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Government Decision

This archive displays posts tagged as relevant to the government decision to intervene in whistleblower litigation. You may also be interested in our pages:

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Supreme Court Clarifies Government's Right to Dismiss False Claims Act Cases Brought by Whistleblowers

Posted  06/20/23
False Claims Act
The Supreme Court last Friday (June 16) in United States ex rel. Polansky v. Executive Health Resources, Inc. clarified the scope of the Government's authority to dismiss False Claims Act cases brought by whistleblowers.  In an 8 to 1 decision (with Justice Thomas dissenting), the Court held the Government may move to dismiss both during the seal period when it is investigating the case and after the seal when a...

Tagged in: FCA Federal, FCA Materiality, Government Decision,

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United States Reaches a “Tipping Point” in Managed Care Enforcement: DOJ Intervenes in Constantine Cannon’s Lawsuit Against Kaiser Permanente

Posted  07/30/21
Kaiser Permanente Building with Logo
In a sign that the government’s enforcement efforts against fraud in the Medicare managed care system have reached a tipping point, the U.S. Department of Justice announced today that it is joining a portion of a whistleblower lawsuit brought by a Constantine Cannon client under the False Claims Act against Kaiser Permanente and affiliated entities, one of the nation’s largest managed-care organizations. ...

Tagged in: CC Lawyers, FCA Federal, Government Decision, Healthcare Fraud, Managed Care, Medicare, Risk Adjustment Fraud, Upcoding, Whistleblower Case,

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Fifth Circuit Affirms Government Dismissal Of Cases Brought By Corporate Whistleblower

Posted  07/16/21
gavel on bench
Last week, a three-judge panel of the Court of the Appeals for the Fifth Circuit sided with the government in its bid to dismiss a whistleblower case brought by a limited liability company against pharmaceutical giants Eli Lilly and Bayer.  The case offers another example of the government flexing its dismissal power in the wake of the Granston Memo, a 2018 Department of Justice directive to winnow False Claims Act...

Tagged in: Anti-Kickback and Stark, Court Decision, FCA Federal, Government Decision, Healthcare Fraud, Importance of Whistleblowers, Whistleblower Case,

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Whistleblower Suit Revived by Third Circuit Despite Settlement in Related State Court Action

Posted  08/13/19
Judge's bench with empty chair and gavel
In United States ex rel. Jean Charte v. American Tutor, Inc., the Court of Appeals for the Third Circuit reversed dismissal of a whistleblower’s qui tam action under the False Claims Act, giving the whistleblower the right to pursue her claims. The district court had dismissed the action under state law res judicata principals, because the relator had settled a defamation action brought in state court against her by...

Tagged in: Confidentiality and The Seal, Court Decision, Education Fraud, FCA Federal, FCA State, Government Decision, Whistleblower Case,

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United States Intervenes in Home Health Care Fraud Case

Posted  05/30/19
Doctor Hand Taking Money from Patient's Hand
Last week, the United States intervened in a lawsuit brought against Florida-based Doctor’s Choice Home Care and its two owners.  The Department of Justice alleged that the company bribed doctors to refer patients in violation of the federal Anti-Kickback Statute and Stark Law. Both laws prohibit medical providers from paying or receiving kickbacks in connection with government-funded health care...

Tagged in: Anti-Kickback and Stark, FCA Federal, Government Decision, Home Health and Hospice, Whistleblower Case, Whistleblower Eligibility,

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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...

Tagged in: Court Decision, FCA Federal, Government Decision, Statute of Limitations,

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DOJ Intervenes in Whistleblower’s Suit Alleging Health Care Company Defrauded Medicare

Posted  10/18/17
By the C|C Whistleblower Lawyer Team The Justice Department announced a lawsuit Tuesday against the husband-and-wife owners of a health care company outside Chicago, alleging they violated the False Claims Act by falsely billing Medicare for millions of dollars in unnecessary or nonexistent home healthcare services. According to the lawsuit, the couple netted millions of dollars through the scheme. The...

Tagged in: FCA Federal, Government Decision, Home Health and Hospice, Medical Billing Fraud, Whistleblower Case,

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Allergan to Pay $13M to Resolve Whistleblower-Initiated Suit

Posted  07/5/17
By the C|C Whistleblower Lawyer Team Pharmaceutical maker Allergan, Inc. has agreed to pay $13 million to settle claims it illegally promoted eye drugs through a kickback scheme to induce doctors to prescribe its products. According to the complaint, Allergan improperly provided services such as business consulting and continuing medical education to boost its sales by encouraging doctors to recommend...

Tagged in: Anti-Kickback and Stark, FCA Federal, Government Decision, Whistleblower Rewards,

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May 16, 2017

Whistleblower Partner Mary Inman quoted in the Law360 article discussing the federal government’s intervention in the False Claims Act suit, Feds Take Over Whistleblower's UnitedHealth Overbilling Suit.  Click here to read more.

Tagged in: Government Decision, Managed Care, Risk Adjustment Fraud,

DOJ intervenes in $50 Million Healthcare Fraud Case

Posted  03/2/17
By the C|C Whistleblower Lawyer Team Preet Bharara, US Attorney for the Southern District of New York, announced a civil suit and criminal actions against several doctors and health care entities alleging over $50M in fraud through schemes that lasted over 12 years. Five of the six doctors charged in their personal capacity were arrested in the New York area on Wednesday. The allegations center around Asim...

Tagged in: Anti-Kickback and Stark, FCA Federal, Government Decision, Healthcare Fraud, Lack of Medical Necessity, Medicaid, Medical Billing Fraud, Medicare, Private Insurance Whistleblower Reward Programs, Provider Fraud,

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