Walgreens Agrees to Settle Three Civil Fraud Lawsuits Totaling Over $270 Million
Walgreens Boots Alliance, Inc. ("Walgreens") has agreed to pay $269.2 million to settle two whistleblower lawsuits accusing it of overbilling federal healthcare programs for over a decade. In both settlements, Walgreens "admitted and accepted responsibility for conduct the Government alleged in its complaints under the False Claims Act". The U.S. Department of Justice made the announcement on January 22, 2019. In addition, Walgreens recently settled another False Claims Act claim, although the monetary value is modest in comparison with the first two. In the third settlement, Walgreens agreed to pay $3.5 million to the U.S. and the State of Wisconsin to settle allegations that, from 2011 to 2014, Walgreens violated Wisconsin Medicaid rules by dispensing routinely stimulant medications to Wisconsin Medicaid beneficiaries without first verifying that the prescribing physician ordered the medication for a medically appropriate treatment. More
The Public Disclosure Bar
The False Claims Act qui tam provision allows private citizens to act as whistleblowers, and file a lawsuit on behalf of the government if they are aware of fraud taking place. These whistleblowers, or relators, are eligible to receive a portion of the money the government recovers if the lawsuit is successful.
It is important to note that the False Claims Act is designed to encourage people to report fraud that might otherwise go undetected; it is not designed to reward people who repeat allegations that have already been publicized. To that end, the False Claims Act includes language stipulating that the court will dismiss a case if substantially the same allegations contained therein were already publicly disclosed and the relator bringing the action is not an original source of the information. This section of the Act is commonly referred to as the "public disclosure bar". More
An Overview of Nursing Home Fraud: False Claims Act Cases from the Last Three Years
The last three years have seen several FCA cases related to nursing home fraud achieve success. Two cases of note—one against a skilled nursing facility chain and one against a rehabilitation therapy provider—settled for over $100 million, and a recent Third Circuit decision revived a dismissed case against a pharmaceutical company and narrowed the public disclosure bar. Still other cases involving similar allegations of inflating reimbursement levels and engaging in illegal kickback schemes have settled for millions or involved criminal prosecution of the individuals responsible. More
Lincare Settles False Claims Act Allegations for $5.25 Million
Lincare, Inc., one of the nation's largest providers of durable medical equipment has paid $5.25 million to resolve allegations brought forth through a qui tam action filed by a Relator on behalf of the United States. More
Attorney General Nominee Historically Opposed to False Claims Act Whistleblower Provision
William Barr, currently an attorney at Kirkland & Ellis who is nominated for the position of Attorney General, has historically been opposed to the False Claims Act qui tam whistleblower provision which allows private citizens to sue in the name of the United States government. More
False Claims Act and the Opioid Crisis: First-ever Civil Injunction Filed by Justice Department to Combat Opioid Over-Prescription
In August 2018, the U.S. Department of Justice announced allegations against an Ohio doctor for violating the False Claims Act (FCA) in addition to violating the Controlled Substances Act (CSA) for prescribing opioid prescriptions in excessive amounts or to those who are not in need of the medication. Although an FCA case is not the most traditional approach to these issues, it is clear that the Justice Department is making the opioid crisis a top priority and therefore potentially invoking the FCA more often in these cases. The government's focus on the opioid crisis has been consistently increasing and expanding from targeting manufacturers of opioids to targeting prescribers and healthcare providers that submit claims to federal health care programs or to the federal government.
DOJ Publishes FCA Statistics for Fiscal Year 2018
The Department of Justice announced in a press release on December 21, 2018 that False Claims Act cases recovered more than $2.8 billion for the federal government for the 2018 fiscal year. This total recoveries amount includes settlement and judgment amounts for all cases.
Escobar decision continues to affect major FCA cases
In 2016, the Supreme Court decided the landmark FCA case Universal Health Servs., Inc. v. United States ex rel. Escobar, 136 S.Ct. 1989 (2016). Escobar resolved a circuit split over the implied false certification theory of liability under the FCA, upholding the theory as valid but tightly circumscribing its scope through a "rigorous" interpretation of the Act's materiality and scienter requirements—holding that "[a] misrepresentation about compliance with a statutory, regulatory, or contractual requirement must be material to the Government's payment decision in order to be actionable under the False Claims Act." Escobar, 136 S.Ct. at 1996. This holding continues to percolate through the federal courts, proving determinative in several recent cases of interest. More
US Government continues to combat health care fraud in Chicago
Both the False Claims Act and criminal health care fraud laws continue to be powerful tools for combating health care fraud—and many criminal health care fraud cases could also have been FCA cases, had a whistleblower come forward in time. More
Wisconsin taxpayers have lost millions since the 2015 repeal of the Wisconsin FCA
Wisconsin taxpayers have missed out on over $11 million in Medicaid fraud settlements since the Wisconsin legislature and Gov. Scott Walker repealed the Wisconsin False Claims Act in 2015, reports the Wisconsin Center for Investigative Journalism. Wisconsin is the only state to have repealed its FCA, despite Gov. Walker's anti-government-waste platform. More
Subscribe to this blog's feedRecent Posts
- Walgreens Agrees to Settle Three Civil Fraud Lawsuits Totaling Over $270 Million
- The Public Disclosure Bar
- An Overview of Nursing Home Fraud: False Claims Act Cases from the Last Three Years
- Lincare Settles False Claims Act Allegations for $5.25 Million
- Attorney General Nominee Historically Opposed to False Claims Act Whistleblower Provision
- False Claims Act and the Opioid Crisis: First-ever Civil Injunction Filed by Justice Department to Combat Opioid Over-Prescription
- DOJ Publishes FCA Statistics for Fiscal Year 2018
- Escobar decision continues to affect major FCA cases
- US Government continues to combat health care fraud in Chicago
- Wisconsin taxpayers have lost millions since the 2015 repeal of the Wisconsin FCA
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