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In June 2016, AmSurg Corp. and Envision Healthcare Holdings, Inc. (Envision) announced they have signed a definitive merger agreement pursuant to which the companies will combine in an all-stock transaction. Upon completion of the merger, which is expected to be tax-free to the shareholders of both organizations, the combined company will be named Envision Healthcare Corporation and co-headquartered in Nashville, Tennessee and Greenwood Village, Colorado. The company's common stock is expected to trade on the New York Stock Exchange under the ticker symbol: EVHC. Bass, Berry & Sims served as lead counsel on the transaction, led by Jim Jenkins. Read more.

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Inside the FCA blogInside the FCA blog features ongoing updates related to the False Claims Act (FCA), including insight on the latest legal decisions, regulatory developments and FCA settlements. The blog provides timely updates for corporate boards, directors, compliance managers, general counsel and other parties interested in the organizational impact and legal developments stemming from issues potentially giving rise to FCA liability.

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Middle District of Tennessee Clarifies Pleading Standards for the Presentment of False Claims

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November 25, 2015

Earlier this month, the U.S. District Court for the Middle District of Tennessee dismissed a relator's qui tam lawsuit, finding that the relator had failed to adequately allege the presentment of false claims to the government. In U.S. ex rel. Prather v. Brookdale Senior Living, Inc., the relator alleged that Brookdale submitted false claims for home health services that did not meet the technical requirements for billing under Medicare rules and regulations. Defendants argued that the allegations failed to include sufficient detail regarding the actual submission of requests for anticipated payment (RAP) claims and that the relator failed to plead the requisite legal falsity of both RAP and final episode payment claims.

The district court dismissed the second amended complaint with prejudice, finding that the relator did not meet the "strict requirement" that she allege the submission of actual false claims to a federal healthcare program. The district court found that despite including information regarding treatment dates, the entity providing the treatment, and the Brookdale community at which the patient resided for four exemplar patients and several hundred patients in attached exhibits, the complaint failed to allege the presentment of any false claim. The district court held that it was "insufficient for Prather to point to a patient that received home health care services and allege that a RAP was, or must have been, submitted, by some corporate authorization, for some amount, at some date around the date of treatment, and that some payment was likely received in return from the government, based just on the generally delineated circumstances of the patient's receipt of home health services from a defendant entity." The information provided was "too general and too attenuated from the Medicare Billing process to satisfy the requirements of the law concerning the presentment of specific false claims."

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