1. Home
  2. |Insights
  3. |Public Disclosure Of "Industry-Wide" Overbilling Practice Bars Qui Tam Suit Based Upon Similar But Undisclosed Fraudulent Transactions

Public Disclosure Of "Industry-Wide" Overbilling Practice Bars Qui Tam Suit Based Upon Similar But Undisclosed Fraudulent Transactions

Client Alert | 1 min read | 02.21.06

In United States ex rel. Gear v. Emergency Medical Assocs. of Ill. , the Seventh Circuit took an expansive view of the False Claims Act's ["FCA"] "public disclosure" bar , concluding that media and governmental reports concerning the general type of unlawful scheme alleged in a qui tam complaint sufficed to defeat the court's jurisdiction, even though such reports did not identify the particular defendant or any specific instances of its alleged misconduct. Specifically, the Seventh Circuit held that medical journal articles and a series of Department of Health and Human Services Office of Inspector General audits concerning "industry-wide" Medicare billing abuses in which hospitals sought reimbursement for services provided by residents as if they were licensed attending physicians, were "public disclosures" that barred the relator's complaint involving alleged similar overbilling schemes, despite the fact that the disclosures did not identify the two defendants or their specific fraudulent transactions.

Insights

Client Alert | 3 min read | 04.23.24

DOJ Promises NPAs to Certain Individuals Through New Voluntary Self-Disclosure Pilot Program

On April 15, 2024, the Acting Assistant Attorney General for the Criminal Division of the Department of Justice (“DOJ”) Nicole Argentieri announced a new Pilot Program on Voluntary Self-Disclosure for Individuals (“Pilot Program” or “Program”). The Pilot Program offers a clear path for voluntary self-disclosure by certain corporate executives and other individuals who are themselves involved in misconduct by corporations, in exchange for a Non-Prosecution Agreement (“NPA”). The Pilot Program specifically targets individuals who disclose to the Criminal Division at DOJ in Washington, D.C. information about certain corporate criminal conduct. By carving out a clear path to non-prosecution for those who qualify, DOJ has created another tool to uncover complex crimes that might not otherwise be reported to the Department. ...