Ninth Circuit Refuses to Kill Incentive Compensation Ban Whistleblower Suit
Posted 08/31/18
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Massachusetts High Court Bars Companies as Whistleblowers Under State False Claims Act
Posted 08/9/18
Constantine Cannon Partner Jessica Moore on Court’s Decision in Medicare Advantage Case
Posted 07/23/18
Becker’s Hospital Review published Four Key Takeaways From 9th Circuit’s Resurrection of the Silingo Medicare Advantage Case, written by Constantine Cannon partner Jessica T. Moore. In the article, Ms. Moore analyzes the Ninth Circuit’s July, 2018, ruling in U.S. ex rel. Silingo v. WellPoint, Inc., a case brought by a whistleblower under the False Claims Act alleging risk adjustment fraud in Medicare’s Part C...
10th Circuit Finds that Doctor’s Judgment is Not Automatically Reasonable and Necessary
Posted 07/20/18
By Poppy Alexander
Top-level heart surgeons work in a rarified world, where few may question their medical judgment. Yet that judgment is not infallible-and its presence is not in itself a protection against False Claims Act liability. The Tenth Circuit recently held as much in United States ex rel. Polukoff v. St. Mark’s Hospital et al., finding that a doctor may be exercising medical judgment while still...
False Claims Act Developments: Sixth Circuit Rules that Timing Matters When It Comes to Certifying Plans of Care
Posted 06/21/18
By Leah Judge
Reaffirming the importance of patient plans of care, the Sixth Circuit recently held that the timing of a physician’s certification of such plans is material to the government’s decision to pay for home health services. The case marks another circuit court’s application of the materiality standard announced in Universal Health Servs., Inc. v. United States ex rel. Escobar, and serves as a rebuke...
Dodd-Frank's Anti-Retaliation Protections Apply Only to Whistleblowers Who Report to the SEC
Posted 02/23/18
In Digital Realty Trust, Inc. v. Somers, a 9-0 opinion by Justice Ginsburg, the Supreme Court held that the anti-retaliation provisions of the 2010 Dodd-Frank Act do not extend to employees who have reported internally but extend only to employees who have reported suspected securities law violations to the SEC. The Supreme Court's decision reversed the Ninth Circuit, and resolved a longtime circuit split. The Fifth...
Florida Judge Erases $350M Jury Verdict in FCA Case
Posted 01/18/18
By the C|C Whistleblower Lawyer Team
Last Thursday, a judge in the Middle District of Florida threw out a $350M jury verdict against a nursing home provider. The basis of the decision was a stringent interpretation of the FCA’s materiality element. The ruling heavily relied upon the 2016 Supreme Court decision in Universal Health Services v. Escobar. This is the latest example of that ruling being hashed out in...
District Court Gives Short Shrift to Payment Terms in Recent Brookdale Decision
Posted 06/30/17
A recent district court decision from the Middle District of Tennessee serves as a reminder that qui tam relators would be wise to ferret out and include in their filings examples of any instances in which the government has taken enforcement action against companies involved in the type of misconduct they allege. It also underscores the point that courts must remember that the government has to pick and choose...
Eighth Circuit Rules That Public Disclosure Bar Applies in Drug Price Inflation Suit
Posted 05/31/17
Early this month, the U.S. Court of Appeals for the Eighth Circuit declined to revive a whistleblower’s False Claims Act (FCA) suit, ruling that prior litigation and government reports triggered the statutory public disclosure bar, even though the public disclosures at issue did not mention the defendants in the case. The case, United States ex rel. Lager v. CSL Behring. LLC, concerned fraud in the prescription drug...
Fifth Circuit Applies “Demanding” Escobar Materiality Standard
Posted 04/5/17
By Rosie Dawn Griffin
The Supreme Court’s holding in Universal Health Services, Inc. v. United States ex rel. Escobar continues to be hashed out in the lower courts.
Last month, the Fifth Circuit applied Escobar’s materiality standard in U.S. ex rel Abbott et al. v. BP Exploration and Production, Inc. et al., a whistleblower case former BP contractor Kenneth Abbott brought under the False Claims Act (FCA) in...