The First Circuit will decide the causation standard required in False Claims Act (FCA) cases predicated on the Anti-Kickback Statute (AKS), deepening a circuit split on the issue and potentially teeing up Supreme Court intervention.
U.S. District Judge Nathaniel Gorton asked the First Circuit to review his recent ruling that the government need not prove
On August 25, 2023, the Third Circuit continued its trend of rulings unfavorable to FCA healthcare defendants in the latest appeal of U.S. ex rel. Druding et al. v. Care Alternatives et al., No. 22-1035, 2023 WL 5494333 (3d Cir. 2023), holding that medical record-keeping issues and documentation errors may be material under the
On July 25, 2023, U.S. Senator Chuck Grassley (R-IA), introduced a bill that aims to, among other things, make it easier for the government to satisfy the False Claims Act’s materiality requirement when the government has made payment on a claim the government knows to be false or fraudulent. The bill, titled the “False Claims
On Friday, July 21, 2023, DOJ announced it has reached a $377,453,150 settlement with Booz Allen Hamilton Holding Corporation (Booz Allen), the parent company of Booz Allen Hamilton, Inc., the large government and military contractor that also has commercial and international customers. DOJ alleged that Booz Allen violated the False Claims Act by “improperly billing
In its June 14, 2023, decision in United States ex rel. Michelle Calderon v. Carrington Mortgage Services, LLC, No. 22-1553, 2023 WL 3991013, (7th Cir. 2023), the Seventh Circuit explained the high bar for relators to prove proximate causation in FCA suits based on alleged false certifications of mortgage loans for Federal Housing Administration
On June 16, 2023, the Supreme Court in United States ex rel. Polanksy v. Executive Health Resources, affirmed the Third Circuit’s deferential standard regarding the government’s ability to dismiss False Claims Act (FCA) whistleblower cases being litigated by qui tam relators. Notwithstanding this deferential standard, the Court rejected the government’s position that it has
On June 1, 2023, in U.S. ex rel. Schutte v. SuperValu Inc., the Supreme Court clarified the state-of-mind (or “scienter”) standard under the False Claims Act (FCA), holding that a defendant’s subjective belief that a claim was false was sufficient to establish the FCA’s scienter element. In doing so, the Court rejected the Seventh
On May 3, 2023, the Seventh Circuit affirmed $10 million in insurance coverage for a False Claims Act (FCA) settlement in a case based on alleged Anti-Kickback Statute violations. Astellas US Holding, Inc. v. Federal Insurance Company concerns a settlement of an investigation into whether a pharmaceutical manufacturer’s sponsorship of patient assistance plans violated the
Last week, the Sixth Circuit closed two paths the government and relators have tried to take to expand liability for medical providers under the Anti-Kickback Statute (AKS) and False Claims Act (FCA): the meaning of “remuneration” under the AKS and the causation standard for AKS-based FCA claims.
The AKS, which prohibits referrals in
Sen. Chuck Grassley (R-Iowa) recently criticized “activist judges” for rewriting the text of the False Claims Act to achieve their own policy goals, revealing plans to reintroduce legislation that would correct “unduly restrictive” interpretations of the statute and expand liability for defendants.
Grassley — who delivered his remarks in a pre-recorded keynote speech at the