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"Presentment" Defense Rejected In Medicare FCA Case

Client Alert | 1 min read | 01.05.06

The developing case law interpreting the False Claims Act's imposition of liability on anyone who "knowingly presents, or causes to be presented" a false claim to the federal government should especially interest any company whose "government" business involves directly invoicing someone other than the government itself -- e.g., a grantee, a state or local government, a fiscal intermediary, or a prime contractor -- even though federal funds may ultimately be included in the payment. Another recent decision in this line, United States v. Squire , 2005 WL 3470297 (N.D. Illinois Dec. 12, 2005), denied a Medicare provider's motion to dismiss, holding that the provider may "cause" a false claim to be "presented" by means of a convoluted pathway, where the provider's requests for payment are submitted directly to a "fiscal intermediary" (administrative services contractor) which determines the correct amount of the provider's compensation and then authorizes a commercial bank to draw down a daily total from the Medicare trust funds held by the Federal Reserve Bank, a daily total which includes -- among a great many other things -- an amount used to compensate the provider.

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Client Alert | 10 min read | 07.03.25

Focus on Transnational Cartels Continues: FinCEN Targets Three Mexican Financial Institutions with Special Measures, Restricting Their Access to U.S. Financial System

The Orders represent FinCEN’s first actions using new special measures authority under the Fentanyl Sanctions Act and FEND Off Fentanyl Act of 2024 (codified at 21 U.S.C. § 2313a) (the “Fentanyl Act”) and continue the Trump Administration’s broader efforts against transnational cartels and narcotics trafficking....