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False Claims Act Statistics, News & Analysis

DOJ Heads for the Hills after Judge Rips FCA Case as a "House of Cards"

On October 27, 2017, Magistrate Judge Theresa Carroll Buchanan in the Eastern District of Virginia gave the government a brutal reality check on the viability of its case in United States of America ex rel. Ribik v. HCR ManorCare Inc., et al. when she plainly informed them at a hearing on defendants’ motion for sanctions: “I don’t think this case should have ever been brought.” DOJ has responded to this reproof by filing a motion to voluntarily dismiss the entire case with prejudice.

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  • 14
  • November
  • 2017

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Too Good To Be True? DOJ Teases Policy Shift to Dismiss Meritless Qui Tams

With good excuse, we at LLB are a bit late to the party on this bit of news. It appears that Michael Granston, the director of the DOJ Commercial Litigation Branch, Fraud Section — the office charged with guardianship of the FCA for all of DOJ — chose a health care compliance conference to announce what could be a major shift in enforcement policy. In an October 30 speech, which appears to have been covered only by RAC Monitor in the first instance, Granston announced that going forward, DOJ will move to dismiss cases it finds to be meritless, rather than permitting relators to litigate on their own.

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  • 03
  • November
  • 2017

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Frighteningly Large Settlement for Hospice Provider Whose Patients Lived

The day before Halloween, the DOJ announced that Chemed Corporation and its various subsidiaries have agreed to a $75 million settlement for submitting allegedly false hospice services claims to Medicare for reimbursement. Touting this as “the largest amount ever recovered under the False Claims Act from a provider of hospice services,” the government sets the tone early in the new fiscal year for a high-recovery agenda.

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  • 31
  • October
  • 2017

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Escobar Continues to Bring More Treats Than Tricks For FCA Defendants — Seventh Circuit Overrules Longstanding Causation Precedent, Adopts Proximate Cause Standard

Handing out a pre-Halloween treat to FCA defendants, the Seventh Circuit last week overruled its 1992 decision adopting a “but-for” causation standard to join its sister circuits in holding that FCA plaintiffs must prove that a defendant’s false claim was both the but-for and proximate (i.e., foreseeable) cause of the government’s loss.

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The More Things Change, the More They Stay the Same: Analyzing Recoveries by Circuit for FY 2017

We’re back with the third installment of our series analyzing FCA statistics for DOJ FY 2017, this time taking a closer look at recoveries by circuit. After our prior posts describing the steep drop in recoveries overall from last year, it may not come as a surprise to LLB readers that the geographic analysis has changed a fair bit in the last year. Only one of the leaders from DOJ FY 2016 is still at the top in DOJ FY 2017: the Eleventh Circuit. Indeed, the Eleventh Circuit, which ranked third last year with $808 million across 100 recoveries, came out in front in DOJ FY 2017 with the DOJ raking in $771.52 million across 26 recoveries. This means that the number of cases brought to conclusion in 2017 dropped 74% from the previous year, but DOJ’s payout dropped only by 5%. Does this signal a smarter, more targeted civil fraud bar in the Eleventh Circuit, or is this mathematical windfall simply a fluke? Impossible to say definitively, but it is worth noting that almost half of this year’s Eleventh Circuit total (45.4%) was recovered from just one matter (the Shire Pharmaceuticals LLC medical device case we blogged about last week).

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  • 19
  • October
  • 2017

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Not a Bullseye, But the Government Hits Its Mark, Settling Triple Canopy for $2.6 Million

Earlier this week, the U.S. Attorney’s Office for the Eastern District of Virginia announced that defense contractor Triple Canopy has agreed to settle the long-running FCA suit related to its provision of security services in Iraq. Although a victory for the government, contractors can take some comfort from the fact that the $2.6 million settlement represents less than 25 percent of the damages sought in the government’s complaint-in-intervention (which totaled more than $12 million when trebled). $500,000 of the settlement will be paid to the relator pursuant to the FCA’s qui tam provisions.

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Healthcare Post-Mortem: Medical Industry Continues to be High-Value Target for FCA Enforcement

Last week we gave you the bottom line of how much DOJ (and relators) recovered in FY 2017. As we promised, we are doing a series of sector-specific posts – analyzing each for industry-specific trends. Today is Healthcare: Who’s paying, how often, and how much?

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It’s Déjà vu All over Again: Resetting the FCA Stats Tracker for FY 2018

It’s that time again; time to press the reset button and reflect on the past fiscal year’s FCA statistics. Fiscal Year 2017, which came to a close on September 30th, was a big year here at LLB as it marks the first year we were able to track FCA statistics for the entire year in real time. LLB has been through some changes since the last time we did this; just recently, we premiered our new custom date range tool on the data set for increased precision in your searches and today we premiered a new copy link feature. However, one thing has remained constant: our readership’s interest in FCA enforcement statistics. With that in mind, we now present to you a breakdown of our preliminary assessment of FY 2017.

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Time to Take Your Medicine: Fifth Circuit Decision Diagnoses Problems with Causation Arguments

Last month, we covered United States ex rel. King v. Solvay Pharmaceuticals, Inc. on the issue of the FCA’s public disclosure bar pre-Affordable Care Act. Today, we explore another aspect of that same opinion — the causation requirements necessary to sustain a fraudulent inducement FCA claim. The Fifth Circuit delivered relators a dose of bitter medicine in its opinion, affirming the district court’s grant of summary judgment to the defendant pharmaceutical company on the grounds that relators failed to demonstrate a causal link between the alleged false statements and any actual false claims.

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Litigation Update: Ninth Circuit Stays Mandate to allow Gilead to Seek Cert on Key Post-Escobar Issues

We reported previously on yet another implied certification case raising significant questions about materiality and falsity in the post-Escobar world, United States ex. rel. Campie v. Gilead Sciences, Inc., in which the Ninth Circuit reversed the district court’s dismissal of the case.

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Up-Up-And-Away: $92.9 Million FCA Verdict Balloons to $295.5 Million Judgment After Court Imposes Treble Damages and Near-Max FCA Penalties

On Friday, a Houston federal court entered judgment totaling $295.5 million in an FCA and FIRREA (Financial Institutions Reform, Recovery, and Enforcement Act of 1989) case, up from the jury’s verdict of $92.9 million. The case is United States v. Allied Home Mortgage Corporation, et al., 4:12-cv-02676-GCH (S.D. Tex.), and it centers around defaulted home mortgage loans insured through the U.S. Department of Housing and Urban Development (HUD). We here at LLB previously wrote about the jury’s verdict in this intervened qui tam (available here).

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Futrell Enters the Fray on Whether the FCA Covers the E-Rate Program Despite Funding from Telecomm. Industry

Last month, a Missouri district court in U.S. ex rel. Futrell v. E-Rate Program, LLC handed down a decision of interest to the telecommunications industry. The defendant contracts with schools and school districts to help them obtain funds under the E-Rate Program, a program that provides subsidies and discounts to schools to secure affordable telecommunications and Internet access. The program is administered by USAC, a private non-profit organization subject to regulations of (but not controlled by) the FCC, and is funded by mandatory contributions from private interstate telecommunications carriers. The Futrell court found that FCA liability may exist in such circumstances, even though the USAC funds are not government dollars. The Futrell decision adds to a disagreement between at least two district courts and one circuit court on this issue.

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  • 26
  • September
  • 2017

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False Claims Act Cert. Monitor: Eight FCA Petitions on the 2017 Docket So Far

With the first day of fall comes the new term at the Supreme Court, and with the new term comes the chance to catch up with petitions we wrote about last year and with new petitions filed over the summer. We know of at least six FCA petitions that were set to be considered at the Court’s Long Conference on September 25, and we should learn their fates this week. Meanwhile, we have tracked down two other petitions still in briefing. These petitions touch on everything from the Rule 9(b) pleading standard, to reverse false claims, to knowledge in the face of ambiguous rules, to Escobar’s two-part falsity test, to sanctions for relator misconduct.

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Back to Basics with the Original Source: Pre-ACA Public Disclosure Bar

With the fate of the Affordable Care Act in question these days, the FCA community nevertheless continues its struggle to understand and cope with the changes wrought to the statute over seven years ago through the 2010 ACA amendments. And yet, due in large part to the quirky nature of the FCA’s sealing provision, which results in cases existing “undercover” for years, application of pre-ACA law remains an occasional necessity. In September, the Eighth and Fifth Circuits each examined the question of what it means to be a pre-ACA “original source,” the saving grace for relators whose allegations would otherwise be subject to dismissal under the public disclosure bar.

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Open Season for FCA Relators? Ninth Circuit Finds Falsity in Gilead Case Despite Possible Discrepancy with Sister Court

We’re back with our second installment on the Ninth Circuit’s decision in United States ex. rel. Campie v. Gilead Sciences, Inc., No. 15-16380, 2017 WL 2884047 (9th Cir. July 7, 2017). If Gilead’s materiality ruling left you scratching your head, then best take a seat now, because the falsity analysis is even more puzzling. But peel back the problematic legal analysis, and what seems to have driven the Ninth Circuit to let this case proceed past the pleadings is that relators alleged specific examples of the defendant having misled the government about the product it was selling. Despite our other criticisms of this opinion, Gilead’s emphasis on alleged specific misrepresentations is a saving grace because it is consistent with Escobar’s two-part implied certification test, which requires (1) a specific representation that (2) is made a misleading half-truth by omission.

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