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 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
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
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
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
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. 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
Contractors and providers may face false claims damages when they fail to return overpayments even though no fraud is involved. A recent civil settlement demonstrates that the government is targeting failure to repay, and it can be as costly as fraudulent billing.… Continue Reading
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
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
