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 …
The Difference between Expecting Referrals & Inducing Them
November 4, 2016 Leave a Comment
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 …
False Claims that Don’t Violate the False Claims Act
September 26, 2016 Leave a Comment
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 …
7th Cir. Demands Objective Standards in Whistleblower Complaint
September 22, 2016 Leave a Comment
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 …
Strangest Regulatory Interpretation of the Month
September 21, 2016 Leave a Comment
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 …
The Law Doesn’t Forbid Submitting False Claims
August 24, 2016 Leave a Comment
An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims. That made all the difference in an appeal of summary judgment in favor of a physician group that, according to the relator, failed to comply with …