FCA NOW

Relator Failed to Sufficiently Plead its FCA Action by Relying on Big Data Alone, Resulting In Big Dismissal

Andrew Brantingham

In early August, the U.S. District Court for the Western District of Texas granted a hospital system’s motion to dismiss a False Claims Act case that illustrates the increasing intersections in FCA litigation between data analytics and health care providers’ efforts to increase revenue through aggressive management of coding and billing practices. United States ex rel. Integra Med Analytics, LLC v. Scott et al., No....

Granston Memo in Action: Eighth Circuit Affirms Government Dismissal of FCA Claims Related to Minnesota Bridge Collapse

Caitlin Hull

Just days after the twelfth anniversary of the Minnesota 35W bridge collapse, the Eighth Circuit summarily affirmed the dismissal of a False Claims Act case alleging that Minnesota government officials conspired to submit false claims and obtain $250 million in federal funding. United States ex rel. Davis v. Hennepin Cty., No: 19-2298 (8th Cir. Aug. 14, 2019). Focused on the aftermath of the 35W bridge...

False Claims Act: New Developments for an Old Law

Alex Hontos

The past 18 months have been a (relatively) wild time for the False Claims Act — on the books since 1863. In FY2018 the Department of Justice obtained more than $2.8 billion in settlements and judgments from cases involving fraud and false claims against the United States government. Add to this staggering statistic the fallout of the Supreme Court’s decision in Universal Health Services Inc....

Software Provider and DOJ Reach $8.6M Settlement for FCA Case Involving Alleged Cyber Security Shortcomings

Jack Huerter

Amid increased public and government attention to cyber security, a qui tam plaintiff’s lawsuit has resulted a large settlement for a government contractors’ purported misrepresentations regarding compliance with government cyber security standards. In what is believed to be the first-of-its-kind settlement of an FCA claim premised upon cyber security misrepresentations, Cisco Systems recently agreed to pay $8.6 million to the federal and state governments. The...

An Ambulance Provider’s Long Road to Settlement

Vanessa J. Szalapski

On June 20, 2019, more than six years after the case was first set into motion by the Relator, the U.S. Attorney’s Office for the District of Maryland announced in a press release that Hart to Heart Ambulance Services, Inc. (“Hart to Heart”) settled a false claims act case—which alleged that it submitted false claims to Medicare for ambulance transports that were not medically necessary—for...

Alleged Violations of Government Data Security Requirements Yield FCA Settlement

T. Augustine Lo

On May 31, 2019, U.S. Attorney Stephen McAllister of the District of Kansas announced a $250,000 settlement with Coffey Health System to resolve a False Claims Act case.  The case arose from allegations that the hospital’s patient data security was insufficient to justify an incentive payment from the federal government.  The two whistleblowers each will receive $50,000 from the settlement. In 2016, two whistleblowers filed...

$34 Million Reversal: First Circuit Overturns Its Precedent and Redirects Relator’s FCA Award to Another

Siena Caruso

Earlier this month, the U.S. Court of Appeals for the First Circuit overturned its own precedent to hold the FCA’s first-to-file rule is “non-jurisdictional.” In so doing, the First Circuit flipped the district court’s award of $34 million from one whistleblower to another. United States v. Millenium Labs., Inc., No. 17-1106, 2019 U.S. App. LEXIS 13506 (1st Cir. May 6, 2019). The appeal arises out...

Supreme Court Settles Circuit Split and Reads the False Claims Act Statute of Limitations Provision Broadly in Boon to Relators

Ben Kappelman

On May 13, 2019, the U.S. Supreme Court decided Cochise Consultancy, Inc. v. United States ex rel. Hunt, No. 18–325, and resolved a circuit split regarding the statute of limitations for an FCA claim brought by a relator between six and ten years after a violation, but less than three years after the government knew or should have known the relevant facts. The Court held...

Sutter Health LLC Pays $30 Million to Settle Alleged Overpayment of Medicare Advantage Funds, but Faces Similar Allegations in Separate Qui Tam

Erin Conti

On April 12, 2019, the U.S. Department of Justice announced Sutter Health LLC—along with its affiliates Sutter East Bay Medical Foundation, Sutter Pacific Medical Foundation, Sutter Gould Medical Foundation, and Sutter Medical Foundation—would pay $30 million to settle allegations they provided inaccurate information about Medicare Advantage Plan beneficiaries in order to receive inflated payments. The settlement stems from a coordinated effort between the U.S. Department...

Fifth Circuit Affirms: Res Judicata Bars FCA Retaliation Suit

Briana Al Taqatqa

Last week, the U.S. Court of Appeals for the Fifth Circuit considered an appeal from the Eastern District of Louisiana, which dismissed appellants’ FCA retaliation claims based on res judicata. Res judicata, or “claim preclusion,” is the principle that a matter may not be re-litigated once it has been decided on the merits. Appellants had previously brought employment discrimination actions against Lockheed Martin alleging they...