False Claims Act

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Hooper, Lundy & Bookman has some of the nation’s most experienced and highly regarded False Claims Act (FCA) experts. Many partners of the firm have been involved in such work for well over 25 years.  

Our level of technical expertise is often critical in providing sound advice to and representing clients in FCA investigations and cases, including defending whistleblower (qui tam relator) lawsuits.

At any given time, the firm is involved in numerous false claims act investigations throughout the country. Our attorneys have represented health care providers and suppliers in some of the most significant and largest False Claims Act cases in the country, including the largest federal health care fraud investigation in U.S. history and numerous, state and federal whistleblower lawsuits.

Our attorneys have significant experience negotiating criminal, civil and administrative settlements before many government entities, including the  Centers for Medicare and Medicaid Services  the U.S. Department of Justice’s Criminal and Civil Divisions, the Office of Inspector General of HHS and state attorneys general.

Investigations and cases have involved hospice services, DME issues, hospital and skilled nursing facility cost reporting and billing issues, DRG coding, emergency room physician billing, laboratory billing, therapy billing, quality of care issues, alleged worthless services, psychiatric services issues, physician billing and coverage issues and alleged kickback issues (please also see our Stark and anti-kickback practice area).

In addition to our representation of health care providers and suppliers, we have been chosen to represent national and statewide associations as amicus curiae in a number of False Claims Act related cases. And, a number of our attorneys are nationally known experts who have lectured and published widely in their areas of specialized FCA knowledge.

Following is a sample of some of the significant federal and state FCA cases we have handled in trial and appellate courts throughout the country:

United States v. Mackby, 261 F.3d 821 (9th Cir. 2001).  Damages/penaltiesawards under the False Claims Act must be examined to determine whether they are excessive under the Eighth Amendment of the Constitution.

United States v. McKesson, 900 F. Supp. 2d 683 (N.D. Miss. 2012), 784 F. Supp.2d 664 (N.D. Miss. 2011) and 649 F. 3d 322 (5th Cir. 2011). important False Claims case pursued by the Department of Justice in Washington D.C., which resulted in rulings of significance to the health care industry.

United States ex rel. Serrano v. The Oaks Diagnostics, 568 F. Supp. 2d 1136 (C.D. Cal. 2008) holding that government complaint did not satisfy specificity requirements of pleadings an FCA case regarding medical necessity issues.

United States ex rel. Thompson v. Columbia/HCA Health, 125 F. 3d 899 (5th Cir. 1997) holding that a relator failed to adequately plead the lack of medical necessity of hospital services under the FCA.

United States ex rel. Pogue v. Diabetes Treatment Centers of America, 238 F. Supp. 2d 258 (D.D.C. 2002), one of several important court decisions in multi-district litigation involving one of largest Medicare investigations in history of the FCA.

United States ex rel. Swann v Covenant Care, Inc. 279 F. Supp. 2d 1212, (E.D. Cal. 2002), holding that violations of conditions of participation do not give rise to FCA liability and that worthless services had not been sufficiently alleged or proven.”

People v. Duz-Mor Laboratories, (1999) 68 Cal. App. 4th 654.  The decision holds among other things, that liability under the California FCA did not arise when a laboratory relied on guidance from regulators in coding for services.

We are one of the few firms in the Country to have actually tried FCA cases against the government giving us a very credible reputation with the government and relators’ counsel as a firm that will do all that is necessary to protect its clients’ interests.  This greatly assists our clients’ leverage in negotiating settlements with the government and relators.

For media assistance, please contact Maura Fisher at 202-580-7714.