In a closely watched appeal, the U.S. Court of Appeals for the First Circuit ruled on February 18 that to satisfy the causation requirement in False Claims Act (FCA) actions based on alleged Anti-Kickback Statute (AKS) violations, the government or relator must prove that the alleged kickbacks were the “but-for” cause of the defendant’s allegedly false claims. The First Circuit joins the Sixth and Eighth Circuits in adopting this defendant-favorable standard, with only the Third Circuit requiring a less-stringent showing.Continue Reading First Circuit Adopts “But-For” Causation Standard for Proving Kickback FCA Violations

Brian Irving
Brian Irving represents businesses and individuals in complex litigation and government investigations, focusing on healthcare fraud, securities fraud, and business disputes. Brian’s clients span a variety of industries, including healthcare, pharmaceuticals, government contracting, and financial services. Brian has successfully represented clients in federal and state courts at both the trial and appellate levels, and in arbitrations and other forms of alternative dispute resolution.
Fourth Circuit Holds that Violation of CIA Can Support Reverse False Claims and Adopts Relaxed Rule 9(b) Presentment Requirement
On February 3, the U.S. Court of Appeals for the Fourth Circuit reversed a district court’s grant of a motion to dismiss, holding in relevant part that:Continue Reading Fourth Circuit Holds that Violation of CIA Can Support Reverse False Claims and Adopts Relaxed Rule 9(b) Presentment Requirement
COVID-19 Relief Scrutiny
We recently co-authored an article for The Banking Law Journal about the Department of Justice’s (DOJ) ongoing efforts to target businesses it alleges to have fraudulently received COVID-19 relief funds.Continue Reading COVID-19 Relief Scrutiny
DOJ Brings Nationwide False Claims Act Lawsuit Against CVS for Alleged Violations of Controlled Substances Act
On December 13, the U.S. Department of Justice (DOJ) intervened in a False Claims Act (FCA) lawsuit alleging that CVS Pharmacy Inc. and its subsidiaries improperly sought federal reimbursement for prescriptions filled in violation of the Controlled Substances Act (CSA).
Continue Reading on BassBerry.com
Rite Aid and OptumRx Settlements Highlight Enforcement Focus on Pharmacy Corresponding Responsibility for Dispensing Controlled Substances
On July 10, the Department of Justice (DOJ) announced a nearly $410 million settlement with Rite Aid Corporation to resolve allegations that Rite Aid and its affiliates ignored red flags and knowingly dispensed unlawful controlled substances in violation of the False Claims Act (FCA) and Controlled Substances Act (CSA). Continue Reading Rite Aid and OptumRx Settlements Highlight Enforcement Focus on Pharmacy Corresponding Responsibility for Dispensing Controlled Substances
Recent DOJ Indictment Involving Done Global Telehealth Prescriptions
I was quoted in a Law360 Healthcare Authority article examining the recent indictment against two executives of Done Global Inc. accused of defrauding government programs by improperly providing Adderall via telehealth visits. Continue Reading Recent DOJ Indictment Involving Done Global Telehealth Prescriptions
Causation Split: First Circuit Pauses Teva Appeal; Regeneron Appeal Going Forward
False Claims Act (FCA) practitioners have been closely watching cases in which courts address the causation requirement in FCA actions based on Anti-Kickback Statute (AKS) violations. Continue Reading Causation Split: First Circuit Pauses Teva Appeal; Regeneron Appeal Going Forward
Watch Now | Legal Rx: How to Navigate Controlled Substances Enforcement & Diversion Webinar

In a recent webinar, we discussed the recent increase in government enforcement against healthcare providers under the Controlled Substances Act (CSA) that has occurred over the past year.Continue Reading Watch Now | Legal Rx: How to Navigate Controlled Substances Enforcement & Diversion Webinar
COVID-19 Relief Enforcement Actions Highlight Ongoing Risk
The Department of Justice (DOJ) continues to demonstrate its sustained interest in COVID-19 relief fraud as an enforcement priority and we can expect to see persistent enforcement in this area. Continue Reading COVID-19 Relief Enforcement Actions Highlight Ongoing Risk
Drug Diversion within Long-Term Care Industry
In a recent McKnight’s Long-Term Care News article, we discussed heighted scrutiny within the long-term care industry related to drug diversion and compliance with the Controlled Substances Act (CSA). Healthcare organizations, and not just diverting employees, are more often being held accountable for diversion of controlled substances.Continue Reading Drug Diversion within Long-Term Care Industry