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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
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
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
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
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
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
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
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
Cooperation In The Eye Of The Beholder: DOJ Official Bill Baer Elaborates On Cooperation In False Claims Act And Other Civil Enforcement Matters
The law is uncertain. One example of this uncertainty is how the "Yates Memo" is to be applied in civil cases—in particular, what constitutes "cooperation" and how cooperation may benefit a company under investigation for False Claims Act violations.
United States
21 Oct 2016
Another Court Rejects Claims Based On Differences Of Clinical Judgment; Also Rejects Extrapolation Attempt
On June 20, 2016, the United States District Court for the Northern District of Texas granted summary judgment in defendants' favor on all but her retaliation claims in relator's FCA suit...
United States
30 Jun 2016
Recent District Court Decision Highlights FCA's Effective But Underutilized "Government Action" Bar
The relator in Bennett alleged that the defendant, Biotronik, paid doctors to enroll patients in studies that lacked scientific and medical value, as a result of which doctors prescribed Biotronik's cardiac devices.
United States
29 Apr 2016
District Of Massachusetts Rejects Relators' Attempt To Convert Products Liability Theory Into FCA Claim
On February 2, 2016, U.S. District Court for the District of Massachusetts dismissed a complaint alleging sweeping allegations of purported fraud under the False Claims Act relating to hip replacement devices.
United States
9 Feb 2016
Seventh Circuit Strictly Construes Original Source Requirement Against ‘Bounty-Hunting' Relator
In a decision released yesterday in U.S. ex rel. Bogina v. Medline Industries, Inc., the U.S. Court of Appeals for the Seventh Circuit affirmed a district court's dismissal of a relator's FCA complaint.
United States
6 Jan 2016
Helping Government Investigate Alleged "Fraud" Is Insufficient To Support Retaliation Claim
Retaliation claims under the False Claims Act (FCA) by purported whistleblowers are a dime a dozen.
United States
11 Dec 2015
U.S. Attorney Manual Revised To Reflect Yates Memorandum's Focus On Individuals
Pursuant to the Yates Memorandum's directive that the U.S. Attorneys' Manual (USAM) be revised to reflect this increased focus on individuals, on November 16, 2015, such revisions were released.
United States
19 Nov 2015
On Remand, Eastern District Of Virginia Narrowly Construes Supreme Court's KBR Holding
In a November 12, 2015 decision in a long running qui tam suit under the False Claims Act (FCA), the U.S. District Court for the Eastern District of Virginia dismissed a relator's case pursuant to the first-to-file bar (31 U.S.C. § 3730(b)(5)) for the second time.
United States
19 Nov 2015
"Worthless Services" Claims Continue To Receive Serious Scrutiny
On October 5, 2015, the U.S. District Court for the Northern District of Illinois dismissed with prejudice a complaint alleging False Claims Act (FCA) and Illinois False Claims Act violations based on Medicaid billing...
United States
19 Oct 2015
SDNY Holds That Corporate Attorney-Client Privilege Trumps Individual Advice-Of-Counsel Defense
In the wake of the U.S. Department of Justice's (DOJ) recent memorandum regarding increased focus on individual culpability for corporate wrongdoing (on which we previously posted here) comes a district court decision with significant implications for individuals who attempt to assert an advice-of-counsel defense based on consultation with company counsel.
United States
30 Sep 2015
Issues Of Fact Must Really Be Genuine: Another District Court Ends A Relator's FCA Suit On Scienter Grounds
On the heels of the recent Omnicare summary judgment ruling ( covered in this blog) comes another scienter-based summary judgment victory for a False Claims Act (FCA) defendant...
United States
23 Sep 2015
Omnicare Decision Demonstrates That Relators Cannot Rely On Ambiguous Evidence Of Intent To Survive Summary Judgment, And Should Exercise Caution
On September 3, the U.S. District Court for the Southern District of Texas granted summary judgment in favor of Omnicare in United States ex rel. Ruscher v. Omnicare, Inc.
United States
20 Sep 2015
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