• 10.23.18

    Lessons Learned From Recent ‘Lack of Medical Necessity’ FCA Cases

    The Centers for Medicare & Medicaid Services (CMS) covers services that are “reasonable and necessary.”

  • 10.23.18

    Supreme Court Declines to Provide Guidance on FCA Pleading Requirements

    On October 1, 2018, the U.S. Supreme Court denied a petition for a writ of certiorari asking the Court to weigh in on just how precisely a whistleblower must plead the submission of a false claim.

  • 02.21.18

    Applying Escobar’s Heightened Materiality Standard: Limiting FCA Liability

    In United States ex rel. Petratos v. Genentech, Inc., 855 F.3d 481 (3d Cir. 2017), the Third Circuit affirmed the district court’s order dismissing an FCA complaint on the grounds that the relator could not establish materiality based on the guidance set forth in Escobar.

  • 01.25.18

    DOJ Releases Guidance for Evaluating Dismissal of Qui Tams

    A recent memo issued by the U.S. Department of Justice (DOJ) sets forth the issues it considers in deciding whether to seek the dismissal of qui tam cases filed by relators, and, although written for internal government use, provides guidance to defendants in arguing for such dismissal motions to ...

  • 06.16.16

    False Claims Act: Supreme Court Decides Implied Certification Case

    On June 16, 2016, the Supreme Court decided Universal Health Services v. U.S. ex rel. Escobar, holding that the implied false certification theory can be a basis for False Claims Act liability if a claim for payment makes specific representations about the services provided but fails to disclose ...

  • 05.29.15

    It’s an Absolute Privilege to Meet You!

    On May 15, 2015, the Texas Supreme Court ruled that an internal investigation report provided by Shell Oil Company to the DOJ in 2009 in connection with an FCPA investigation enjoys “absolute privilege” and therefore cannot be the basis for a defamation case against the company.

  • 04.21.15

    It’s Stifling in Here!

    On April 1, 2015, the SEC announced its first-ever enforcement action against a company for using restrictive language in confidentiality agreements with witnesses interviewed during internal investigations that has the potential to improperly stifle whistleblowers and impede the whistleblowing ...

  • 03.19.15

    The SEC’s Settlement with Goodyear: A Cautionary Tale

    In a settlement announced on February 24, 2015, the SEC found Goodyear to be in violation of the FCPA in connection with bribes paid by two foreign subsidiaries, one of which came into Goodyear’s ownership through acquisition.