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1
Third Circuit Perpetuates Tuomey's Controversial Stark Law "Volume Or Value" Standard
In U.S. ex rel. J. William Bookwalter, III, M.D. et al. v. UPMC et al., the US Court of Appeals for the Third Circuit endorsed two controversial interpretations of the Stark Law's...
United States
11 Oct 2019
2
Healthcare Enforcement Quarterly Roundup | Q2 2019
In this second installment of the Healthcare Enforcement Quarterly Roundup for 2019, we cover several topics that have persisted over the past few years and identify new issues that will shape
United States
3 Sep 2019
3
Health Care Enforcement Quarterly Roundup | Q4 2018
This latest installment of the Health Care Enforcement Quarterly Roundup reflects on trends that persisted in 2018 and those emerging trends that will carry us into 2019 and beyond.
United States
8 Feb 2019
4
Process Improvements Not A Basis To Establish Scienter: District Court Grants Summary Judgment To Defendants
In a January 10, 2019, decision, the US District Court for the District of Arizona granted summary judgment to Defendants because Relators failed to raise a genuine issue of material fact on the issue of "knowledge" ...
United States
25 Jan 2019
5
Health Care Enforcement Quarterly Roundup | Q3 | September 2018
In the latest installment of Health Care Enforcement Quarterly Roundup, we examine key enforcement trends in the health care industry that we have observed over the past few months. In this issue,
United States
9 Oct 2018
6
Health Care Enforcement Quarterly Roundup Q3 | September 2018
In the latest installment of Health Care Enforcement Quarterly Roundup, we examine key enforcement trends in the health care industry that we have observed over the past few months.
United States
9 Oct 2018
7
Health Care Enforcement Quarterly Roundup (October 2018)
In the latest installment of Health Care Enforcement Quarterly Roundup, we examine key enforcement trends in the health care industry ...
United States
9 Oct 2018
8
Sky-Diving Without A Parachute? Ninth Circuit Reluctantly Holds Escobar's Two-Part Test Mandatory, For Now
In the aftermath of the Supreme Court's 2016 Escobar decision, the majority of litigation regarding that decision's impact has concerned the issue of materiality.
United States
11 Sep 2018
9
Health Care Enforcement Quarterly Roundup - July 2018
Over the past 18 months, we have closely monitored the Trump administration's approach to health care enforcement issues, with a particular focus on whether prosecution of the False Claims Act (FCA) ...
United States
25 Apr 2018
10
DOJ Continues Action Against Medicare Advantage Plans, Showing Increased Focus On Intersection Of The FCA And Managed Care
Last year, DOJ intervened in United States ex rel. Poehling v. UnitedHealth Group., Inc. (C.D. Cal.). In this case, DOJ alleged FCA violations relating to Medicare Advantage ....
United States
23 Apr 2018
11
Private Equity Sponsor Named As FCA Defendant
DOJ also made news in February 2018 when it named a private equity firm as a co-defendant in United States ex rel. Medrano and Lopez v. Diabetic Care Rx, LLC d/b/a Patient Care America, e ...
United States
23 Apr 2018
12
DOJ Maintains Focus On FCA Enforcement Against Individuals
In September 2015, DOJ issued the well-known "Yates Memo" (named for then-Deputy Attorney General Sally Yates), which focuses on individual accountability for corporate wrongdoing.
United States
23 Apr 2018
13
Courts Continue To Interpret Escobar Favorably For FCA Defendants
One of the most significant developments in FCA litigation in recent years was the Supreme Court's unanimous 2016 ruling in Universal Health Services, Inc. v. United States ex rel. Escobar ...
United States
23 Apr 2018
14
DOJ Leadership Reaffirms Expanded Enforcement Of The FCA To Combat Opioid Epidemic
In his March 2018 confirmation hearing, President Trump's nominee to head DOJ's Civil Division, Joseph "Jody" Hunt, signaled that DOJ would continue with its aggressive enforcement of the FCA.
United States
23 Apr 2018
15
Guidance Memoranda Continue To Be Used By DOJ Leadership To Endorse Enforcement Priorities And Protocols
DOJ has long used guidance memoranda to reflect enforcement priorities and provide specific guidance to its prosecutors. This remains true in the Trump administration. In the first quarter of 2018 ...
United States
23 Apr 2018
16
Another Court Grants Summary Judgment To FCA Defendant Based On Escobar's Materiality Standard
On April 6, 2018, the U.S. District Court for the Eastern District of Pennsylvania granted a motion for summary judgment filed by a waste company in an implied certification case under the False Claims Act (FCA)...
United States
13 Apr 2018
17
Guidance On Guidance: DOJ Limits Use Of Agency Guidance Documents In Civil Enforcement Cases
In a two-page memorandum, the US Department of Justice (DOJ) announced a broad policy statement prohibiting the use of agency guidance documents as the basis for proving legal violations in civil ...
United States
21 Feb 2018
18
SDNY Dismisses Sub-Prime Mortgage Crisis Complaint On Materiality Grounds Because Government Paid Claims Despite Notice Of Alleged Fraud
On March 2, 2017, the US District Court for the Southern District of New York applied the materiality standard announced by the Supreme Court of the United States in Universal Health Services...
United States
17 Mar 2017
19
The FCA And Medical Necessity: An Increasingly Tenuous Relationship
On January 19, 2017, another district court ruled that a mere difference of opinion between physicians is not enough to establish falsity under the False Claims Act.
United States
17 Feb 2017
20
Court Rejects Criminal Defendant's Attempt To Dismiss Indictment Based On Favorable Defense Verdict In Non-Intervened FCA Case
On January 26, 2017, the US District Court for the Western District of Virginia rejected a defendant's attempt to invoke collateral estoppel principles to dismiss an indictment for fraud.
United States
10 Feb 2017
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