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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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FCA Deeper Dive: Original Sources under the FCA's Public Disclosure Bar

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January 20, 2016

The FCA continues to be the federal government's primary civil enforcement tool for investigating allegations that healthcare providers or government contractors defrauded the federal government. In the coming weeks, we will take a closer look at recent legal developments involving the FCA. This week, we examine the FCA’s public disclosure bar and recent cases considering whether disclosures are sufficient to bar FCA claims.

Courts have continued to clarify the requirements for a relator to be considered an original source, and thus exempted from the public disclosure bar, under the FCA's pre-PPACA and post-PPACA versions. In these cases, courts have typically focused on the requirements that a relator have "direct and independent knowledge of the information on which the allegations are based" (pre-PPACA) and "knowledge that is independent of and materially adds to the publicly disclosed allegations or transactions" (post-PPACA).

The Third and Sixth Circuits made significant rulings regarding the type of knowledge that a relator must possess to have "direct knowledge" to qualify as an original source under the pre-PPACA statute. In U.S. ex rel. Antoon v. Cleveland Clinic Foundation, 788 F.3d 605 (6th Cir. 2015), the Sixth Circuit held that "proof of first-hand knowledge of fraud" is "not a necessary component" to establishing direct knowledge and that "direct knowledge is knowledge gained by relator's own efforts and not acquired from labor of others." This case-by-case determination is controlled by the character of the relator's discovery and investigation. The Sixth Circuit found that the relator did not qualify as an original source because the "heart" of his FCA claim was founded on a review of medical records and he could only "speculate" about whether a physician was personally involved in the surgery that formed the basis of his fraud allegations. "Mere suspicion" that fraudulent activity resulted based on a review of medical records did not entitle the relator to original source status.

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To continue reading the content in this article on the firm's Inside the FCA blog, please click here to view the post.

Bass, Berry & Sims' Inside the FCA blog features news, commentary and thought leadership covering FCA, healthcare fraud and procurement fraud.

 

 


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