In Wisconsin Bell, Inc. v. United States ex rel. Heath, the Supreme Court clarified the definition of “claim” under the FCA. The case resolves a split between the Fifth and Seventh Circuits on whether a request for reimbursement under the E-Rate subsidies program meets the statutory definition of a “claim.”
Continue Reading Supreme Court Clarifies “Claim” Definition Under False Claims ActFirst Circuit Adopts “But-For” Causation Standard for Proving Kickback FCA Violations
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 ViolationsThe Surge in FCA Whistleblower Lawsuits: What’s Driving the Trend and What Comes Next?
Whistleblower-driven False Claims Act (FCA) lawsuits are on the rise, raising critical questions about the factors fueling this trend and its potential impact on enforcement.
Continue Reading The Surge in FCA Whistleblower Lawsuits: What’s Driving the Trend and What Comes Next?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 RequirementImpact of Trump Administration’s Executive Order on DEI Programs and FCA Liability
As federal contractors and grant recipients navigate the changing landscape of diversity, equity, and inclusion (DEI) programs, the Trump administration’s rescinding of Executive Order No. 11246 (EO) raises new concerns about potential False Claims Act (FCA) liability for non-compliance.
Continue Reading Impact of Trump Administration’s Executive Order on DEI Programs and FCA LiabilityExecutive Order on DEI Programs: Implications for Healthcare and False Claims Act Risks
The Trump administration’s recent executive order targeting diversity, equity, and inclusion (DEI) programs is reshaping the landscape for healthcare providers, with potential legal and regulatory implications that are still unfolding.
Continue Reading Executive Order on DEI Programs: Implications for Healthcare and False Claims Act RisksHHS-OIG Year in Review 2024
In 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) provided useful insights to the healthcare industry regarding how it approaches various fraud and abuse issues in an increasingly complex healthcare environment.
Continue Reading HHS-OIG Year in Review 2024Success of Repeat Whistleblower in Recent FCA Settlement
I commented on the success of serial whistleblower Cecilia Guardiola in her most recent False Claims Lawsuit (FCA) against a healthcare provider. Since 2007 she has secured at least four settlements totaling more than $43 million against healthcare companies; her cut of the settlements is estimated to be about $7.7 million.
Continue Reading Success of Repeat Whistleblower in Recent FCA SettlementImpact of Court Decision for Qui Tam Provisions of the FCA
I discussed the impact of a September 2024 court decision related to qui tam provisions under the False Claims Act (FCA) in an article published by the Health Care Compliance Association (HCCA). The article outlines predictions concerning enforcement trends for 2025.
Continue Reading Impact of Court Decision for Qui Tam Provisions of the FCACOVID-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