"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.
Insights
Client Alert | 3 min read | 02.13.26
In October 2024, the FTC adopted a final rule that substantially modified the HSR form, requiring new categories of information and documents. The final rule was the most significant overhaul of the HSR premerger notification requirements in decades. The new requirements imposed additional time and expense on merging parties, with the FTC estimating that the new form would likely take triple the amount of time to complete than the previous form. Numerous groups, including the U.S. Chamber of Commerce, sued to challenge the rule.
Client Alert | 12 min read | 02.13.26
What Organ Procurement Organizations Need to Know About CMS's New Proposed Rule
Client Alert | 9 min read | 02.12.26
Client Alert | 3 min read | 02.12.26
