The FCA Insider

The FCA Insider

Insights and updates on False Claims Act Litigation

Category Archives: FCA Defenses

Subscribe to FCA Defenses RSS Feed
Defense Arguments, FCA Defenses, FCA Litigation

Fifth Circuit Concurrence Adds Voice to FCA Constitutionality Questions

A first appellate circuit judge has questioned the False Claim Act’s constitutionality.  In the Fifth Circuit’s decision last month in United States ex rel Montcrief v. Peripheral Vascular Assocs., P.A., No. 24-50176, — F. 4th –, 2025 WL 939890 (5th Cir. Mar. 28, 2025), Judge Stuart Kyle Duncan separately wrote a concurring opinion to express… Continue Reading
FCA Defenses

Recent Decision from Eastern District of New York Confirms D&O Coverage for False Claims Act Defense Costs

A recent decision by the U.S. District Court for the Eastern District of New York illustrates how directors and officers (D&O) policies can provide valuable insurance coverage for defense costs and potential liabilities arising from False Claims Act (FCA) litigation. In Northern Metropolitan Foundation for Healthcare, Inc. v. RSUI Indemnity Company, the insured — an… Continue Reading
Defense Arguments, FCA Defenses, FCA Litigation

Seventh Circuit Clarifies Pleading Standard for Anesthesiologist’s False Claims Action

The Seventh Circuit recently reversed a lower court’s ruling that an amended complaint in a qui tam lawsuit filed under the False Claims Act (FCA) alleging fraudulent anesthesiology billing practices failed to meet the pleading standard under Rule 9(b) of the Federal Rules of Civil Procedure. In U.S. ex. rel. Mamalakis vs. Anesthetix Management LLC,… Continue Reading
Defense Arguments, FCA Defenses

Sixth Circuit Affirms Dismissed FCA Case against Walmart involving Opiate Prescription Allegations

The U.S. Court of Appeals for the Sixth Circuit dismissed a relator-pharmacist’s False Claim Act (FCA) case, holding that the pharmacist claims, largely based on a stolen Medical Expenses Summary, lacked merit. In U.S. ex. rel. Sheoran v. Wal-Mart Stores East, Case No. 20-2128 (6th Cir. June 4, 2021), the court dismissed all claims brought… Continue Reading
CMS Guidance, DOJ, FCA Defenses, FCA Litigation, Investigations, OIG, Regulatory, Settlements, Stark Law

2021’s First-Half Notable Themes on The FCA Insider

As vaccination rates rise, the COVID-19 pandemic continues to reverberate through 2021. These reverberations also impacted the healthcare fraud and abuse landscape that is the basis of The FCA Insider’s coverage. To-date, 2021 has seen more than three dozen posts on topics ranging from False Claims Act (FCA) court opinions, U.S. Department of Justice (DOJ)… Continue Reading
FCA Defenses

The Perils of Pleading the Fifth in the Corporate Fraud Context

“Pleading the Fifth” is one of the most commonly known phrases in the U.S. legal system, and the right against self-incrimination is one of the Constitution’s most meaningful protections. That said, the costs and risks of exercising that right in the corporate fraud context may outweigh the benefits. To learn about some of the limits… Continue Reading
FCA Defenses

Request to File Amended Complaint for Fraud Rejected for Failure to Allege Facts with Particularity

After granting defendants’ motion to dismiss and dismissing plaintiff’s action with prejudice, the U.S. District Court for the Middle District of North Carolina recently denied relator’s motion to alter or amend the judgment and file an amended complaint alleging Anti-Kickback Statute (“AKS”) and False Claims Act (“FCA”) violations. Central to the court’s decision to deny… Continue Reading
FCA Defenses, FCA Litigation

Michael Podberesky Discusses Circuit Split on FCA’s False Statement Standard

In an April 7, 2021, interview with Federal News Network, Washington, D.C., partner Michael Podberesky discussed how federal contractors are impacted by the U.S. Supreme Court’s recent decisions denying two petitions for writs of certiorari, thereby declining to resolve a circuit court split regarding the False Claims Act’s standard for pleading and proving the falsity element. Because of… Continue Reading
FCA Defenses

Court Dismisses FCA Retaliation Complaint Involving Speaker Fees

In U.S. ex rel. Manieri v. Avanir Pharmaceuticals, Inc., 2021 WL 857102 (N.D. Oh. Mar. 8, 2021), the Northern District of Ohio dismissed a relator’s claim that he had been improperly retaliated because he had raised concerns about alleged fraudulent conduct involving speaker fees under the False Claims Act (FCA) and the Federal Anti-Kickback Statute… Continue Reading
DOJ, FCA Defenses, Individual Liability

Eleventh Circuit Affirms 11-year Prison Sentence for Substance Abuse Treatment Center Physician

Last month, the Eleventh Circuit upheld the conviction and 11-year prison sentence of a physician-Medical Director of two substance abuse treatment centers in Florida who was convicted by a jury of participating in a conspiracy to commit healthcare fraud.  On appeal, Arman Abovyan, a board-certified internal medicine physician, challenged his convictions based on insufficiency of… Continue Reading
Defense Arguments, FCA Defenses, FCA Litigation

Fifth Circuit Vacates Fraud Conviction after Denying Codefendants’ Appeal

The U.S. Fifth Circuit recently reversed a former home health agency employee’s conviction and vacated his sentence related to three counts of healthcare fraud and abuse. Jonathan Nora was convicted by the trial court of conspiracy to commit health care fraud, aiding and abetting healthcare fraud, and several violations of the Federal Anti-Kickback Statute (AKS)… Continue Reading

We use cookies to enhance your experience of our website. By continuing to use this website, you agree to the use of these cookies. For more information and to learn how you can change your cookie settings, please see our policy.

Agree