Legal Insights & Articles

Oklahoma Medicaid False Claims Act

The Oklahoma Medicaid False Claims Act (“Oklahoma Medicaid FCA”) provides severe penalties for individuals who submit false claims to SoonerCare (Oklahoma’s Medicaid program). It also provides powerful incentives and protections for private individuals with knowledge of Medicaid fraud to pursue claims on the State’s behalf. The Oklahoma Legislature adopted the Oklahoma Medicaid FCA in [...]

By |2020-08-24T11:30:10-04:00September 3rd, 2019|False Claims Act Information|

Availability of Information Online Does Not Automatically Bar Qui Tam Action

The Public Disclosure Bar in False Claims Act Cases A provision of the False Claims Act commonly referred to as the Public Disclosure Bar stops relators from pursuing actions on behalf of the government if the “transactions and allegations” of fraud have been publicly disclosed through various sources listed in the statute. 31 U.S.C. [...]

By |2020-08-24T11:32:56-04:00August 28th, 2019|False Claims Act Legal News|

Failure to Accurately Report Drug Prices Constitutes Medicare and Medicaid Fraud

On August 5, 2019, the United States District Court for the Central District of Illinois issued a rare ruling granting partial summary judgment for plaintiff-relators in a False Claims Act case. United States ex rel. Schutte v. SuperValu, Inc. et al., No. 11-3290, 2019 WL 3558483 (C.D.Ill. Aug. 5, 2019). Relying heavily on the [...]

By |2020-08-24T11:36:05-04:00August 21st, 2019|False Claims Act Legal News|

Medicare Would “Likely” Not Pay for Hospice Care for Deceased Patients

If one reads between the lines of a May 7, 2019 opinion from the U.S. Court of Appeals for the Fifth Circuit (covering Texas, Louisiana and Mississippi), it appears that the court comes to the seemingly unremarkable conclusion that Medicare would not intentionally pay for hospice care for patients who are dead: “Relators claimed [...]

By |2020-08-24T11:37:36-04:00August 6th, 2019|False Claims Act Legal News|

What is the Foreign Corrupt Practices Act?

The Foreign Corrupt Practices Act (“FCPA” or “the Act”) (15 U.S.C. §§ 78dd-1, et seq.) is a 1977 federal statute passed to enhance financial transparency among American companies. The FCPA was passed in response to investigations conducted by the Security and Exchange Commission (“SEC”) in the early 1970’s that found bribery directed towards foreign [...]

By |2020-08-24T11:40:00-04:00August 1st, 2019|SEC Fraud|

Government Joins Case Involving Drug Manufacturer’s Illegal Payments of Patient Co-Pays on Expensive Drug

The Department of Justice, with the Office of the United States Attorney of the Eastern District of Pennsylvania, recently joined a lawsuit filed by private whistleblowers against Mallinckrodt ARD LLC, a drug manufacturer. The Government’s complaint was filed on June 4, 2019, although the case had initially been filed in 2012. The case alleges [...]

By |2020-08-24T11:42:32-04:00June 17th, 2019|False Claims Act Legal News|

Court Rewards Relators’ Extraordinary Contribution to False Claims Act Litigation by Awarding 28.5% Relator Share

In U.S. ex rel. Bibby v. Wells Fargo Bank, N.A., 369 F. Supp. 3d 1346 (N.D. Ga. 2019), the district court that had handled the False Claims Act (“FCA”) litigation for the last seven years of its thirteen-year history rejected the Government’s attempt to limit relators to the minimum statutory share and instead awarded [...]

By |2020-08-24T11:43:20-04:00June 14th, 2019|False Claims Act Legal News|

Utah False Claims Act

Utah has enacted a False Claims Act (“Utah FCA”), Utah Code Annotated sections 26–20–9.5 et seq.). The Utah FCA prohibits parties from “enter[ing] into an agreement, combination, or conspiracy to defraud the state by obtaining or aiding another to obtain the payment or allowance of a false, fictitious, or fraudulent claim for a medical benefit.” Utah Code [...]

By |2020-08-24T11:43:54-04:00June 12th, 2019|False Claims Act Information|

What is Cost Report Fraud?

Cost report fraud occurs when nursing homes, hospitals, and other healthcare providers for patient care falsely submit claims to the government for reimbursement. Medicare Part A healthcare providers that are paid under the fee-for-service based system can abuse federal government funding by: Inflating their patient care costs; Seeking reimbursement from the government for costs [...]

By |2020-08-24T11:44:24-04:00June 10th, 2019|Healthcare Fraud|
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