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February 9, 2017
General
Avoiding Application of the False Claims Act’s First-to-File Bar
The False Claims Act’s first-to-file rule provides that “[w]hen a person brings an action under [the False Claims Act], no person other than the Government may intervene or bring a related action based on the facts underlying the pending action.” 31 U.S.C. § 3730(b)(5). This blog provides an overview of […]
January 25, 2017
General
Medicare Advantage Fraud Part I: Presentment of False Claims by Medical Providers to Medicare Advantage Organizations
Medicare fraud is one of the prime drivers of litigation under the False Claims Act (“FCA”). Under traditional Medicare, service providers are directly reimbursed with federal government funds. In 2003, Congress significantly expanded the availability of an alternative to traditional Medicare known as Medicare Advantage. Medicare Advantage differs from traditional […]
December 23, 2016
General
The False Claims Act’s Seal Requirement
On December 6, 2016, in State Farm Fire and Casualty Co. v. United States ex rel. Rigsby, [1] the Supreme Court resolved a circuit split in holding that a violation of the False Claims Act’s (“FCA”) seal requirement does not automatically require dismissal of a relator’s claims. Still, relators and […]
November 16, 2016
General
Excellent Opinion in Support of False Claims Act Case for Customs Fraud
The appeals court for the Pennsylvania-New Jersey-Delaware region recently issued an excellent ruling permitting claims of import fraud to proceed. The ruling addressed several different issues, but this article will focus only on two – finding that sufficient details had been pled based on a credible methodology for alleging that […]
November 15, 2016
General
Businesses That Misrepresent Their “Special Status” Eligibility for Contract or Grant Preferences Can Be Liable Under the False Claims Act
By Susan Schneider Thomas “The Congress has established a number of statutory goals designed to help small businesses compete for Federal contracts. In addition to the goal of awarding at least 23 percent of all Federal prime contracting dollars to small businesses, the Congress also established Government-wide contracting goals for […]
November 13, 2015
General
Federal Government Investigating Soaring Pharmacy Reimbursement Claims in Military
According to a startling article published in the Wall Street Journal, several compounding pharmacies are facing possible liability under the False Claims Act for illegal billing practices surrounding customers enrolled in coverage through the military’s TRICARE healthcare insurance program. Described by investigators as “widespread fraud,” the investigation spans across at […]
November 12, 2015
General
What is Commodities Future Trading? 4 Things You Should Know About Commodity Futures and Fraud
Of the various whistleblower programs in place to date, probably the least well-known is that involving the trade of commodities and futures – an industry regulated by the Commodities Futures Trading Commission. This area of trading can be highly unpredictable, and often the savviest investors are hesitant to take on […]
November 11, 2015
General
US Software Firms Pay $13 Million to Settle Claims of Unlawful Employment of Russians
Entering into a contract with the US Department of Defense naturally necessitates confidentiality, discretion, and, in some cases, top-level security clearances. Accordingly, government contracts generally contain clauses relating to employment practices the contractor must follow in order to protect national security and ensure that all workers on the project are […]
November 10, 2015
General
Defense Contractor Alleged to Have Overcharged Military for Fruits & Vegetables
Los Angeles-based Coast Produce Company recently found itself in a real pickle amid allegations that it grossly overcharged the U.S. military for the delivery and provision of fresh fruits and vegetables. According to a recent press release, the defense contractor agreed to settle the allegations for $4 million and entered […]
November 9, 2015
General
Justice Department Settles With Hundreds of Hospitals Amid Healthcare Fraud Claims
In today’s case, we review one of the largest False Claims Act settlements in terms of sheer breadth, number of defendants, and number of healthcare fraud claims. The settlement, which involved 457 hospitals and healthcare facilities across the United States, resulted in a $250 million payout to the government, and […]
November 6, 2015
General
Maine Dermatology Settles Medicare Fraud Allegations for Over $600,000
With a current caseload of over 50 million enrollees, and as one of the prime programs targeted for fraud nationally, the Medicare program has a lot on its plate. In today’s case, we review a recent Medicare settlement between the federal government, the state government of Maine, and a Portland-area […]
November 5, 2015
General
South Dakota Loggers Settle False Claims Act Allegations of Illegal Employment Practices
In one of the few False Claims Act cases to come out of South Dakota, two contractors related to the logging industry have agreed to pay $1.2 million to settle claims that they violated the terms of their agreement with the U.S. Forest Service and billed for the work nonetheless. […]
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