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FCA Settlement Does Not Bar Third-Party Claims

Client Alert | 1 min read | 12.03.09

In Cell Therapeutics Inc. v. Lash Group Inc. (9th Cir. Nov. 18, 2009), the Ninth Circuit ruled that an FCA settlement entered into between a drug manufacturer and the government and relator did not preclude the drug manufacturer from bringing state common law claims against an expert in Medicare reimbursement protocol for having allegedly advised that the false Medicare billings were proper. Although a company found to have violated the FCA may not shift its FCA liability to a third party, the suit was not foreclosed because, first, "independent" claims for damages were asserted; and, second, a settlement agreement without an admission of FCA liability does not constitute a finding of FCA liability, which could preclude recovery against a third party.

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Client Alert | 8 min read | 03.05.26

Fifth Circuit Decision in Health Care Fraud Case Highlights Importance of Careful Drafting in Civil RICO Complaints

A recent decision by the United States Court of Appeals for the Fifth Circuit, Farmers Texas County Mutual Insurance Co. v. 1st Choice Accident & Injury, LLC, No. 24-20275 (5th Cir. Feb. 24, 2026), offers important lessons for health care payors and other potential plaintiffs considering civil claims under the federal Racketeer Influenced and Corrupt Organizations Act (RICO). Although the Fifth Circuit’s decision focused on a procedural issue, the underlying case turned on a fundamental pleading failure: the plaintiff insurers did not adequately describe the fraudulent network they were suing as a RICO “enterprise.” The result was dismissal of a $14 million fraud case....