As Medicare Advantage attracts more eligible beneficiaries, it is also drawing attention from False Claims Act (FCA) prosecutors. In 2022, enrollment in Medicare Advantage plans reached 28.7 million Medicare beneficiaries, or 49% of eligible beneficiaries. Recently, the United States intervened in a qui tam case against Cigna filed in the Southern District of New York and
Industry organizations in business, healthcare, pharmaceuticals, and medical technology filed amicus briefs this week in support of the False Claims Act (FCA) defendants in the Supreme Court case United States, ex rel. Polansky v. Executive Health Resources, Inc. As previously reported here, this case raises whether the government has the proper authority to dismiss
With some estimates as high as $80 billion, fraud within the Small Business Administration’s Paycheck Protection Program (PPP) has been described as the worst in a generation. The government has taken note with aggressive enforcement strategies across the country. Starting with what can be described as low-hanging fruit, the government’s enforcement efforts have expanded and
The Eighth Circuit split with the Third Circuit over the appropriate causation standard in False Claims Act (FCA) cases involving alleged violations of the Anti-Kickback Statute (AKS), holding that the 2010 amendments to the AKS created a “but-for causal requirement” (United States ex rel. Cairns v. D.S. Medical, LLC).
In 2010, Congress amended
On June 21, 2022, the Supreme Court granted certiorari in United States ex rel. Polansky v. Executive Health Resources, Inc., a case which will decide whether the Department of Justice maintains the authority to dismiss False Claims Act (FCA) qui tam suits brought by private relators after it initially declines to intervene. The Court