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What can recent FCA decisions tell us about the Seventh Circuit pleading standard for health care billing fraud claims? | Thompson Coburn LLP


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False Claims Act (“FCA”) complaints are subject to the heightened pleading requirements of Rule 9(b),
Universal Health Servs., Inc. v. United States, 136 S. Ct. 1989, 2004, 195 L. Ed. 2d 348 (2016). But circuits are split on whether that requirement should be relaxed for relators, or whistleblowers, who lack direct access to the alleged fraud. 
The Fourth, Eighth, and Eleventh circuits seemingly apply Rule 9(b) more rigidly, while the First, Third, Fifth, Sixth, Seventh, Ninth and Tenth circuits have a more flexible approach. In 2019, the U.S. Supreme Court was expected to resolve this split, but before the Court issued its decision, the parties settled, leaving the circuit split in place. In this article, we examine recent decisions that illustrate a possible shift in the Seventh Circuit’s pleading standard. ....

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SavaSeniorCare settles 'unfounded' False Claims Act allegations for $11.2M - News


Annaliese Impink
“We have spent 10 years and several million dollars vigorously defending our position in these cases,” Annaliese Impink, spokeswoman for SavaSeniorCare Administrative and Consulting LLC, said in a statement Friday. 
“As stated in the settlement agreement, we believe that the allegations were unfounded. Nevertheless, the cost of continuing to litigate would have exceeded the settlement payment. We believe it is the right time to put these matters behind us as we begin to recover from the pandemic,” she added. 
The claims stem from a 2015 False Claims Act complaint filed against the nursing home chain. It alleged that from October 2008 and September 2012 the operator submitted false claims for rehabilitation therapy services in a “systemic effort” to increase its Medicare revenues  ....

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DC Taxpayers Face More Scrutiny Under New False Claims Act | Troutman Pepper


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On Jan. 13, 2021, District of Columbia Mayor Muriel Bowser signed the False Claims Amendment Act,[1] which expanded liability under the Washington, D.C., False Claims Act, or FCA, to encompass tax-related claims.
The amendment is effective unless Congress jointly disapproves it during a 30-day review period currently underway.[2] It enables the D.C. attorney general to bring a new category of D.C. FCA cases and incentivizes private citizen whistleblowers to file more qui tam complaints.
D.C. now joins New York and Illinois in taking the novel step of expanding its FCA to apply to tax fraud an expansion that, if successful, could become a wave of the future and create heightened exposure for many businesses and individuals. ....

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New York Receives $105 Million In Tax Revenue And Damages Under False Claims Statute, While Other States Take Steps To Remove Their Tax Bar - Finance and Banking


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In early March, New York State Attorney General Letitia James
and New York City Corporation Counsel John E. Johnson announced a $105 million settlement
against a hedge fund manager for tax evasion. The New York
authorities were alerted to the potential of fraud in October 2018
by a whistleblower lawsuit brought under New York s False
Claims Act (FCA). This settlement adds to the more than $460
million in tax-related false claim settlements the state has
collected to date. This recovery should alert businesses to the
continued trend of states pursuing tax claims under their ....

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