Berger & Montague, PC
Berger & Montague, PC
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  • FERA and the False Claims Act, Part I: No Direct Presentment Required
    By Jonathan DeSantis In May 2009, Congress passed the Fraud Enforcement and Recovery Act of 2009 (“FERA”), which implemented substantial changes to the False Claims Act (“FCA”) for the first time in two decades.[1]  This three-part series of blog articles will discusses three of the most important changes, including (1) a clarification that the FCA […] The post FERA and the False Claims Act, Part ...
Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • The False Claims Act Tax Bar
    By Jonathan DeSantis The False Claims Act (“FCA”) generally applies to all false or fraudulent “claims” and broadly defines “claims” as including any request or demand for Government funds.[1]  However, a little known provision of the FCA provides that it “does not apply to claims, records, or statements made under the Internal Revenue Code.”[2] This […] The post The False Claims Act Tax Bar appea...
Berger & Montague, PC
Berger & Montague, PC
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  • Retaliation Claims Under the False Claims Act
    By Susan Schneider Thomas Two recent decisions by district courts illustrate some of the issues that continue to arise in claims under Sec. 3730(h) of the False Claims Act (“FCA”), for retaliatory conduct against those who report or might report false claims. Terminating an Employee Based on the Fear of FCA Claims Can Support a […] The post Retaliation Claims Under the False Claims Act appeared fi...
Berger & Montague, PC
Berger & Montague, PC
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  • Issues Arising Under the False Claims Act’s First-to-File Rule
    By Susan Schneider Thomas The First-to-File Rule One of the many procedural obstacles that a potential qui tam plaintiff must overcome is the first-to-file (“FTF”) rule.  This provision of the False Claims Act (“FCA”) states that “no person” other than the Government may intervene or bring a related action based on the facts underlying the […] The post Issues Arising Under the False Claims Act’s F...
Berger & Montague, PC
Berger & Montague, PC
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  • “Transactions of Fraud” in the Third Circuit
    By Shauna Itri The Third Circuit has repeatedly held that “to constitute ‘allegations or transactions,’ the public disclosure must either allege the actual fraud, or must allege both the misrepresented state of facts and the true state of facts such that an inference of fraud may be drawn.” United States ex rel. Morgan v. Express […] The post “Transactions of Fraud” in the Third Circuit appeared f...
Berger & Montague, PC
Berger & Montague, PC
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  • Ninth Circuit Applies Escobar to Assess Materiality in False Claims Act Case
    By Jonathan DeSantis The Ninth Circuit recently applied the materiality requirement for claims under the False Claims Act (“FCA”) and provided guidance for the application of the Supreme Court’s seminal decision on the FCA’s materiality requirement in Universal Health Servs., Inc. v. United States ex rel. Escobar.[1] The False Claims Act’s Materiality Requirement Under the […] The post Ninth Circu...
Berger & Montague, PC
Berger & Montague, PC
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Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

Berger & Montague, PC
Berger & Montague, PC
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  • Court Allows False Claims Act Case Involving Janssen’s HIV/AIDS Drugs to Proceed
    By Joy Clairmont On May 31, 2017, the United States District Court for the District of New Jersey allowed relators’ False Claims Act (“FCA”) lawsuit against Janssen to proceed to litigation.  United States et al. v. Johnson & Johnson, et al., Civ. A. No. 12-7758, 2017 WL 2367050 (D.N.J. May 31, 2017).  Although claims against […] The post Court Allows False Claims Act Case Involving Janssen’s HIV/...
Berger & Montague, PC
Berger & Montague, PC
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Berger & Montague, PC
Berger & Montague, PC
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  • History and Purpose of the Public Disclosure Bar
    By Shauna Itri Early Public Disclosure Bar In the early 1940s, some enterprising individuals filed False Claims Act (“FCA”) actions based not on their own independent knowledge of a fraud but on information revealed in criminal indictments. S.Rep. No. 99–345, at 10–11 (1986).  This harmed the government because the FCA required the government to pay […] The post History and Purpose of the Public D...
Berger & Montague, PC
Berger & Montague, PC
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  • Bringing a False Claims Act Case Without Identifying Specific Claims to the Government
    By Susan Schneider Thomas We wrote earlier about the important holding in one of this Firm’s cases, U.S. ex rel. Groat v. Boston Heart Diagnostics Corp., 2017 WL 2533341 (D.D.C. June 9, 2017), regarding the responsibility of a medical laboratory to ascertain whether lab tests ordered by physicians are medically necessary. That opinion also includes […] The post Bringing a False Claims Act Case Wit...
Berger & Montague, PC
Berger & Montague, PC
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  • The False Claims Act’s Public Disclosure Bar Routinely Results in Windfalls to Fraudsters
    By Daniel Miller In 1986, in an effort “to strike a balance between encouraging private persons to root out fraud and stifling parasitic lawsuits,” United States ex rel. Zizic v. Q2Administrators, LLC, 728 F.3d 228, 235 (3d Cir. 2013), Congress narrowed the the public disclosure bar so that more whistleblowers would file cases. Despite this […] The post The False Claims Act’s Public Disclosure Bar...
Berger & Montague, PC
Berger & Montague, PC
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  • Health First Entities Agree to Pay $3.5 Million to Resolve False Claims Act Lawsuit
    By Russell Paul Health First, Inc. and related entities have agreed to pay $3.5 million to resolve a False Claims Act lawsuit filed in 2014 by a whistleblower (the “relator”). The related entities include Health First, Inc., Health First Health Plans, Inc., Health First Medical Group, Holmes Regional Medical Center, Palm Bay Hospital, Cape Canaveral […] The post Health First Entities Agree to Pay ...
Berger & Montague, PC
Berger & Montague, PC
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  • Court Finds That Labs Must Ensure That the Tests They Perform are Medically Necessary
    By Russell Paul On June 9, 2017, the United States District Court for the District of Columbia denied the defendant’s motion to dismiss in the False Claims Act lawsuit titled U.S. et al. ex rel. Tina D. Groat v. Boston Heart Diagnostics Corp., No. CV 15-487 (RBW), 2017 WL 2533341, at *1 (D.D.C. June 9, […] The post Court Finds That Labs Must Ensure That the Tests They Perform are Medically Necessa...
Berger & Montague, PC
Berger & Montague, PC
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Berger & Montague, PC
Berger & Montague, PC
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  • Pharmacy Discount Programs Can Lead to a Violation of the False Claims Act
    By Russell Paul Retail pharmacies that offer a discount drug pricing program to consumers must charge Medicare the same prices for drugs that they charge consumers who participate in those programs. To do otherwise violates the False Claims Act (“FCA”). The specific question is whether a pharmacy that offers a discount drug pricing program for […] The post Pharmacy Discount Programs Can Lead to a ...
Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • Common Challenges With the Qui Tam Seal Requirement: What Whistleblowers Can Expect
    By Susan Schneider Thomas One of the various procedural requirements imposed on whistleblowers is that they file their cases “under seal.”  Not much is explained in the False Claims Act (“FCA”) as to what that means, other than the general understanding that no notification of the filing to the defendant takes place, what is commonly […] The post Common Challenges With the Qui Tam Seal Requirement...
Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • District Court Rejects the Industry-Wide Public Disclosure Bar, Part II
    By Jonathan DeSantis In Part I of this blog series, we discussed the False Claims Act (“FCA”)’s public disclosure bar and the so called industry-wide public disclosure bar. In this blog post, we will examine a recent qui tam case that discusses and rejects the industry-wide public disclosure bar. An industry-wide public disclosure bar is […] The post District Court Rejects the Industry-Wide Public...
Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • District Court Rejects the Industry-Wide Public Disclosure Bar, Part I
    By Jonathan DeSantis The False Claims Act (“FCA”) permits private individuals, known as relators, to sue on the Government’s behalf to recover funds that were fraudulently or falsely obtained from the Government.  If a relator successfully recovers money for the Government, the FCA provides that the relator is entitled to a substantial percentage of the […] The post District Court Rejects the Indu...
Berger & Montague, PC
Berger & Montague, PC
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Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • The “Government Knowledge Inference” Under the False Claims Act
    By Joy Clairmont Government knowledge no longer serves as an absolute bar to False Claims Act (“FCA”) actions as it did in the past.  Now, the focus is on the defendant’s state of mind.  Courts consider whether at the time of submitting the “false” claims to the government, the defendant fully cooperated and shared all […] The post The “Government Knowledge Inference” Under the False Claims Act ap...
Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • Are There “Special” Frauds Involving Specialty Drugs? Part II
    By Susan Thomas In Part I of this blog series, we defined the term “specialty drugs” and addressed whether fraud is common in the specialty drugs arena. In this blog post, we will examine how the federal Anti-Kickback Statute impacts specialty drug fraud, whether there are special frauds involving specialty drugs, and what to do […] The post Are There “Special” Frauds Involving Specialty Drugs? Pa...
Berger & Montague, PC
Berger & Montague, PC
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New blog articles detected.

  • Are There “Special” Frauds Involving Specialty Drugs? Part I
    By Susan Thomas If you work in an industry involving pharmaceuticals, whether as a drug sales rep, a PBM employee or a direct healthcare provider, you’ve probably heard a lot about specialty drugs.  But what exactly are they?  Is fraud common in this area?  How do you know if your employer is playing by the […] The post Are There “Special” Frauds Involving Specialty Drugs? Part I appeared first on...

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