Addressing an issue of first impression, the First Circuit has clarified the burden to satisfy the knowledge element required in False Claims Act (FCA) cases in the context of laboratory testing and Medicare fraud. The Medicare Act permits reimbursement of diagnostic laboratory tests only if they are “reasonable and necessary” for diagnosis or treatment of
On Friday, the Eleventh Circuit heard oral arguments in United States ex rel. Zafirov v. Florida Medical Associates, LLC regarding the constitutionality of the qui tam provisions in the False Claims Act, which allow private persons, known as relators, to file civil enforcement actions for violations of the FCA. The panel consisted of Trump-appointed Judges
The Department of Justice (DOJ) recently obtained several cybersecurity-related False Claims Act (FCA) settlements totaling more than $50 million dollars. Collectively, these settlements reflect a clear message: Cybersecurity is an enforcement priority for the second Trump administration, and any organization that contracts with the federal government is a potential target.
On June 6, 2025
The public-disclosure bar is a defense to the False Claims Act (FCA) that prevents relators from pursuing fraud and false claims allegations that have already been publicized, unless the relator is the original source of the information. As statutorily defined, a relator is an “original source” if they voluntarily disclosed the information to the government
On May 12, 2025, Department of Justice (DOJ) Criminal Chief Matthew Galeotti issued a memorandum addressing the “Fight Against White-Collar Crime.” The memorandum lists several priorities for white-collar criminal prosecutions. While the first priority – healthcare fraud and federal program and procurement fraud – is not surprising, the second priority – trade and customs fraud
It has long been the law of the Eleventh Circuit that, under the False Claims Act (FCA) and Federal Rule of Civil Procedure 9(b), a relator must provide sufficient “indicia of reliability … to support the allegation of an actual false claim for payment being made to the government.” U.S. ex rel. Clausen v. Laboratory
On February 18, 2025, the First Circuit joined the Sixth and Eighth Circuits in adopting a “but for” causation standard in cases involving per se liability under the federal Anti-Kickback Statute (AKS) and the False Claims Act (FCA). In U.S. v. Regeneron Pharmaceuticals, the First Circuit held that for an AKS violation to automatically
In 2024, the government and whistleblowers were party to 558 False Claims Act (FCA) settlements and judgments, just slightly fewer cases than last year’s record. As a result, collections under the FCA exceeded $2.9 billion, confirming that the FCA remains one of the government’s most important tools to root out fraud, safeguard government programs, and
The Justice Department released its annual False Claims Act statistics on Wednesday, January 15, detailing the number of cases filed, recoveries made, and relators’ shares awarded in fiscal year 2024. The government recovered $2.9 billion dollars in 2024, with 57% of that total coming from healthcare cases, 3% from defense spending cases, and the remainder
On December 6, 2024, Principal Associate Deputy Attorney General Marshall Miller provided an update on the Justice Department’s (DOJ) corporate criminal enforcement efforts during his keynote address at the Practicing Law Institute’s White Collar Crime 2024 Program. Among other topics, Miller addressed ongoing efforts to combat corporate crime using self-disclosure policies and whistleblower programs