C&M Health Law

C&M Health Law

Analysis, commentary, and the latest developments in health care law and policy

David W. O'Brien

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Supreme Court To Take Up Implied Certification Theory of FCA Liability

Posted in Fraud, Waste & Abuse, Health Care Reform & ACA, Litigation
Last week, in a case that will have a significant impact on future False Claims Act (FCA) suits against health care entities, the Supreme Court granted certiorari in Universal Health Services, Inc. v. United States ex rel. Escobar.  By agreeing to hear the case, the Court will resolve the circuit split over the so-called “implied… Continue Reading

Settlement in FCA Qui Tam Case Disposes of Claims Alleging Falsely Certified Compliance with Medicare Advantage Rating Instructions

Posted in Fraud, Waste & Abuse, Litigation, Medicare
 After a protracted battle, Kaiser Foundation Health Plan, Inc. (Kaiser) recently settled a False Claims Act (FCA) qui tam case alleging that it falsely certified compliance with Medicare Advantage (MA) bidding instructions that relator claimed resulted in billions of dollars in damages to the United States. Crowell & Moring represented Kaiser in the litigation. Kaiser’s… Continue Reading