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Court Decision

This archive displays posts tagged as relevant to court decisions involving whistleblower laws. You may also be interested in our pages:

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Intermountain Settles Dispute Pending Before Supreme Court, Leaving 9(b) Ambiguity Unresolved

Posted  05/24/19
Doctor Holding Heart in Palms
Earlier this month, a Utah-based hospital chain announced it would settle whistleblower Dr. Gerald Polukoff’s case alleging the hospital performed unnecessary heart surgeries on Medicare patients, thereby overcharging the federal government in violation of the False Claims Act (FCA). Defendant Intermountain Health, the largest healthcare provider in the Intermountain West, had petitioned the U.S. Supreme Court to...

Second Relator to File Wins First-to-File Fight in First Circuit

Posted  05/16/19
Runners on track race to cross finish line
After Millennium Health agreed in 2015 to pay $227 million plus interest to settle claims that it submitted false claims bills for excessive urine testing, $34 million – 15% of the total – was set aside to resolve the competing claims of more than seven different relators who had filed qui tam cases against Millennium that were dismissed as part of the settlement.  Since that time, several of the relators have...

Whistleblowers Win One in Supreme Court with Clarification on Statute of Limitations for False Claims Act Actions

Posted  05/15/19
U.S. Supreme Court building and plaza
In a unanimous opinion written by Justice Clarence Thomas, the Supreme Court affirmed that the False Claims Act’s statute of limitations applies in the same manner to all whistleblower-initiated actions, regardless of whether the United States has intervened in the action or not.  The decision resolves a three-way split among the federal circuit courts. In the underlying litigation, U.S. ex rel. Hunt v. Cochise...

Data Whistleblower Case Raises Question of What is a Public Disclosure

Posted  02/21/19
Rows of chairs with people waiting in hospital billing office
As regular readers know, we have been closely tracking the progress of data analysis firm Integra Med Analytics’ whistleblower lawsuit under the False Claims Act against Providence Health and its consultant J.A. Thomas and Associates, Inc. (JATA).  The case alleges a conspiracy between Providence and JATA to upcode for specific Major Complications or Comorbidities (MCCs). This case is part of a growing number of...

Federal Judge — CFTC Can Regulate “Cryptocurrency” Fraud

Posted  10/10/18
Cryptocurrency
In good news for investors, a Massachusetts federal judge recently ruled that the Commodity Futures Trading Commission (CFTC) has the authority to fight fraud in the booming virtual currency market. The decision follows on the heels of a ruling in New York where a different federal judge reached the same conclusion. Through the Commodity Exchange Act, Congress authorized the CFTC to fight fraud involving...

Third Circuit Clarifies the Public Disclosure Bar in United States ex rel. Silver v. PharMerica

Posted  09/7/18

Whistleblower Marc Silver secured a victory from the Third Circuit on September 4, 2018, which held that his action was not blocked by the “public disclosure bar” of the False Claims Act, reversing a lower court that had dismissed his action. The Third Circuit’s opinion appropriately recognizes that a whistleblower can use non-public information as a bridge between public information and allegations of fraud,...

Ninth Circuit Refuses to Kill Incentive Compensation Ban Whistleblower Suit

Posted  08/31/18
By Leah Judge
Education Fraud
Last week, the Ninth Circuit refused to kill a False Claims Act lawsuit alleging that San Francisco’s Academy of Art University violated the federal incentive compensation ban. The ban, which falls under Title IV of the Higher Education Act, prohibits schools that receive federal funds from paying incentives to employees for securing enrollments. The ban operates to protect students from pushy recruiters looking to...

Massachusetts High Court Bars Companies as Whistleblowers Under State False Claims Act

Posted  08/9/18
In a decision handed down Tuesday, the Massachusetts Supreme Judicial Court ruled that only individuals, not companies, have standing to bring a whistleblower action under the State's False Claims Act. The decision in Phone Recovery Services, LLC. v. Verizon of New England, Inc. is groundbreaking in its limitation of who qualifies as a whistleblower. At the same time, it likely is quite limited in its reach as it is...

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 Sarah “Poppy” Alexander
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...
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