Sunday, February 28, 2021

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Physician Alleged Fraudulent Diagnoses, but Could Not Say Whether They Resulted in Claims; United...

The district court granted the defendants’ motion for summary judgment in a case alleging employment retaliation under the FCA. The plaintiff alleged that she was constructively discharged after raising concerns about the use of an improper diagnosis to justify the admittance of patients to rehabilitation services. However, the court found the relator had no knowledge […]
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Second Circuit: “Payment Decision” Includes Contract Formation in Fraudulent Inducement Cases; United States Court...

The Second Circuit reversed a district court’s dismissal of a government complaint alleging a federal contractor fraudulently obtained contracts meant for service-disabled veteran-owned small businesses. The government alleged the contractor had created a sham SDVOSB to act as a pass-through company for contract set-asides, after the contractor’s original company outgrew eligibility. The district court held […]
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Courts Continue to Diverge on How Post-Complaint Government Conduct Affects Materiality Analysis Under Escobar

Two recent decisions by district courts in the Third Circuit illustrate the continued divide among courts regarding the extent to which the government’s declination...

Senator Grassley and Senior DOJ Official Discuss Potential False Claims Act Changes and Enforcement...

On February 17, 2021, Senator Chuck Grassley (R-IA) and Brian Boynton, Acting Attorney General for the Department of Justice’s Civil Division, provided opening remarks at the Federal Bar Association’s annual Qui Tam Conference. Both emphasized the key role of the FCA in combating fraud against the Government, and noted an anticipated increase in FCA enforcement […]
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Expert Can Testify on Work Environment, But Can’t Tell Jury How to Feel About...

The district court mostly denied the defendant’s motion to exclude expert testimony submitted on behalf of the plaintiff. The plaintiff alleged that his former employer falsified diagnoses to qualify patients for rehabilitation care and that the pressure to participate in this alleged fraud created an intolerable work environment that resulted in his constructive discharge. The […]
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Opinions Alone Insufficient Basis for Expert Declaration; United States District Court for the Middle...

The district court granted the defendants’ motion to exclude expert testimony in a qui tam case alleging healthcare fraud and employment retaliation. The expert witness asserted that his employment experience qualified him to remark on the legitimacy of certain diagnoses to support admittance to a rehabilitation hospital and whether the use of such diagnoses was […]
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Claims Frivolous if Relator Cannot Show Knowledge, Materiality; United States District Court for the...

The district court granted the defendants’ motion for the award of reasonable fees and expenses in relation to their successful defense of a qui tam case. The court previously held that time-barred claims were clearly frivolous, but the Ninth Circuit vacated that decision, given the more recent holding in Cochise. On remand, the district court […]
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Vague Assertion of “Inside Knowledge” Insufficient to Support Kickback, Billing Fraud Allegations; United States...

The district court granted the defendants’ motion to dismiss a qui tam case alleging violations of the Anti-Kickback Statute and Stark Law. The relator alleged the main defendant improperly paid its physicians to refer patients to other, in-house providers, but did not adequately explain the details of the kickback scheme. The relator also failed to […]
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Fastest 5 Minutes: Suspension/Debarment, False Claims Act, and Oversight (February 19)

This week’s episode covers suspension and debarment, False Claims Act developments, and oversight relating to the pandemic response, and is hosted by partner Peter Eyre and associate Gabby Trujillo. Crowell & Moring’s “Fastest 5 Minutes” is a biweekly podcast that provides a brief summary of significant government contracts legal and regulatory developments that no government […]
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Defendants Who Falsely Certified 8(a) Eligibility Doubled Down on Fraud With Every Bid; United...

The district court denied the defendants’ motion to dismiss a qui tam complaint alleging fraud on SBA’s 8(a) program. The relators alleged that after the defendants aged out of the program, they formed a sham company to continue to obtain contract set-asides. The defendants argued the relators had failed to demonstrate scienter and failed to […]
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