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February 27, 2019 Healthcare Fraud

Objective Falsity Requirement Under the False Claims Act

Can a False Claims Act case go forward where the only evidence of whether the services at issue were medically necessary are two competing and opposing medical opinions? In a prior blog, we discussed recent holdings in AseraCare I, AseraCare II and Vista Hospice[1].  The main issue addressed in those […]
February 25, 2019 Healthcare Fraud

Differences in Medical Opinion Under the False Claims Act

Courts have recently grappled with the issue of whether a Relator can maintain a case under the False Claims Act (“FCA”) where she retains an expert that says the medical services provided were not medically necessary and the defendant’s medical service provider or its retained expert says the exact opposite […]
February 22, 2019 False Claims Act Information

Whistleblower Rewards: How They Work

The federal False Claims Act (“FCA”) allows an individual with knowledge of fraud upon the federal government, often known as a whistleblower or qui tam relator, to bring a lawsuit on the federal government’s behalf to recover the funds. Many states  have adopted similar laws that apply to fraud upon state […]
February 21, 2019 False Claims Act Information

What is a Qui Tam Relator?

In False Claims Act (“FCA”) cases, the qui tam relator is the whistleblower who brings the FCA claims against the company or individual who is committing fraud. Usually a qui tam relator is an insider—typically a current or former employee—who has access to confidential information showing that his or her […]
February 6, 2019 False Claims Act Information

Tennessee Whistleblower Law

The Tennessee False Claims Act  (“Tennessee FCA”) mirrors the federal False Claims Act (“FCA”), but it involves claims made to state and local governments in Tennessee, as opposed to the federal government. The Tennessee Medicaid False Claims Act (“Tennessee Medicaid FCA”) applies to any false claims made to Tennessee’s state […]
February 4, 2019 Medicaid Fraud

Medicaid Fraud

Medicaid pays for approximately 20% of all healthcare expenses in the United States, over $600 billion each year. Well over 500,000 healthcare providers, ranging from hospital chains to individual doctors to ambulance helicopter pilots, receive payments from Medicaid every year. Inevitably a few of the providers will try to defraud […]
January 31, 2019 False Claims Act Information

What is Whistleblowing?

The eighteenth-century philosopher, Edmund Burke, long ago cautioned that, “All that is necessary for the triumph of evil is that good people do nothing.” That admonition still holds true today.  Whistleblowing involves individuals willing to come forward to stop fraud and other wrongdoing against the government (and by extension, the […]
January 25, 2019 Healthcare Fraud

What is a Kickback Scheme?

Quite simply, a kickback is an inducement – offering or giving something of value in exchange for getting business referrals. Although that type of behavior can be perfectly legal in some segments of the commercial world, it is not permitted when the business that is being referred is paid for […]
January 16, 2019 News

Berger Montague Elects Michael Dell’Angelo New Member of Firm’s Executive Committee, Elevates Shareholder Ruthanne Gordon to Chief Administrative Officer

Berger Montague is proud to announce that the firm has elected Michael Dell’Angelo as the newest member of its Executive Committee. The firm has also selected Shareholder Ruthanne Gordon to serve as its first Chief Administrative Officer.
January 8, 2019 False Claims Act Information

Vermont False Claims Act

In 2015, Vermont enacted its own version of the federal False Claims Act.[1] Generally speaking, the Vermont False Claims Act is very similar to the Federal False Claims Act except that the Vermont law prohibits fraud upon the state government, while the federal law prohibits fraud upon the federal government. […]
January 3, 2019 News

Berger Montague Names Eric L. Cramer New Firm Chairman and Announces Next Phase of Firm’s Evolution

Berger Montague is pleased to announce that it has elected Eric L. Cramer its new firm Chair. Mr. Cramer is the fifth Chair in the firm’s illustrious 49-year history. He has been with the firm since 1995, most recently serving as co-chair of the firm’s antitrust department and on the firm’s Executive Committee.
December 18, 2018 News

H. Laddie Montague Jr. and Eric L. Cramer Included in Who’s Who Legal: Thought Leaders – Competition 2019

Berger Montague is proud to announce that Chairman Emeritus & Of Counsel H. Laddie Montague Jr. and Chairman Eric L. Cramer are included in Who’s Who Legal: Thought Leaders – Competition 2019.
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