"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 | 5 min read | 10.22.25
Sixth Circuit Reaffirms Privilege Protections During Internal Investigations
On October 3, 2025, the Sixth Circuit reaffirmed that the attorney-client privilege and the work-product doctrine protections apply to materials created during attorney-led internal investigations. In re FirstEnergy Corp., No. 24-3654 (6th Cir. Oct. 3, 2025).
Client Alert | 4 min read | 10.21.25
Pivot Point for 340B: HRSA Rebate Model Pilot Program Approaches Launch
Client Alert | 5 min read | 10.20.25
What’s new for Belgian Construction Contracts under the New Book 7 of the Civil Code
Client Alert | 3 min read | 10.17.25
California Enacts New Requirements and Restrictions for Health Care Transactions