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What is the Medicare Fraud Strike Force?

Although fraud against the federal and state governments occurs in many different industries, there is always a lot of attention paid to healthcare fraud because it involves such enormous government expenditures, and it has such a huge impact on the beneficiaries of government healthcare programs. That impact can be through […]

Prestigious Universities and Research Institutions Commit Grant Fraud Too

By Sherrie Savett Major universities rely on government grant money to supplement their revenues from tuition, endowments, and contributions. Purely research entities which are not full universities and where there is little or no tuition revenue depend even more heavily on government grant money, especially in the area of medical […]

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 […]

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 […]

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 […]

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 […]

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 […]

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.

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 […]

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 […]

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.

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 […]