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 …
False Claims that Don’t Violate the False Claims Act
January 23, 2017 Leave a Comment
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 …
Whistleblower Can’t Use Discovery Info to Satisfy Rule 9(b)
October 20, 2016 Leave a Comment
Rule 9(b) requires a whistleblower alleging fraud to “state with particularity the circumstances constituting fraud.” Tom Bingham provided the particularity, but his case was nevertheless dismissed because of the way he came by the information. Tom filed a qui tam action against HCA alleging that it …
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 …