21 results for 'cat:"Fraud" AND cat:"False Claims"'.
J. Tunheim dismisses the animal-rights organization's suit alleging that the pork producer improperly applied for Covid-19 relief while engaging in inhumane and unsanitary practices. The pork producer's allegedly false statement that it was not engaged in illegal activity was not material to its application for Paycheck Protection Plan loans, so it is not liable under the False Claims Act. Noncompliance with anti-garbage feeding laws, notwithstanding the laws' connection to the prevention of zoonotic disease, is not sufficiently tied to the purpose of the PPP. There is also good reason to believe that the government regularly paid out PPP funds to other entities despite knowing that they were engaged in illegal activity.
Court: USDC Minnesota, Judge: Tunheim, Filed On: May 28, 2024, Case #: 0:21cv2061, NOS: Qui Tam (31 U.S.C. § 3729(a)) - Torts - Personal Property, Categories: fraud, false Claims, Covid-19
J. Gershon dismisses, with prejudice, a third-amended False Claims Act suit against the maker of durable medical equipment and two health care providers alleging they submitted fraudulent reimbursement claims to Medicare and Medicaid. The relators fail to allege they were the original sources of the information at the heart of their case and thus fail to meet the law’s original source exception.
Court: USDC Eastern District of New York, Judge: Gershon, Filed On: April 30, 2024, Case #: 1:18cv2600, NOS: False Claims Act - Torts - Personal Injury, Categories: fraud, Health Care, false Claims
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J. Kness grants a pharmacy chain’s motion to dismiss the government’s joint complaint and intervention, but denies the pharmacy chain’s motion to dismiss the relators’ third amended complaint. This suit involves the pharmacy chain’s alleged attempt to garner Medicare and Medicaid kickbacks by inducing Cook County patients to fill their prescriptions at one of its specialty pharmacy locations. The court finds the government’s intervention does not allege a proper theory of False Claims Act liability, but that the relators’ amended complaint does.
Court: USDC Northern District of Illinois, Judge: Kness, Filed On: March 29, 2024, Case #: 1:14cv1558, NOS: False Claims Act - Torts - Personal Injury, Categories: fraud, Health Care, false Claims
J. Gallagher grants, in part, two medical device firms’ motion to exclude a relator’s expert in the allegations of violations of the False Claims Act and Anti-Kickback Statute. The complaint claims that the firms used a surgeon locator on their website to market potential clients for the Lap-Band product. The relator’s expert has almost 20 years of experience as an accountant and fraud examiner with certification in healthcare compliance. The expert matched the firms’ spreadsheets to the Medicare and Medicaid procedures for the calculations regarding the amount of “inducement-tainted Lap-Band devices.” He fails to account for causation means in the claims at issue are irrelevant and offer no factfinder value. Therefore, the “number of claims” opinions are denied and will not be presented to the jury.
Court: USDC Maryland, Judge: Gallagher, Filed On: March 18, 2024, Case #: 1:17cv668, NOS: False Claims Act - Torts - Personal Injury, Categories: fraud, Experts, false Claims
J. Ozerden partly grants a medical center administrator's motion to dismiss claims filed by relators for allegedly submitting false Medicare reports. Some of the claims exceed the statute of limitations, specifically claims based on reports submitted before October 18, 2012.
Court: USDC Southern District of Mississippi , Judge: Ozerden, Filed On: December 21, 2023, Case #: 1:16cv38, NOS: Qui Tam (31 U.S.C. § 3729(a)) - Torts - Personal Property, Categories: fraud, Medicare, false Claims
J. Saylor certifies for interlocutory appeal the court’s conclusion that, if a Medicare reimbursement claim includes items or services stemming from an Anti-Kickback Statute violation, the claim must also be shown to constitute a false claim under the False Claims Act. Two different judges reached different conclusions on that issue in separate cases.
Court: USDC Massachusetts, Judge: Saylor, Filed On: October 25, 2023, Case #: 1:20cv11217, NOS: False Claims Act - Torts - Personal Injury, Categories: fraud, Medicare, false Claims
J. Seeger grants a rehab clinic’s motion to dismiss fraud claims brought by two of its former executive employees, which allege that the clinic provided patients with unnecessary therapy in order to milk them for Medicare payouts. The court finds the former employees have not provided sufficient evidence to substantiate their claims, but grants them two weeks to amend their complaint.
Court: USDC Northern District of Illinois, Judge: Seeger, Filed On: September 8, 2023, Case #: 1:18cv6063, NOS: False Claims Act - Torts - Personal Injury, Categories: fraud, Medicare, false Claims
J. Teeter rules the government may pursue Medicare fraud claims against a physician and his wife, who is also a physician. The government sufficiently showed in court that the couple knew they were falsely submitting 1,383 Place of Service codes.
Court: USDC Kansas, Judge: Teeter, Filed On: August 18, 2023, Case #: 2:17cv2395, NOS: False Claims Act - Torts - Personal Injury, Categories: fraud, Medicare, false Claims
J. Bell denies a health care consulting firm summary judgment in a 13-year-old case brought against it for false claims and deceptive trade practices by a private emergency health care provider. In 2008, the firm’s new CEO began an aggressive push to inappropriately raise inpatient admissions in all emergency rooms under the provider, which contracted with the firm. While the firm argues that the provider simply failed to comply with new corporate guidelines, the provider claims the firm constantly pressured it to commit fraud and that the firm wrongfully terminated the contract, then replaced it with a provider who was willing to do its bidding.
Court: USDC Western District of North Carolina, Judge: Bell, Filed On: August 16, 2023, Case #: 3:10cv472, NOS: Other Statutory Actions - Other Suits, Categories: fraud, Trade, false Claims
J. Wood finds that the lower court properly found for the mortgage servicer in a False Claims Act suit brought by a former employee. The employee showed that the alleged false representations to the U.S. Department of Housing and Urban Development were material to the agency's decision to pay out various claims under the federal mortgage insurance program. However, she cannot show that the false representations caused the subsequent default, and therefore that the agency suffered a monetary loss. Affirmed.
Court: 7th Circuit, Judge: Wood, Filed On: June 14, 2023, Case #: 22-1553, Categories: fraud, Housing, false Claims