The US Senate resumes business this week after a week-long recess with Senate Republicans hoping to begin to draft their version of health care reform legislation. Senate Majority Leader Mitch McConnell (R-Ky.) has expressed doubt whether Republicans will have the
Fourth circuit declines to rule on the appropriateness of statistical sampling in FCA cases
As expected after oral arguments, the Fourth Circuit Court of Appeals declined to decide whether parties may use statistical sampling to prove False Claims Act liability in United States ex rel. Michaels v. Agape Senior Community, Inc., Nos.
DOJ recovers $4.7 billion in 2016, third highest in FCA history
The Department of Justice (“DOJ”) announced yesterday that it recovered over $4.7 billion in fiscal year 2016 in civil cases involving claims of fraud against the government under the False Claims Act (“FCA”). This is the third largest annual recovery
First and Fourth Circuit Courts of Appeal hear oral arguments in two key FCA cases
Last week, the Fourth Circuit and First Circuit heard oral argument in two separate cases dealing with key False Claims Act (“FCA”) issues. First, the Fourth Circuit Court of Appeals heard oral arguments for the interlocutory appeal in United States
Physicians’ compensation structure results in $17M Stark Law fine and CIA for hospital
Lexington Medical Center (“LMC”), a 428-bed hospital in South Carolina, has agreed to pay $17 million to resolve allegations that it violated the federal False Claims Act (“FCA”), 31 U.S.C. §§ 3729 et seq., and Physician Self-Referral Law (“Stark Law”), 42 U.S.C. § 1395nn, by allegedly providing improper financial incentives to 28 physicians for referrals.
Legal Update: DOJ announces near doubling of FCA penalties
The DOJ has confirmed that the amount of False Claims Act civil penalties is set to nearly double following recent updates to FCA regulations.
SCOTUS endorses “implied certification” FCA claims
In a closely watched decision, the U.S. Supreme Court has unanimously endorsed a version of the “implied false certification” theory of liability under the False Claims Act (“FCA”). In a decision that leaves almost as many questions unanswered as it resolved, the Court held that a material omission on a claim for payment may give rise to liability where two conditions are met:
OIG reports gain in expected recoveries for fraud and abuse matters
On Tuesday, the OIG released its Semiannual Report to Congress, which stated that expected recoveries for fraud and abuse activities total $2.77 billion in the first half of fiscal year 2016. This represents a gain of almost $1 billion when compared to the first half of fiscal year 2015. The report, which covers the time period of October 1, 2015 through March 31, 2016, stated that the $2.77 billion consisted of approximately $554.7 million in expected recoveries from audits and roughly $2.22 billion in expected recoveries from government investigations. Some recoveries are expected as settlement amounts may have been agreed to in principle, but the parties are still working on the details of the settlement agreement.
FCA civil penalties to increase substantially under proposed rule
Earlier this week, the Railroad Retirement Board (RRB) became the first federal agency to promulgate an interim final rule implementing provisions of the Bipartisan Budget Act of 2015 intended to index civil penalties assessed under certain statutes to inflation. The RRB’s proposed final rule would double civil penalties assessed under the False Claims Act (FCA).
Fifth Circuit upholds limits on attorneys’ fees in FCA whistleblower suit
A decision by the Fifth Circuit Court of Appeals may help FCA defendants challenge relators’ claims for attorneys’ fees, especially where relators’ counsel fails to keep adequate time records distinguishing between work for which the relators recovered an award and work where they did not.