In a recent landmark decision, the United States District Court for the District of Minnesota dramatically reduced the damages and penalties awarded in a major False Claims Act (“FCA”) case.  United States of America ex rel. Kipp Fesenmaier v. The Cameron-Ehlen Group, Inc., et al., Case No. 13-cv-3003 (D. Minn., Feb. 8 2024) (Dkt. 1086).  The case initially concluded with a staggering judgment of over $487 million against the defendants.  However, after post-trial motions, the court reduced the judgment over 55% to approximately $216 million, citing the Excessive Fines Clause of the federal constitution as a limiting factor.

At trial, the jury found that a distributor of eye surgery products and its owner violated the Anti-Kickback Statute (AKS) by providing remuneration to ophthalmologists which led to the submission of 64,575 false claims to Medicare, resulting in $43,694,641.71 in single damages.  These damages were then trebled under the FCA, and statutory penalties were assessed for each false claim resulting in an order to pay $487,048,705.13.

In post-trial briefing, the defendants sought judgment as a matter of law, a new trial, and a reduction in the monetary judgment on the grounds that the award violated the Excessive Fines Clause. The Court denied the request for a new trial and for judgment as a matter of law, except for one transaction related to a trip to New York City.  However, the Court granted a reduction in the judgment on constitutional grounds, amending the award to $216,675,248.55.

In its analysis, the Court considered the reprehensibility of the defendants’ conduct, the relationship between the penalty and the harm to the victim, sanctions in other cases for comparable misconduct, legislative intent, and the defendants’ ability to pay.  The Court found that while the defendants’ conduct was serious, certain aspects, such as the benefit derived by the defendants and the nature of some remunerative transactions (e.g., a salad and soda at a Christmas party), were less severe than typical AKS cases.  Additionally, the Court noted that the penalties were partly due to the structure of Medicare’s billing process, which requires separate claims for different fees.

The Court also observed that the ratio of punitive damages to compensatory damages was excessive.  Comparing sanctions in similar cases, the Court concluded that the Excessive Fines Clause permits a maximum recovery of $216,675,248.55, which includes actual damages, trebled damages, and penalties.  

This case serves as a critical reminder of the potential for constitutional challenges to play a decisive role in the outcome of FCA litigation.  The approximately $271 million reduction in damages underscores the importance of strategic litigation and a deep understanding of the constitutional protections available to defendants.  This case highlights the need for defendants and their counsel to scrutinize the punitive aspects of FCA judgments and to consider post-judgment relief motions as a viable avenue for mitigating financial liability.

For further discussion on the implications of this landmark decision and strategic approaches in FCA litigation, please reach out to our experienced legal team.

Note: Our lawyers leveraged AI in creating this blog post, including using a transcript summary created by generative AI. As we explore the potential of generative AI in the legal space, it is our intention and our practice to be transparent with our readers and to showcase the results we are achieving using generative AI with publicly available resources. Crowell’s AI group is comprised of lawyers and professionals across our global offices, including from Crowell & Moring International (CMI), our international public policy entity, with decades of sector-specific experience. We intend to lead by example in our own responsible use of AI, as it pertains to both the risks and benefits. Should you have questions about the use of generative AI in the legal sector or Crowell’s use of AI, please contact innovation@crowell.com.

Print:
Email this postTweet this postLike this postShare this post on LinkedIn
Photo of Michael Shaheen Michael Shaheen

Michael Shaheen is a partner in the White Collar & Regulatory Enforcement and Health Care groups in the Washington, D.C. office of Crowell & Moring. His practice focuses on federal litigation, investigations, and enforcement actions. Michael has significant experience with the False Claims…

Michael Shaheen is a partner in the White Collar & Regulatory Enforcement and Health Care groups in the Washington, D.C. office of Crowell & Moring. His practice focuses on federal litigation, investigations, and enforcement actions. Michael has significant experience with the False Claims Act (FCA), with particular emphasis on health care fraud.

Before joining Crowell & Moring, Michael served as a Trial Attorney with the Fraud Section of the Department of Justice (DOJ), where his work primarily involved investigating and prosecuting FCA matters. At DOJ, he obtained judgments totaling hundreds of millions of dollars and was involved in the settlement of numerous false claims cases of similar magnitude. Michael served in a variety of roles in these cases, ranging from first-chair trial attorney to lead investigator.

Photo of Spencer Bruck Spencer Bruck

Spencer Bruck is counsel in Crowell & Moring’s Health Care group where he represents clients in litigation, fraud and abuse, and compliance matters. He recently joined the firm from the Office of the New York State Attorney General where he led civil health

Spencer Bruck is counsel in Crowell & Moring’s Health Care group where he represents clients in litigation, fraud and abuse, and compliance matters. He recently joined the firm from the Office of the New York State Attorney General where he led civil health care fraud and qui tam investigations involving managed care organizations, pharmaceutical companies, national pharmacies chains, hospital groups, nursing homes, independent medical groups, and other providers.

These investigations arose under the False Claims Act, Anti-Kickback Statute, Stark Law, the New York State Executive and Social Services laws, and managed care contracts. As part of his investigations, Spencer regularly liaised with CMS, HHS-OIG, DOJ, NYS DOH, NYS OMIG, and the New York State Comptroller. Spencer also negotiated self-disclosures with providers involving the HHS-OIG, the NYS OMIG, and the NYS MFCU protocols.

Spencer’s government experience helps him counsel health care entities on regulatory policy and guidance; represent health care entities responding to government surveys, audits, and investigations; conduct internal investigations or compliance reviews; advise on managed care contracts and reimbursement issues; and assist on administrative applications and matters before regulatory agencies; and represent entities in matters in state and federal courts, and in administrative proceedings.

Spencer also litigates complex commercial disputes federal, state, and arbitral forums with a focus on representing managed care companies.

Photo of Michelle Chipetine Michelle Chipetine

Michelle Chipetine is a counsel in Crowell & Moring’s New York office and a member of the firm’s Intellectual Property and Health Care groups. Michelle’s practice focuses on patent litigation and representing health care entities and not-for-profit corporations on a wide range of…

Michelle Chipetine is a counsel in Crowell & Moring’s New York office and a member of the firm’s Intellectual Property and Health Care groups. Michelle’s practice focuses on patent litigation and representing health care entities and not-for-profit corporations on a wide range of transactional, corporate, and regulatory matters. Michelle also maintains an active pro bono practice.

Michelle graduated cum laude from Fordham University School of Law, where she was a legal writing and torts teaching assistant and actively involved with Fordham’s Neuroscience and Law Center. During law school, Michelle worked for Mount Sinai Innovation Partners, where she facilitated the transfer and commercialization of technologies developed by Mount Sinai researchers. Michelle also studied neuroscience at Vassar College, where she graduated cum laude.