Defense Victories Regarding the Knowledge Requirement under the False Claims Act

By Sarah Wirskye - On

The False Claims Act (31 U.S.C. §§3729-3733; “FCA”) imposes liability on persons and companies who defraud the government. Last year, DOJ recovered more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims against the government. Notably, of the over $5.6 billion recovered, over $5 billion involved the health …

Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) releases Solutions to Reduce Fraud, Waste and Abuse in HHS Programs

By Sarah Wirskye - On

The U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) released its annual Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG’s Top Unimplemented Recommendations. The OIG directed most of its recommendations to CMS to help “reduce improper payments, prevent and deter fraud, and foster economical payment policies.” Specific …

Department of Justice Publishes FY 2021 False Claims Act Data

By Sarah Wirskye - On

The Department of Justice (DOJ) published fiscal year 2021 False Claims Act data. The False Claims Act (31 U.S.C. §§3729-3733) (“FCA”) imposes liability on persons and companies who defraud the government.  It is the federal government’s primary tool in combating fraud against the Government. https://wirskyelawfirm.com/false-claims-act-basics/.  The DOJ recovered more than $5.6 billion in settlements …

What to Expect in Healthcare Fraud Prosecutions in 2022

By Sarah Wirskye - On

The government’s focus on healthcare fraud and abuse continued in 2021.  Even stronger enforcement is expected by Biden’s new Secretary of Health and Human Services Xavier Becerra, who previously served as California’s Attorney General. The following trends seen in 2021 are expected to continue in 2022. Kickbacks and Referral Arrangements. The government’s focus on …

Biden Administration Unveils United States’ Strategy on Countering Corruption

By Sarah Wirskye - On

In December 2021, the Biden administration released the United States Strategy on Countering Corruption (“Strategy”). Htttps://www.whitehouse.gov/wp-content/uploads/2021/12/United-States-Strategy-on-Countering-Corruption.pdf. The Strategy follows up on establishing the fight against corruption as a core national security interest of the United States in the National Security Study Memorandum-1 (NSSM-1) earlier in 2021. The Strategy discusses the impacts of corruption and …

DOJ Announces New White Collar Criminal Enforcement Policies

By Sarah Wirskye - On

Deputy Attorney General (DAG) Lisa Monaco announced the Department of Justice’s (DOJ’s) new approach to prosecuting corporate crime at the ABA’s 36th National Institute on White Collar Crime. Htttps://www.justice.gov/opa/speech/deputy-attorney-general-lisa-o-monaco-gives-keynote-address-abas-36th-national-institute. The primary announcements addressed: (1) individual accountability, (2) company prior conduct, and (3) corporate monitors. Individual Accountability The DOJ is restoring prior guidance that to …

District of Maryland Dismisses False Claims Act Action based on Conclusory Intent Allegations

By Sarah Wirskye - On

In United States ex rel. Fitzer v. Allergan, Inc., et al., 1:17-cv-00668-SAG (D. Md. Sept. 10, 2021), the court dismissed a declined False Claims Act (FCA) action, under 31 U.S.C. § 3729, et seq. The court dismissed the action without prejudice, based upon a holding that the allegations that defendants knew they were acting …

Eastern District of Pennsylvania Dismisses False Claims Act Case based on Quality of Care

By Sarah Wirskye - On

In Taylor v. Comhar, Civ. 16-1218 (E.D. Pa. Aug. 30, 2021), the court dismissed a False Claims Act (FCA) action in which the government declined to intervene. The relator, a licensed professional nurse named Sarah Taylor, alleged that treatment facilities for disabled individuals fraudulently billed Medicare and Medicaid for substandard care. In dismissing the …

Fifth Circuit Reverses Lower Court Denial of Rule 41 Motion When Government Seized Attorney-Client Privileged Seized Material

By Sarah Wirskye - On

In Harbor Healthcare Systems LP v. United States, No. 19-20624 (July 15, 2021), the Fifth Circuit reversed a decision by the District Court for the Southern District of Texas denying a Rule 41(g) motion for return of property.  The Court held that the “district court erred in its assessment of the pre-indictment harm resulting …

COVID-19 Telehealth Fraud Indictment

By Sarah Wirskye - On

Telemedicine has been growing over the last several years, and COVID-19 has accelerated that growth. Several provisions in the CARES Act relaxed telemedicine rules.  In addition to the CARES Act, there have been many other legislative and policy changes on both the national and state levels. However, providers should recognize that these policy changes …