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Senator Chuck Grassley and Seema Verma Discuss the Importance of the False Claims Act to CMS

On February 16, 2017, the Senate Finance Committee held a confirmation hearing for Seema Verma to become the nation’s next Administrator of the Centers for Medicare and Medicaid Services (“CMS”). During her testimony, Senators raised wide-ranging questions about the best ways to maintain the quality of the Medicare and Medicaid […]

Laboratories May be Liable under the False Claims Act for Submitting Claims for Screening Tests to Medicare

Laboratory tests are not medically necessary when they do not “determine a disease or illness. . . or medically or surgically manage an illness.” Strand Analytical Labs., LLC v. Burwell, 2015 WL 4603258, at *17 (S.D. Ind. July 30, 2015) (“The plain meaning of the words diagnose and treat do […]

A Laboratory’s Liability for Medically Unnecessary Lab Tests under the False Claims Act, Part II

In Part I of this blog series, we discussed when lab tests are considered “reasonable and necessary” under the False Claims Act (“FCA”) and therefore reimbursable by government health insurers such as Medicare and Medicaid, as well as a laboratory’s responsibility for ensuring that lab tests submitted for reimbursement are […]

A Laboratory’s Liability for Medically Unnecessary Lab Tests under the False Claims Act, Part I

This article addresses the liability of a diagnostic testing laboratory under the False Claims Act (“FCA”) for conducting lab tests that are ordered by a doctor and submitting claims for payment to government health insurers, such as Medicare and Medicaid, for those lab tests when those tests are not medically […]

“Medically Necessary” Ambulance Services Under the False Claims Act

A non-intervened False Claims Act case filed against Medstar, an ambulance company, settled for $12.7 million on January 17, 2017.  The qui tam case was filed on October 4, 2013 in the Federal District Court of Massachusetts under the caption United States ex rel. Dale Meehan v. MedStar et als, […]

Can You Sue A Company Under the False Claims Act If You Don’t Have Copies of Claims for Payment?

A common problem for potential whistleblowers trying to start a case under the False Claims Act (“FCA”) is that they do not always have access to individual claims for payment made by the target defendant. Often this results because the employee does not work in the finance or billing division […]

Using Differences in Geographic Scope to Avoid the First-to-File Rule in False Claims Act Whistleblower Cases

As recounted in our previous blog entry, the federal False Claims Act (“FCA”) contains a first-to-file rule, which 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 […]

Piercing the Attorney Client Privilege in Qui Tam Whistleblower Cases Under the False Claims Act

It is well established that the scope and conduct of discovery are well within the sound discretion of the trial court. Gaul v. Zep Mfg. Co., No. 03-2439, 2004 U.S. Dist. Lexis 1990, at *3 (E.D. Pa. Feb. 5, 2004) (quoting Marroquin-Manriquez v. Immigration and Naturalization Serv., 699 F.2d 129, 134 […]

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 […]

Shareholder Investigation of BT Group plc

TORONTO–(BUSINESS WIRE)–Morganti Legal, a firm focused on representing shareholders with investments in international companies, has commenced an investigation into potential violations of securities laws by BT Group plc (NYSE: BT, LSE: BT.A, and FSE: BTQ) in connection with the Company’s “inappropriate” accounting in its Italian division. On October 27, 2016, BT […]

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 […]

Morganti Legal Initiates Ontario Shareholder Litigation against Volkswagen Aktiengesellschaft

TORONTO–(BUSINESS WIRE)–Morganti Legal, P.C., a cross border shareholders’ rights law firm, has commenced a shareholder lawsuit against Volkswagen AG (“VW”) for publishing investor documents containing misrepresentations of material fact about its business operations between March 12, 2009 and September 18, 2015. The lawsuit alleges that VW published core and non-core investor […]