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DOJ Files Statement Of Interest Rebutting Application Of A “But-For” Causation Standard In False Claims Act Cases Predicated On Violations Of The Anti-Kickback Statute

On October 27, 2023, in a declined District of Massachusetts qui tam case called United States ex rel. Witkin v. Medtronic, Inc., the Department of Justice (“DOJ”) filed a sweeping statement of interest on the proper causation standard in False Claims Act (“FCA”) cases predicated on violations of the anti-kickback statute (“AKS”), as well as . . .

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Yogibo Agrees to Pay Over $217K to Resolve Customs Fraud Allegations

On July 26, 2023, the Department of Justice announced that it had reached a settlement for $217,832 with bean bag furniture maker Yogibo, LLC, in a customs fraud False Claims Act qui tam action that we initiated last year on behalf of our client, the former Warehouse Manager at a Yogibo facility in Nashua, New . . .

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U.S. Attorney’s Office in Vermont Poised to Settle Fifth Electronic Health Records False Claims Act Case

According to a press release issued earlier this week, EHR provider NextGen Healthcare, Inc., has accrued approximately $35 million to settle a Department of Justice matter. According to NextGen’s prior SEC filings, the company has been under investigation by the United States Attorney’s Office in Vermont since at least 2017 in connection with the certification . . .

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U.S. Attorney’s Office Resolves Second Nursing Home Case Involving Improper Medicare Advantage Disenrollments

Yesterday, the United States Attorney’s Office for the Southern District of New York announced its second False Claims Act settlement involving allegations of illegal disenrollment of nursing home residents from their Medicare Advantage plans. The settlement serves both as a further warning to nursing home operators not to engage in such conduct, and as a . . .

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Update on Causation in False Claims Act Cases Predicated on Violations of the Anti-Kickback Statute

Last week, I posted on the likely limited effect of the Eighth Circuit’s decision in United States ex rel. Cairns v. D.S. Medical, LLC, 42 F.4th 828 (8th Cir. 2022), which held that the government (or the relator) must prove “but-for” causation to show damages in a False Claims Act case predicated on violations of . . .

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Recent Developments Suggest That The Cairns Decision Does Not Doom False Claims Act Cases Predicated On Violations Of The Anti-Kickback Statute, Even In The Eighth Circuit

In September 2018, the United States Attorney’s Office for the Eastern District of Missouri announced that it had obtained a $5,495,931 judgment against Dr. Sonjay Fonn and Deborah Seeger after a trial in a False Claims Act case involving alleged kickbacks to Dr. Fonn from a spinal implant distributorship that Ms. Seeger owned. The amount . . .

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What to Do When a Whistleblower Is an Attorney, or the Whistleblower Provides Counsel with Potentially Privileged Documents

For a recent Federal Bar Association Qui Tam conference, I put together a slide presentation that addressed, among other things, issues that arise when a whistleblower is an attorney, or when a whistleblower shares potentially privileged documents with their attorney. I learned some things from researching these issues, so I thought I would share what . . .

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Recent Settlement Highlights Perils of Outsourcing Diagnostic Work to Overseas Vendors

Until recently, federal healthcare regulations required that nonphysician personnel who performed diagnostic tests for an independent diagnostic testing facility (“IDTF”) must have a state license or certification to do such work. 42 C.F.R. § 410.33(c) (2021). On December 20, 2022, the United States Attorney’s Office for the Eastern District of Pennsylvania announced that BioTelemetry, Inc., and its subsidiary . . .

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In latest EHR False Claims Act Settlement, Modernizing Medicine Agrees to Pay $45 Million

After losing a motion to compel production of a key document, the U.S. Attorney’s Office in Vermont nevertheless has managed to notch another large False Claims Act settlement with an electronic health record (“EHR”) company. On November 1, 2022, that office announced that Modernizing Medicine, Inc. (“ModMed”), a Florida-based electronic EHR technology vendor, has agreed to pay . . .

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Recent Settlement with Florida Physician Practice Highlights Continuing Risks of Upfront “Rebates”

On October 3, 2022, the U.S. Attorney’s Office in Boston announced that a Florida physician practice, Southeast Florida Hematology and Oncology Group, P.A. (“SEFHOG”), had agreed to pay $130,000 to resolve allegations that, among other things, it took an upfront “transition rebate” from Cardinal Health, a large drug distributor, in exchange for agreeing to purchase 90 percent . . .

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