False Claims Act cases do not often go to trial, so they are noteworthy when they do. EDNY Judge John Gleeson has scheduled an FCA jury trial in October, United States ex rel. Ryan v. Lederman. Earlier this year, the Court granted summary judgment to the government in part and scheduled the remaining issues
Failure To Promptly Return Overpayments Arising From Computer Glitch Leads To False Claims Act Complaint
At the end of June, the U.S. Attorney’s Office in Manhattan filed a False Claims Act complaint against Beth Israel Medical Center, St. Luke’s-Roosevelt Hospital Center, and Continuum Health Partners, United States v. Continuum Health Partners, Inc., alleging that defendants had knowingly failed to return overpayments owed to Medicaid arising out of a
False Claims Act Complaint Dismissed Where Defendant Followed State Regulations
A recent SDNY False Claims Act decision provides strong support for the argument that a false claim may not be based on conduct that follows federal or state rules and guidelines.
In United States ex rel. Doe v. Taconic Hills Central School District, relators alleged that the New York City Department of Education (“DOE”)
United States Provides Supreme Court With Its View of False Claims Act Pleading Standard
On Tuesday, the United States filed an Amicus Curiae Brief on a closely watched petition for certiorari. The Department of Justice articulated the government’s view of the proper standard for pleading fraud in a False Claims Act case. The petition in United States ex rel. Nathan v. Takeda Pharms. N. Am. asked the Court to
Lawyers’ Ethical Violation Leads To Qui Tam Dismissal
In U.S. ex rel. Fair Laboratory Practices Associates v. Quest Diagnostic, Inc., the Second Circuit upheld the dismissal of a health care fraud qui tam action because of ethical violations by one of the relators, who was formerly general counsel of defendant Unilab Corporation.
The former general counsel, along with two other former employees
Admission of Wrongdoing Requirement May Make SDNY Less Attractive to Qui Tam Relators
In U.S. ex rel. Wolfson v. Park Avenue Medical Associates, the U.S. Attorney’s Office in the Southern District of New York entered into a $1 million False Claims Act settlement against three related companies for improperly billing Medicare for behavioral health services. The settlement agreement provided that the defendants “admit, acknowledge and accept responsibility
Proposed “Fairness” Amendments to the False Claims Act
Earlier this month, a bill to amend the False Claims Act (“FCA”), the “Fairness in Health Care Claims, Guidance and Investigations Act,” was introduced in the House of Representatives. According to one of the bill’s sponsors, Rep. Howard Coble (R-NC), the bill’s purpose is to ensure that unintentional billing disputes are not penalized as
Department of Justice Announces Record-Setting Year of False Claims Act Recoveries
Earlier this week, the Department of Justice announced that it had recovered nearly $5 billion in settlements and judgments under the False Claims Act in fiscal year 2012. The $4.959 billion figure was a new record for a single year, eclipsing the previous one-year record by $1.7 billion.
In breaking down the $5 billion in
Hospital Settles False Claims Act Case For $7 Million
In late October the U.S. Attorney’s Office in the Southern District of New York announced the settlement of a False Claims Act case against Westchester Medical Center (“WMC”) for $7 million, for submitting false reimbursement claims to Medicaid from August 2001 through June 2010 involving outpatient behavioral health services. The settlement is to be
The False Claims Act and Federal Grants
In United States ex rel. Feldman v. van Gorp , decided last week, the Second Circuit ruled on an issue of first impression concerning False Claims Act (“FCA”) damages in the context of a federal grant for medical research funding, and also addressed the FCA’s materiality standard.
In Feldman, Cornell University and a psychiatry