False Claims Act

False Claims Act News

Federal Court Cases May Have Some Healthcare Providers Asking For Peace, Not War (6/13/2013)
Last summer, a federal judge in Houston ruled that the Wartime Suspension of Limitations Act (WSLA), found in Title 18, § 3287 of the U.S. Criminal Code, applied to a civil False Claims Act case and suspended the statute of limitations until five years after the conclusion of the conflicts in Iraq and Afghanistan. While the decision was novel at the time, the government’s continued reliance on the WSLA threatens to make it more difficult for False Claims Act defendants, including healthcare providers, to assert a statute of limitations defense.

Physicians Are My Friends; Surely I Can Get Paid to Talk To Them! (6/13/2013)
On April 26, 2013, the DOJ intervened in a whistleblower case alleging Novartis Pharmaceuticals Corporation (Novartis) knowingly and willfully violated the federal False Claims Act by inducing physicians to prescribe Novartis drugs in the form of payments to the physicians for speaking at programs that did not appear to be bona fide. The DOJ's intervention occurred just days after it filed a separate case against Novartis alleging kickbacks in the form of discounts and rebates to at least 20 pharmacies.

Hospital Ordered to Produce Privileged Documents Under the Crime-Fraud Exception (5/30/2013)
A magistrate judge in the U.S. District Court for the Middle District of Florida recently ordered a hospital defendant in a False Claims Act case to turn over two prime documents to the DOJ and the whistleblower that would seem to fall within the traditional confines of the attorney-client privilege. The complaint alleges that Halifax entered into several specialty physician employment agreements that provided for compensation that was not commercially reasonable, exceeded fair market value and/or took into account the volume or value of referrals or other business generated in violation of the federal Stark Law, and in turn, the federal False Claims Act.

Groundhog Day for Tuomey: Jury Finds Hospital Violated Stark Law and False Claims Act (5/16/2013)
On May 8, 2013, a jury in the Columbia Division of the U.S. District Court for the District of South Carolina returned a verdict finding that Tuomey Healthcare Systems, Inc. violated the Stark Law and the False Claims Act by submitting 21,730 claims to Medicare tainted by improper relationships with eighteen physicians.

SSixth Circuit Holds Physician Supervision and Enrollment Issues Are Not Conditions of Payment for Purposes of False Claims Act Liability (4/18/2013)
The Sixth Circuit Court of Appeals recently issued a decision overturning an $11.1 million False Claims Act verdict against MedQuest Associates, Inc. for submitting claims to Medicare in violation of the Medicare conditions of participation. In this decision, the Sixth Circuit expanded on its recent precedent by stating that the False Claims Act should not be used to penalize providers for technical noncompliance with the complicated Medicare regulatory scheme.

False Claims Act: Health System Settles Allegations Related to Payments to Physician Advisors (2/7/2013)
The DOJ recently issued a press release related to a settlement agreement between the U.S. Attorney's Office for the District of New Jersey, the state of New Jersey and a New Jersey hospital system wherein the system agreed to pay a total of $12.6 million to the U.S. and New Jersey to resolve allegations that it violated the federal and New Jersey civil false claims acts by submitting claims for cardiology services that resulted from improper payments to cardiologists.

10 Fraud and Abuse Enforcement Trends You Can't Afford to Ignore in 2013 (2/7/2013)
To paraphrase a famous quote, "Those who do not learn from history are doomed to repeat it," and providers who ignore the significance of the federal government's healthcare fraud enforcement efforts in 2012, do so at their own peril. Using lessons from 2012, we have compiled a list of the ten fraud and abuse enforcement trends that providers simply cannot afford to ignore in 2013.