Multi-defendant criminal investigations present a classic prisoner’s dilemma. The parties would benefit from cooperating with one another but are incented to become adversaries, most often due to a lack of information sharing and resultant lack of trust and transparency. Fortunately, the law provides a tool: the common-interest privilege, which enables parties to share information in … Continue Reading
The start of a new year presents an opportune time to reflect on the past. We have been tracking and reporting on the U.S. Department of Justice (“DOJ”)’s Civil Cyber-Fraud Initiative (“CCF Initiative”), which former U.S. Deputy Attorney General Lisa O. Monaco announced in October 2021. The CCF Initiative employs the powerful False Claims Act (“FCA”) in … Continue Reading
At Global Investigations and Compliance Review, we’ve been keeping close tabs on the fallout from the Supreme Court decisions at the end of June. We mentioned in a previous post that the SEC v. Jarkesy opinion may have consequences beyond the specific situation of SEC civil penalties. As we think about this more, there could be … Continue Reading
Join #TeamSPB’s Ben Glassman, Keith Bradley and Patricia Doersch for a timely webinar on the major decisions recently issued by SCOTUS. The panel will cover each of the recent decisions (Loper Bright v. Raimondo, SEC v. Jarkesy, Ohio v. EPA, and Corner Post v. the Fed) and discuss the consequences, as well as the opportunities … Continue Reading
With its second of two landmark decisions impacting the future of federal agency enforcement, SCOTUS struck down the Chevron decision last week. In a 6-3 decision in Loper Bright Enterprises v. Raimondo, the Court shifted enforcement power away from agencies and to the federal courts. The implications of the Chevron decision are both significant and … Continue Reading
Courts around the country continue to disagree on the causation standard to be applied in False Claims Act cases based on alleged Anti-Kickback Statute violations. Two recent federal district court decisions out of the District of Massachusetts add to differing conclusions on what the causation standard should be, i.e., “but-for,” “exposure,” or some other, less … Continue Reading
We have been tracking and reporting on the U.S. Department of Justice’s Civil Cyber-Fraud Initiative (“CCF Initiative”), which U.S. Deputy Attorney General Lisa O. Monaco announced in October 2021. The CCF Initiative employs the powerful False Claims Act (“FCA”) in an effort to “hold accountable entities or individuals that put U.S. information or systems at … Continue Reading
Earlier this month, the Supreme Court of the United States decided Dubin v. United States, No. 22-10, 2023 WL 3872518, at *1 (U.S. June 8, 2023), in favor of the defendant. Justice Sonia Sotomayor wrote the opinion for the Court, which held that 18 U.S.C. § 1028A(a)(1), aggravated identity theft, is violated only when the … Continue Reading
Earlier this year, we previewed two significant False Claims Act (FCA) cases before the U.S. Supreme Court, United States ex. rel. Schutte v. SuperValu, Inc., No. 21-1326 (“SuperValu”), and United States ex. Rel. Proctor v. Safeway, Inc., No. 22-111 (“Safeway”). The FCA provides that “any person who knowingly presents, or causes to be presented, a … Continue Reading
“If you put something at risk (such as cash, entry fee, dinner or other tangible item) on any amateur and/or professional sporting event with a chance to win something in return, you violate NCAA sports wagering rules.”[1] Once the Supreme Court ruled unconstitutional the federal law[2] prohibiting sports betting in Murphy v. Nat’l Collegiate Athletic … Continue Reading
The Supreme Court recently heard oral argument in the appeal of two False Claims Act (FCA) cases from the Seventh Circuit that called into question the level of intent, or scienter, required to establish corporate liability under the FCA for “knowingly” overbilling the government for goods or services. The Court’s eventual decision may have widespread … Continue Reading
Expert testimony can play a crucial role in the trial process. Consequently, parties often file motions to disqualify the opposing side’s expert witnesses. The success of these motions in federal cases is controlled by the Federal Rules of Evidence (“FRE”), which stipulate that expert testimony must meet certain standards of reliability to be admissible. In … Continue Reading
Last week, the Sixth Circuit issued an important decision limiting the scope of claims alleging violations of the Anti-Kickback Statute that are brought under the False Claims Act. See Shannon Martin, M.D., et al. v. Hathaway, et al., No. 22-1463 (March 28, 2023). Chief Judge Sutton wrote the opinion for the Court, which Judge Siler … Continue Reading
We previously offered insight into two False Claims Act (“FCA”) enforcement actions brought by the U.S. Department of Justice (“DOJ”) as part of its “Civil Cyber-Fraud Initiative” (“CCF Initiative”). Deputy Attorney General Lisa O. Monaco announced the CCF Initiative in October 2021, stating that “[t]he initiative will hold accountable entities or individuals that put U.S. … Continue Reading
The U.S. Department of Justice announced late last year that it would utilize the False Claims Act, the U.S. government’s primary civil tool to redress false claims for federal funds and property, to bring actions against U.S. government contractors and subcontractors who do not meet the cybersecurity requirements of a particular contract or grant. The … Continue Reading
The United States Court of Appeals for the Sixth Circuit recently issued a published opinion regarding entitlement to attorney fees in a False Claims Act settlement that involved multiple relators, each of whom had filed a case in which the government intervened. Addressing arguments based on 31 U.S.C. s. 3730(d)(1), the first-to-file rule, and the … Continue Reading
The Department of Justice (“DOJ”) recently announced its largest ever health care fraud and opioid enforcement action. In a coordinated effort, DOJ charged 345 defendants with more than $6 billion in fraud losses for submitting false and fraudulent claims to federal health care programs and private insurers.… Continue Reading
Joseph “Jody” Hunt, Assistant Attorney General for the Civil Division, provided a glimpse of current civil enforcement priorities of the Department of Justice (DOJ). Speaking at the Federal Bar Association’s annual Qui Tam Conference on February 27, 2020, Hunt pledged that DOJ would pursue qui tam cases involving nursing homes, Medicare Advantage plans, and electronic … Continue Reading
The U.S. government relies upon whistleblowers to drive its recoveries under the False Claims Act. See our analysis here of how the Act’s qui tam provisions work, especially in healthcare, by Colin Jennings, Marisa Darden, and Ayako Hobbs.… Continue Reading
After a dip in the 2018 fiscal year, False Claims Act (FCA) settlements and judgments are back and climbing. The Department of Justice (DOJ) recently announced that it had obtained more than $3.05 billion from FCA settlements and judgments for the 2019 fiscal year. 2018 may have just been an aberration after the 2010s saw … Continue Reading
A post on our Triage blog discusses a decision about the legality of changing medical billing codes in order to maximize revenue from the government. Can that be done consistent with the False Claims Act? See the discussion here.… Continue Reading
The Department of Justice (DOJ) recently intervened in a False Claims Act (FCA) lawsuit involving allegations of kickbacks for prescription drug copays. The DOJ says the lawsuit makes “clear that the Department will hold accountable drug companies that pay illegal kickbacks to facilitate increased drug prices.” The DOJ “will not allow drug companies to use … Continue Reading
On May 31, 2019, the U.S. Attorney for the District of Kansas announced a $250,000 settlement with Coffey Health System, after two whistleblowers filed qui tam suit against Coffey for violations of the False Claims Act. The settlement resolved allegations that Coffey submitted false claims to Medicare and Medicaid pursuant to the Electronic Health Records … Continue Reading
This week, the Civil Division of the U.S. Department of Justice released guidelines on cooperation credit in False Claims Act cases. The guidelines strongly emphasize voluntary disclosure, but also provide insight into other actions that could give rise to cooperation credit.… Continue Reading
