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April 12, 2017
False Claims Act Information
Applying the Anti-Kickback Statute to Pursue Qui Tam Whistleblower Actions Under the Federal False Claims Act and the Delaware False Claims Act
Violations of the Anti-Kickback Statute Form the Basis of False Claims Act Liability Congress has long viewed the elimination of kickbacks as central to any efforts to combat Medicare and Medicaid fraud and abuse. United States v. Greber, 760 F.2d 68, 70-71 (3d. Cir. 1985). Because kickback schemes negatively affect […]
April 10, 2017
False Claims Act Information
Unexpected Problems with the Qui Tam Seal
By law, qui tam cases must be filed under seal. This means that there is no public record of the case having been filed, and the defendant is unaware of the case until the seal is lifted. A plaintiff who breaks the seal by discussing the seal publicly may forfeit […]
April 7, 2017
False Claims Act Information
What Happens If a Prospective Employer Refuses to Hire You Because You Have Been a Whistleblower Before?
Although the federal False Claims Act (“FCA”) and most state statutes provide a whistleblower with claims against retaliation by an employer, it is not clear whether that protection extends beyond the specific company that you reported against. Unfortunately, some prospective or subsequent employers might try to avoid hiring you or […]
April 5, 2017
False Claims Act Legal News
Sweeping Decision Leaves Intact False Claims Act Claims Against Allergan, Inc.
In an opinion issued on March 31, 2017, District Judge Jesse M. Furman of the Southern District of New York substantially denied defendant Allergan, Inc.’s motion to dismiss claims arising under the False Claims Act (“FCA”) and state statutory analogs, in litigation captioned United States ex rel. Wood v. Allergan, […]
March 29, 2017
Grant Fraud
How to Calculate Damages for False Claims Act Cases Based on Research Grant Fraud
The federal government, through its agencies, offers grant funding opportunities to private individuals and entities. Numerous federal agencies offer grants, including the Department of Defense, Health and Human Services and the Department of Energy. Often federal grants are aimed at funding innovative research. In a nutshell, the grant process involves […]
March 27, 2017
False Claims Act Legal News
Another Court Provides Strong Support for Whistleblower Use of Confidential Employer Documents to Expose Alleged Fraud
One of the ways in which companies attempt to discourage whistleblowing or to punish actual whistleblowers is by asserting legal claims against them for using company documents, sometimes in violation of employment agreements or other company employee policies or under various tort laws.[1] In one recent case, for example, the corporate […]
March 24, 2017
Healthcare Fraud
The Federal Anti-Kickback Statute
The federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), (“AKS”) arose out of congressional concern that remuneration provided to those who can influence healthcare decisions would result in goods and services being provided that are medically unnecessary, of poor quality, or harmful to a vulnerable patient population. To protect the integrity […]
March 22, 2017
False Claims Act Information
Meeting the Materiality Requirement of the False Claims Act in Cases Brought by Qui Tam Whistleblowers
The False Claims Act’s Materiality Requirement Under the express language of the False Claims Act (“FCA”), material means having a “natural tendency to influence or be capable of influencing” the government’s decision to pay a claim. 31 U.S.C. § 3729(a)(4). The Escobar Decision Under the 2016 Supreme Court case of […]
March 20, 2017
False Claims Act Information
Fraudulent Inducement as a Legal Theory Under the Qui Tam Provisions of the False Claims Act
While many defendants may assert that fraudulent inducement is not a viable theory of liability in a qui tam case under the False Claims Act (“FCA”), the truth is that the plentiful and better-reasoned authorities to consider this issue support FCA liability for defrauding the FDA. See United States v. […]
March 15, 2017
Rule 9(b)
Pleading Standards in the Eighth Circuit
Federal Rule of Civil Procedure Rule 9(b) Relators in qui tam cases under the False Claims Act (“FCA”) face considerable challenges in meeting pleading requirements in many circuits, including the 8th Circuit. The Rule 9(b) standard in the Eighth Circuit is well described by the Court in United States ex […]
March 13, 2017
False Claims Act Information
False Claims Act Cases Based on Fraudulent Inducement
Liability under the False Claims Act (“FCA”) for fraud in the inducement is established when eligibility to receive funds under a government program was procured by misstatements or other misleading actions. Courts have repeatedly held fraudulent inducement is a viable theory of liability under the FCA. See United States ex […]
March 8, 2017
Healthcare Fraud
Whistleblower Lawsuits Against Medicare Advantage Organizations
In addition to the big qui tam case against UnitedHealth Group that has received so much press recently, there is a similar whistleblower case pending in federal court in Texas alleging False Claims Act (“FCA”) claims against a medical coding company, Censeo Health, L.L.C., and several Medicare Advantage organizations (“MAOs”). […]
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