Blog

»  Posts By    

False Claims Act Defendants Need Not Always Play Defense – Defendants Can Countersue Whistleblowers Under Certain Circumstances

The number of False Claims Act (FCA) whistleblower actions filed has risen steeply in recent years, as the Federal government has stepped up its scrutiny of healthcare provider billing practices and personal injury attorneys have found a profitable new niche in representing provider employees who seek to blow the whistle on their employers as FCA "qui tam" relators. Providers accused of FCA violations should know, however, that they are not without the...

“Reverse” False Claims Act Actions Against Providers Are On the Rise

Delaying the Return of Overpayments to the Government Could Cost You Millions Recent statutory reforms have given rise to a new and increasingly-common form of liability under the False Claims Act (FCA) – so-called "reverse" FCA liability. Specifically, the Fraud Enforcement and Recovery Act of 2009 (FERA) modified the FCA such that it is now a violation of the statute to "knowingly" conceal or avoid repaying an "obligation to pay...

NJ PROVIDER ALERT: New Jersey Office of the Attorney General Takes Hardline and Legally Questionable Stance on the Prescribing of “Subsys”

In an October 17, 2016 "CONSUMER ALERT" issued by the New Jersey Office of the Attorney General (NJOAG), the State warned that "Any physician found prescribing Subsys to patients not qualified for the treatment will be subject to disciplinary action . . . We will not allow patients' lives to be endangered by prescribers who disregard the federal restrictions placed on this drug." A close-reading of the article reveals that the...

First Circuit Dismisses FCA Suit against CVS, Taking an Expansive View of Public Disclosure Bar

In U.S. ex rel. Winkelman et al v. CVS Caremark Corporation et al., 2016 WL 3568145 (1st Cir. 2016), the First Circuit dismissed a False Claims Act (FCA) qui tam action against CVS Caremark brought by former employees turned whistleblowers. These whistleblowers, referred to as "relators" under the FCA, alleged their previous employer had defrauded Medicaid and Medicare Part D to the tune of hundreds of millions of dollars. The...

Fourth Circuit to Rule on Two Novel Questions of Law Concerning the False Claims Act

Permissibility of Using Statistical Sampling to Calculate Damages for Allegedly Medically Unnecessary Services and the Government's Power to Veto a Proposed Qui Tam Settlement of Non-Intervened Claims In U.S. ex rel. Brianna Michaels and Amy Whitesides v. Agape Senior Community, et al., the Fourth Circuit has been called upon to address two False Claims Act (FCA) issues of first impression: (1) whether statistical sampling can be used to calculate damages where the fraud alleged is the rendering...