Earlier this month, Mintz Levin’s Health Care Enforcement Defense Group published its most recent Health Care Qui Tam Update that looks at 23 health care-related qui tam cases unsealed in June 2017. The Update provides an in-depth analysis of six cases in which the government intervened, and discusses why these cases are notable in the health care industry.

The Update also provides a summary of the trends revealed in these recently unsealed cases:

  • The cases identified were filed in federal district courts in 18 states, including four filed in the active Middle District of Florida.
  • Of the cases identified, the federal government intervened, in whole or in part, in eight cases and declined to intervene in 13. There were two cases in which the intervention status could not be determined from the case docket.
  • The entities named in the qui tam actions included outpatient medical providers, laboratory testing companies, inpatient hospitals, and medical supply companies.
  • In all but three cases, the relators were current or former employees of the defendants.
  • Once again, there were long delays in unsealing these cases, with an average time under seal of just over two years and four months. And one case had been under seal for almost nine years.

Click HERE for the full Update and to find our key takeaways from the cases discussed.

Yesterday, Mintz Levin’s Health Care Enforcement Defense Group published its most recent Health Care Qui Tam Update.  This Update covers 42 health care-related False Claims Act qui tam cases that have been unsealed since the last Health Care Qui Tam Update.

Highlights of this Update include:

  • A substantial majority of the unsealed cases have been under seal for periods well in excess of the required statutory period, demonstrating that extension of the seal in qui tam actions continues to be routine.
    • Of the 44 complaints filed in these 42 cases, 75% were filed before 2015, with one unsealed complaint dating back to November 2008 and two others dating back to 2010 and 2011, respectively.
    • Of the remaining complaints, five were filed in 2012, fourteen in 2013, eleven in 2014 and eleven in 2015.
  •  The cases identified were filed in federal district courts in 15 states and the District of Columbia.
  • The federal government declined to intervene in 25 of the 42 cases.

To read the entire Update, click here.

Mintz Levin’s Health Care Enforcement Defense Practice has published its most recent Qui Tam Update, analyzing overall trends in 36 recently unsealed health care related whistleblower cases.

In this issue, the team highlights a case that was filed back in 2006, with allegations that focus on a hospital’s failure to maintain a culture of compliance.

  • United States Of America ex rel. Dan Bisk, State Of New York ex rel. Dan Bisk v. Westchester Medical Center, 1:06cv15296 (S.D.N.Y) – the defendant’s former compliance officer alleged a variety of FCA and Stark Law violations involving the New York hospital, and claimed the defendant retaliated against him; the government focused its investigation on a particular physician practice group.

The team also reviews a trio of cases against the same defendant, alleging dermatology sweetheart deals.

  • United States ex rel. Ross v. Family Dermatology of Penn., P.C., No. 1:11-cv-2413 (N.D. Ga.); United States ex rel. Baucom v. Family Dermatology of Penn., P.C., No. 1:11-cv-4260 (N.D. Ga.); and United States ex rel. Milstein v. Family Dermatology, P.C., 1:13-cv-01027 (N.D. Ga.) – the relators had different levels of involvement with the defendants, but each is a physician who alleged that the multi-state dermatology practice, and its husband and wife owners, would buy dermatology practices, then enter into independent contractor agreements with the remaining physicians, and require them to refer their pathology specimens to a lab owned by the defendants, in violation of FCA, Stark Law and AKS.

Read the full Qui Tam Update for more information about these cases, and the trends we’ve observed in all of the recently unsealed cases. In our Qui Tam Update series, we monitor recently unsealed FCA cases, identify trends in health care enforcement, and discuss noteworthy cases and developments. To receive the Qui Tam Update by email, subscribe here.

Written by: Kimberly J. Gold

Mintz Levin’s most recent Qui Tam Update authored by our Health Care Enforcement Defense Practice provides a broad overview of 65 recently unsealed health care–related qui tam cases, with an in-depth look at six cases.

The six featured cases are:

  • United States ex rel. Fox Rx, Inc. v. Managed Health Care Associates, Inc., No. 2:13cv6154 (C.D. Cal.) and United States. ex rel. Fox Rx, Inc. v. Managed Health Care Associates, Inc., No. 2:13cv8433 (C.D. Cal.), regarding two false claims allegations by a private Medicare Part D sponsor against pharmacy providers.
  • United States ex rel. Angel v. Alliance Rehabilitation LLC, No. 1:10cv2124 D.D.C.), regarding a $2.78 million settlement to resolve allegations of false claims for physical therapy services.
  • United States ex rel. Madany v. Shahab, No. 2:09-cv-13693 (E.D. Mich.), regarding false claims for home health services based on underlying Anti-Kickback Statute violations.
  • United States ex rel. Brown v. Holy Spirit Hospital of the Sisters of Christian Charity, No. 1:12-cv-1197 (M.D. Pa.), regarding false claims for diagnostic tests that were never performed and failure to report or repay overpayments.
  • United States ex rel. Mahmood v. Elizabethtown Hematology Oncology, PLC, et al., No. 3:11-cv-00376 (W.D. Ky.), regarding a $3.7 million settlement to resolve allegations of false claims for chemotherapy infusion treatments.

The Fox cases are significant because they illustrate that whistleblowers can come not only from their current and former employees, but also from their business relationships.  In the past, sponsors of Medicare Part D prescription drug plans have rarely served as relators, but Fox has brought multiple claims against pharmacy providers. One of Fox’s other cases was noted in our November 2013 Qui Tam Update.

In our Qui Tam Update series, we monitor recently unsealed FCA cases, identify trends in health care enforcement, and discuss noteworthy cases and developments. To receive the Qui Tam Update by email, subscribe here.

Mintz Levin’s most recent Qui Tam Update authored by our Health Care Enforcement Defense Practice provides focused analysis of four health care-related qui tam cases in which the government declined to intervene, including one that may be accepted for argument in front of the United States Supreme Court, and discusses the overall trends in government health care fraud enforcement revealed by a review of 32 other recently unsealed qui tam cases.

The four featured cases are:

  • United States ex rel. Nathan v. Takeda Pharm. N. Am., Inc. et al., Docket No. 12-1349 (U.S. 2013) regarding impermissible off-label sales and marketing practices resulting in false claims submitted by a pharmaceutical company;
  • United States ex rel. Fox Rx, Inc. v. Walgreen Company, No. 1:12-cv-07382 (S.D.N.Y.) regarding false claims allegedly submitted to the Medicare Part D program;
  • United States ex rel. Dolan v. Arlington Rehabilitation & Living Center et al., No. 1:10-cv-00368 (N.D. Ill.) regarding false claims submitted by skilled nursing, rehabilitation facilities, and a contract therapy provider; and
  • United States ex rel. Beaujon v. Plaza Health Network, No. 1:12-cv-20951 (S.D. Fla.) regarding a large-scale false claims scheme involving kickbacks paid by skilled nursing facilities to physicians.

The petition for certiorari in the Takeda case attempts to engage the Supreme Court in resolving a circuit split regarding the “pleading with particularity” requirement in Rule 9(b) applicable to cases that allege that the defendants committed fraud.  Rule 9(b) serves an important “gatekeeping” function intended to ensure that only viable claims are permitted to reach the discovery phase of litigation. As such, a Supreme Court decision resolving the debate on whether a pleading with particularity requires claims-specific information about a defendant’s purportedly illegal conduct or not would have significant consequences for qui tam cases in the pipeline.