Medicare Advantage Organizations have come under increased fire as their parent companies continue to acquire more healthcare practices across the country. Experts suggest that this vertical integration has led to inflated Medicare spending, with providers facing new pressure to diagnosis chronic conditions that fetch more money for Medicare Advantage plans.
After a rare False Claims Act (FCA) trial, a St. Paul federal jury has returned a verdict for the government in United States, ex rel. Kipp Fesenmaier v. Cameron-Ehlen Group, Inc., No. 0:13-cv-03003 (D. Minn.).
The jury found that ophthalmic products supplier, Cameron-Ehlen Group, Inc.,
On November 30, 2022, the United States Court of Appeals for the Third Circuit revived a quality control manager’s FCA retaliation claim in United States ex rel. Ascolese v. Shoemaker Constr. Co., — F.4th —, 2022 WL 17335121 (3d Cir. 2022).
The Third Circuit’s precedential opinion addressed for the first time how Congress’s 2009 and 2010 amendments affect the False Claims Act’s retaliation standard.
Takeaway: The Eastern District of New York rules that the tax code gives relator’s counsel superpriority to False Claims settlement proceeds.
On Wednesday, November 9th, the Eastern District of New York ruled that fees owed to relator’s counsel must be paid before the relator’s tax lien,
Takeaway: California has recovered over $2 billion under the State’s False Claims Act since 2001, according to data obtained from the State Attorney General’s Office.
Enacted in 1987, the California False Claims Act (“CAFCA”) is one of the oldest qui tam statutes in the country.
Takeaway: Over ten years, the Maryland False Health Claims Act has returned $160M to the State. This Digest summarizes each of the 173 matters reported under the Act from 2011 through 2021.
Background of the Act
Maryland is one of 32 states with its own qui tam statute.
Takeaway: From 2018 to 2020, the New York False Claims Act yielded an impressive $216,936,354 in recoveries and returned $130,161,812 to New York State’s Medicaid Program.
New York is one of 32 states with its own qui tam statute.[1] Enacted in 2007,
Takeaway: Based on data reported by the State Attorney General, New Jersey’s False Claims Act (NJFCA) has been a legislative success. Between 2010 and 2019, the State netted $147 million under the NJFCA, while relators received $8.8 million. Over ten years, the New Jersey Attorney General filed 9 NJFCA cases,
