Strategic Litigation Choices, Not Government Delay, Pushed Qui Tam Suit Outside Statute of Limitations;...
The district court granted the defendant’s motion to dismiss a qui tam case as untimely, finding the relator was not entitled to equitable tolling...
Attempt to Relitigate Summary Judgment Issues Fails to Raise Extraordinary Circumstance for Interlocutory Review;...
The district court denied the defendants’ motion to stay proceedings and for certification of an interlocutory appeal, finding the defendants failed to raise any controlling issue of law, but merely disagreed with the court’s prior ruling on summary judgment. While the defendants questioned whether medical disagreements could form the basis for an FCA claim and […]
Public Disclosure Bar Jurisdictional, Regardless of Other Pleading Deficiencies; United States Court of Appeals...
The Second Circuit vacated and remanded a lower court’s dismissal of a qui tam suit alleging the defendants failed to report to the government...
Experience With Specific Medical Procedures Not Only Avenue to Determining Expertise of Relator’s Witnesses;...
The district court denied motions to exclude the relator’s expert witnesses and their expert reports. The defendants in the healthcare fraud case argued that the relator’s witnesses did not have hands-on experience with the medical procedures at issue, which the relator argued were provided despite not being medically necessary. However, the court explained there are […]
Compliance Week Offers Roadmap for Auditors Managing COVID-19 Challenges
A new e-Book from Compliance Week shares perspectives from Julie Bell Lindsay, executive director of the Center for Audit Quality, on how public company auditors cope with new challenges deriving from the COVID-19 pandemic. It also explores tips from the AICPA on conducting remote audits, delves into fraud allegations at Luckin Coffee and IQIYI that […]
Res Judicata Cannot Bar Qui Tam Complaint When Government Not a Party to Prior...
The Ninth Circuit vacated and remanded a lower court’s dismissal of a qui tam complaint under the public disclosure bar. The court found the...
Fourth Circuit Finds Allegedly Fraudulent Medicaid Billings Sufficiently Connected to Medical Services Under Insurance...
The Fourth Circuit vacated and remanded a district court’s dismissal of a lawsuit asserting breach of contract claims against an insurance provider who denied...
Employee’s Refusal to Discuss Fee Waivers in Email Raised Reasonable Inference Company Knew Conduct...
The district court denied the defendants’ motion to dismiss a complaint alleging violations of the Anti-Kickback Statue and FCA. While the relator did not...
Obvious Alternate Conclusion Sinks Relator’s Statistical Analysis as Evidence of Fraud; United States Court...
The Ninth Circuit affirmed a district court’s dismissal of a complaint alleging healthcare fraud. In support of the allegations, the relator provided a statistical analysis showing that the defendants billed Medicare using high-value billing codes at a much higher rate than other hospitals. According to the relator, this analysis provided evidence the defendants were fraudulently […]
Ninth Circuit Rejects Appeal Attempting to Revive Fraud Complaint Based on Hospital’s Knowledge of...
The Ninth Circuit affirmed a district court’s dismissal with prejudice of a complaint alleging Medicare fraud. The court agreed the relator’s allegations were too vague and conclusory to support the implausible conclusion that a medical facility was aware that area mountain roads did not meet CMS’ criteria for determining whether a hospital was located in […]