Far-Fetched Whistleblower Claim of the Month

The hospital industry is accustomed to far-fetched whistleblower claims: allegations that a hospital knowingly submitted false or fraudulent Medicare or Medicaid claims or fired a whistleblower for trying to prevent such activity.  But in terms of far-fetched claims decided in January, whistleblower Jana Endicott …

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False Claims that Don’t Violate the False Claims Act

The False Claims Act (FCA) establishes heavy liability (treble damages and penalties that can exceed over $20,000 per claim) for any person who knowingly presents a false claim for payment to the government.  It also provides a right of action for any employee fired for trying to stop violations of the act. So …

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The Difference between Expecting Referrals & Inducing Them

A new Fifth Circuit opinion explains the difference between offering a benefit in order to induce a Medicare referral and offering it in the expectation of a referral.  The difference is important because the former is a serious federal crime, while the latter is perfectly legal. Whistleblower Susan Ruscher …

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False Claims that Don’t Violate the False Claims Act

A recent Fourth Circuit decision answers this riddle, “How can a contractor knowingly submit a false claim to the government without violating the False Claims Act (FCA)?”  Give up?  The answer is blindingly obvious—once you’ve heard it. The answer is that a false claim doesn’t violate the FCA …

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7th Cir. Demands Objective Standards in Whistleblower Complaint

On September 1 the Seventh Circuit affirmed dismissal of three of a whistleblower’s four fraud allegations against a mental health clinic, ruling that the allegations were based on the whistleblower’s subjective judgment rather than objective standards. Rose Presser worked at Acacia Mental Health Clinic as …

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Strangest Regulatory Interpretation of the Month

The Massachusetts federal district court is hands-down winner of the August award for strangest regulatory interpretation of the month. The interpretation came in the context of denial of Omnicare’s summary judgment motion in a False Claims Act (FCA) action brought against it by three whistleblowers.   The …

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