Government Program Fraud, False Claims Act & Qui Tam Litigation Playbook
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May 22, 2025
|2 min read
The U.S. Department of Justice (DOJ) has signaled that it will use the False Claims Act (FCA) as a tool against diversity, equity, and inclusion (DEI) policies that
discriminate against certain groups.
discriminate against certain groups.
May 20, 2025
|10 min read
Rebalancing the Sticks and the Carrots? A New DOJ White-Collar Enforcement Plan
Given the recent changes the Trump Administration has made at the Department of Justice (DOJ),many people have wondered when a formal change to the
DOJ’s white-collar prosecution policies, particularly the corporate self-disclosure policy, might come. During remarks at a Financial Crimes Conference on May
12, Matthew Galeotti, the new Head of the DOJ’s Criminal Division, announced some of the changes to the DOJ’s policies, starting with the new c...Read more
DOJ’s white-collar prosecution policies, particularly the corporate self-disclosure policy, might come. During remarks at a Financial Crimes Conference on May
12, Matthew Galeotti, the new Head of the DOJ’s Criminal Division, announced some of the changes to the DOJ’s policies, starting with the new c...Read more
May 1, 2025
|15 min read
Future FCA Enforcement Expectations in Light of New Administration Priorities and 2024 Recoveries
The annual False Claims Act (FCA) recovery statistics issued by the U.S. Department of Justice for Fiscal Year 2024, coupled with the Trump administration’s
focus on the elimination of waste, fraud, and abuse in government spending and apparent intentions to rely on the FCA to pursue other administration
priorities, signal a likely increase in FCA investigations and actions throughout 2025 and beyond.
focus on the elimination of waste, fraud, and abuse in government spending and apparent intentions to rely on the FCA to pursue other administration
priorities, signal a likely increase in FCA investigations and actions throughout 2025 and beyond.
April 2, 2025
|3 min read
Federal Jury Finds No Liability for SuperValu in FCA Case Remanded for Trial by SCOTUS
Subsequent to remand from the U.S. Supreme Court, United States ex rel. Schutte v. SuperValu Inc., 598 U.S. 739 (2023) (SuperValu) was tried to a jury. On
March 5, 2025, the jury found that SuperValu was ultimately not liable in a whistleblower action that has cast a wide shadow over FCA jurisprudence in recent
years.
March 5, 2025, the jury found that SuperValu was ultimately not liable in a whistleblower action that has cast a wide shadow over FCA jurisprudence in recent
years.
March 13, 2025
|6 min read
On February 18, 2025, the United States Court of Appeals for the First Circuit issued its decision in United States v. Regeneron Pharmaceuticals, Inc. adopting
the more stringent “but for” causation standard for alleged violations of the False Claims Act (FCA) based on violations of the Anti-Kickback Statute (AKS).
the more stringent “but for” causation standard for alleged violations of the False Claims Act (FCA) based on violations of the Anti-Kickback Statute (AKS).
January 31, 2025
|10 min read
Understanding and Addressing Increased FCA Exposure Risks Resulting from DEI-Focused Executive Order
On January 21, 2025, President Trump issued a sweeping executive order titled “Ending Illegal Discrimination and Restoring Merit-Based Opportunity” (EO).
The EO targets diversity, equity, inclusion, and accessibility (DEI) programs in the public and the private sectors. The EO signals that organizations receiving
federal funds, whether through government contracts or otherwise, may be liable under the False Claims Act (FCA)—one of the government’s m...Read more
The EO targets diversity, equity, inclusion, and accessibility (DEI) programs in the public and the private sectors. The EO signals that organizations receiving
federal funds, whether through government contracts or otherwise, may be liable under the False Claims Act (FCA)—one of the government’s m...Read more
October 24, 2024
|4 min read
On October 22, 2024, the Department of Justice announced a False Claims Act (FCA) settlement related to a government contractor’s failure to adhere to
certain cybersecurity requirements. Specifically, Pennsylvania State University (Penn State) has agreed to pay US$1.25M to resolve allegations that it violated
the FCA by failing to comply with cybersecurity requirements in fifteen contracts or subcontracts involving the Department of Defense (DOD) or t...Read more
certain cybersecurity requirements. Specifically, Pennsylvania State University (Penn State) has agreed to pay US$1.25M to resolve allegations that it violated
the FCA by failing to comply with cybersecurity requirements in fifteen contracts or subcontracts involving the Department of Defense (DOD) or t...Read more
July 15, 2024
|3 min read
The Supreme Court’s Recent Rulings—A Boon for Government Contractors?
The Supreme Court of the United States’ recent decisions in Loper Bright Enterprises et al. v. Raimondo, 603 U.S. (2024) and Corner Post v. Board of
Governors, Federal Reserve System, 603 U.S. __ (2024), may provide federal contractors with new arguments and opportunities to challenge agency
regulations in litigation and bid protests.
Governors, Federal Reserve System, 603 U.S. __ (2024), may provide federal contractors with new arguments and opportunities to challenge agency
regulations in litigation and bid protests.
April 8, 2024
|13 min read
2023 DOJ FCA Enforcement: Expectations for Future
On Feb. 22, 2024, the US Department of Justice (DOJ) released its annual False Claims Act (FCA) recovery statistics and announced that it obtained more than
$2.68 billion in settlements and judgments in fiscal year (FY) 2023 from civil cases involving fraud and false claims against the government, a 21% increase
over the prior year’s recoveries. As such, FY 2023 was another strong year for FCA enforcement and marked the fifteenth straight year where re...Read more
$2.68 billion in settlements and judgments in fiscal year (FY) 2023 from civil cases involving fraud and false claims against the government, a 21% increase
over the prior year’s recoveries. As such, FY 2023 was another strong year for FCA enforcement and marked the fifteenth straight year where re...Read more
August 15, 2023
|2 min read
The U.S. Department of Justice (DOJ) has vowed to hold accountable the individuals and entities who “knowingly and improperly sought PPP loans or
forgiveness of those loans.” In furtherance of this promise, the DOJ has reached settlement with two companies and prosecuted two individuals, all of whom
were suspected of fraudulently seeking relief from the Paycheck Protection Program (PPP).
forgiveness of those loans.” In furtherance of this promise, the DOJ has reached settlement with two companies and prosecuted two individuals, all of whom
were suspected of fraudulently seeking relief from the Paycheck Protection Program (PPP).
August 14, 2023
|7 min read
The U.S. Department of Justice (DOJ) continued its health care fraud enforcement activity in June 2023, announcing two convictions and a national
enforcement action involving charges against 78 individuals and over $2.5 billion in alleged fraud. This enforcement activity relates to efforts to defraud
Medicare by billing for supplies that were not medically necessary, compounding drugs to maximize reimbursement from TRICARE, and other all...Read more
enforcement action involving charges against 78 individuals and over $2.5 billion in alleged fraud. This enforcement activity relates to efforts to defraud
Medicare by billing for supplies that were not medically necessary, compounding drugs to maximize reimbursement from TRICARE, and other all...Read more
August 14, 2023
|9 min read
June 2023 FCA Settlement Wrap-Up: DOJ Continues to Crack Down on Health Care Fraud
The U.S. Department of Justice (“DOJ”) announced several settlements related to False Claims Act (“FCA”) allegations this June. The settlements involved
various types of health care entities, which shows the DOJ’s continued interest in pursuing FCA allegations across the health care industry.
various types of health care entities, which shows the DOJ’s continued interest in pursuing FCA allegations across the health care industry.
June 15, 2023
|9 min read
Understanding SuperValu: Scienter in FCA Claims Hinges on Subjective Beliefs
On June 1, 2023, the Supreme Court of the United States issued its decision in the most-watched False Claims Act (FCA) case of the year. In United States ex
rel. Schutte v. SuperValu Inc. (consolidated with United States ex rel. Proctor v. Safeway, Inc.),[1] a unanimous Court held that the question of scienter under
the FCA turns on a person’s subjective beliefs, not what an objectively reasonable person may have believed—rejecting a standard that had bee...Read more
rel. Schutte v. SuperValu Inc. (consolidated with United States ex rel. Proctor v. Safeway, Inc.),[1] a unanimous Court held that the question of scienter under
the FCA turns on a person’s subjective beliefs, not what an objectively reasonable person may have believed—rejecting a standard that had bee...Read more
April 27, 2023
|4 min read
The Sixth Circuit Court of Appeals recently issued a key decision interpreting narrowly an important element of the Anti-Kickback Statute (AKS) and the
interplay between the AKS and the False Claims Act (FCA). The court’s decision perpetuates a circuit split, now two to one, on whether the but-for causation
must be proven to maintain an FCA action on an AKS-violation theory. While not ripe for Supreme Court review yet, the decision signals that this ...Read more
interplay between the AKS and the False Claims Act (FCA). The court’s decision perpetuates a circuit split, now two to one, on whether the but-for causation
must be proven to maintain an FCA action on an AKS-violation theory. While not ripe for Supreme Court review yet, the decision signals that this ...Read more
March 28, 2023
|14 min read
On February 7, 2023, the U.S. Department of Justice (“DOJ”) released its annual False Claims Act (“FCA”) recovery statistics and announced that it had
obtained more than $2.2 billion in settlements and judgments in fiscal year 2022 from civil cases involving fraud and false claims against the government.[1]
The significant decrease in 2022 recoveries stands in stark contrast with DOJ’s near-record breaking fiscal year 2021 where it obtained more tha...Read more
obtained more than $2.2 billion in settlements and judgments in fiscal year 2022 from civil cases involving fraud and false claims against the government.[1]
The significant decrease in 2022 recoveries stands in stark contrast with DOJ’s near-record breaking fiscal year 2021 where it obtained more tha...Read more
February 27, 2023
|6 min read
NortonLifeLock Found Liable After FCA Trial, But Government Leaves Damages Money On The Table
The decision in United States ex rel. Morsell v. NortonLifeLock Inc., No. 1:12-cv-00800 (D.D.C. Jan. 19, 2023), is a striking reminder of the strategic importance
of pushing plaintiffs to prove FCA damages with reasonable certainty.
of pushing plaintiffs to prove FCA damages with reasonable certainty.
August 10, 2022
|5 min read
On July 20, 2022, the Office of Inspector General (“OIG”) for the Department of Health and Human Services issued a Special Fraud Alert (the “Alert”) on
potential fraud schemes involving companies that provide telehealth, telemedicine, or telemarketing services (referred to collectively in the Alert as
“Telemedicine Companies”).[1]
potential fraud schemes involving companies that provide telehealth, telemedicine, or telemarketing services (referred to collectively in the Alert as
“Telemedicine Companies”).[1]
August 8, 2022
|6 min read
On July 26, 2022, the United States Court of Appeals for the Eighth Circuit issued a decision that creates a new circuit split on the question of what evidence is
needed to prove that a violation of the Anti-Kickback Statute (AKS) renders a claim false or fraudulent under the False Claims Act (FCA).
needed to prove that a violation of the Anti-Kickback Statute (AKS) renders a claim false or fraudulent under the False Claims Act (FCA).
November 2, 2021
|4 min read
On October 6, 2021, Deputy Attorney General Lisa O. Monaco announced a new Civil Cyber-Fraud Initiative, by which the Department of Justice (DOJ) will
utilize the False Claims Act (FCA) as a tool to enforce cybersecurity standards required of federal contractors and grant recipients.
utilize the False Claims Act (FCA) as a tool to enforce cybersecurity standards required of federal contractors and grant recipients.
October 5, 2021
|6 min read
On September 8, 2021, the U.S. Department of Justice (DOJ) announced that it reached a $17 million settlement with BAYADA, a Moorestown, New
Jersey-based home-health company, and certain of its affiliates (collectively referred to as BAYADA) for alleged violations of the False Claims Act (FCA) and
Anti-Kickback Statute (AKS). The settlement resolves claims arising out of a qui tam complaint filed against BAYADA by the company’s former dir...Read more
Jersey-based home-health company, and certain of its affiliates (collectively referred to as BAYADA) for alleged violations of the False Claims Act (FCA) and
Anti-Kickback Statute (AKS). The settlement resolves claims arising out of a qui tam complaint filed against BAYADA by the company’s former dir...Read more