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October 11, 2017 Healthcare Fraud

The Anti-Kickback Statute vs. The Stark Law

There is much confusion between the Federal Anti-Kickback Statute and the Stark Law because both laws deal with remuneration related to improper referrals. But there are fundamental distinctions between the two laws. Anti-Kickback Statute [42 U.S §1320a-7b(b)] The federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), (“AKS”) arose out of congressional […]
October 9, 2017 Healthcare Fraud

What is the Stark Law?

Section 1877 of the Social Security Act (“the Act”) (42 U.S.C. 1395nn) is also known as the physician self-referral law and is commonly referred to as the “Stark Law.”[1] The Stark Law was enacted in 1989 with the simple purpose of curbing physician self-referral. It was originally titled the Ethics […]
October 6, 2017 False Claims Act Information

A Relator’s Reliance is Irrelevant in a Public Disclosure Bar Inquiry

By Sherrie Savett and Jonathan DeSantis The False Claims Act (“FCA”) contains a public disclosure bar which, generally speaking, prohibits a relator from pursuing FCA claims where the false or fraudulent conduct on which the claims are based has already been publicly disclosed.[1] Various courts have concluded that the public […]
October 4, 2017 False Claims Act Information

Dismissing a False Claims Act Case: Is the Whistleblower Still Eligible for a Reward?

Consider the following scenario: A whistleblower files a complaint against a defendant under the False Claims Act (“FCA”). Then, the whistleblower voluntarily dismisses that complaint (perhaps because the government has declined to intervene, and the whistleblower does not wish to pursue the case at that time.) But then, the government […]
October 2, 2017 Rule 9(b)

False and Misleading Statements by Omission Can Be Actionable Under the False Claims Act

In bringing a claim under the False Claims Act (“FCA”), typically there are some sort of false or fraudulent statements made to the government. See 31 U.S.C. § 3729(a)(1)(A), (B). However, it should be noted that FCA claims may be committed by an affirmative misrepresentation or omission. See Universal Health […]
September 29, 2017 News

Aetna to Provide Emergency Relief to Members Affected by HIV/AIDS Privacy Breach

Aetna announced yesterday that it is now offering emergency relief for individuals harmed by Aetna’s mailing in July 2017 that disclosed information about HIV/AIDS medication through a large transparent window on the envelope.
September 29, 2017 False Claims Act Information

Declined vs. Intervened False Claims Act Cases

The False Claims Act allows a private individual to bring a case on behalf of the federal government for fraud against the government. In other words, if an individual (a “relator”) knows of another person or entity who is cheating the government through fraud, the False Claims Act allows the […]
September 25, 2017 False Claims Act Information

The Public Disclosure Bar and “Substantially Similar”

After finding that transactions of fraud have been publicly disclosed, the next step in the public disclosure analysis is determining if the allegations in the complaint are “substantially the same” as those publicly disclosed transactions of fraud. See Moore, 812 F.3d at 301. The Public Disclosure Bar Language Pre/Post 2010 […]
September 19, 2017 News

Berger Montague and Kehoe Law Firm, P.C. File Class Action Lawsuits Against Experian and TransUnion Over Inaccurate Tax Lien Reporting

The complaints allege that Experian and TransUnion, two of the “big three” U.S. consumer reporting agencies, willfully violated the Fair Credit Reporting Act (“FCRA”) by reporting tax liens that were already paid and failing to follow reasonable procedures to ensure that the tax lien information they reported was as accurate as possible.
September 12, 2017 False Claims Act Information

FERA and the False Claims Act, Part I: No Direct Presentment Required

In May 2009, Congress passed the Fraud Enforcement and Recovery Act of 2009 (“FERA”), which implemented substantial changes to the False Claims Act (“FCA”) for the first time in two decades.[1]  This three-part series of blog articles will discuss three of the most important changes, including (1) a clarification that […]
August 18, 2017 General

The False Claims Act Tax Bar

The False Claims Act (“FCA”) generally applies to all false or fraudulent “claims” and broadly defines “claims” as including any request or demand for Government funds.[1]  However, a little known provision of the FCA provides that it “does not apply to claims, records, or statements made under the Internal Revenue […]
August 9, 2017 False Claims Act Information

Issues Arising Under the False Claims Act’s First-to-File Rule

The First-to-File Rule One of the many procedural obstacles that a potential qui tam plaintiff must overcome is the first-to-file (“FTF”) rule.  This provision of the False Claims Act (“FCA”) states that “no person” other than the Government may intervene or bring a related action based on the facts underlying […]
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