This development demonstrates that data analytics is the future of enforcement. A fuller description of the Team … Continue Reading

Court’s Detailed Rejection of Plea Leads to New Bargain

By Rebecca Worthington on Posted in Deferred Prosecution Agreement, Department of Justice, False Claims Act (FCA), US Department of Justice
A recent blog post summarized an opinion in which a district court catalogued his reasons for rejecting a corporate “C” plea involving a pharmaceutical company.  Several developments have occurred since the court’s opinion including a plea and sentencing hearing scheduled for January 30, 2018. … Continue Reading

DOJ Recovers $32.3 Million For Drug Pricing Despite Limited Role in FCA Case

By Rebecca Worthington on Posted in False Claims Act (FCA)
The Department of Justice (DOJ) recently announced a False Claims Act (FCA) settlement with Kmart Corporation for $32.3 million.  The settlement is part of a global $59 million settlement; the relator will receive $9.3 million. Former Kmart Employee Filed the Qui Tam James Garbe, the relator, was employed by Kmart as a pharmacist from 2007 until … Continue Reading

Government Fraud Settlements Are Getting More Personal

By Squire Patton Boggs on Posted in False Claims Act (FCA), Fraud
Government fraud settlements are getting more personal. Which means the Yates memorandum is having its intended effect. Issued in 2015, the memo requires that government attorneys focus more on individual liability when resolving fraud investigations. For example, that year only 6 settlements imposed personal liability on physicians settling complaints filed under the False Claims Act. According to … Continue Reading

Kickback Training – What It Doesn’t Cover

By Squire Patton Boggs on Posted in False Claims Act (FCA)
Effective training prepares contractors and providers to recognize more than kickbacks. The example below reveals that not all kickback violations are intuitively obvious. What seems a clear violation to those familiar with anti-kickback and false claims statutes, may seem just a straightforward business arrangement to someone unfamiliar with them. After all, what is wrong when providers … Continue Reading

Applying Escobar — Decisions on Materiality, Falsity and Other Issues

By Rebecca Worthington on Posted in False Claims Act (FCA), Healthcare, U.S. Supreme Court
June 16, 2017, marks the one-year anniversary of the precedent-setting U.S. Supreme Court decision in Universal Health Services v. United States ex rel. Escobar (Escobar), which approved the implied false certification theory as a basis for liability under the False Claims Act (FCA). Because the decision impacts every provider who supplies goods and services to … Continue Reading
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