Close X
Attorney Spotlight

What television show influenced Chad Jarboe's decision to pursue a career in the legal field? Find out more>

Search

Close X

Experience

Search our Experience

Experience Spotlight

Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

Close X

Thought Leadership

Enter your search terms in the relevant box(es) below to search for specific Thought Leadership.
To see a recent listing of Thought Leadership, click the blue Search button below.

Thought Leadership Spotlight

Healthcare Transactions: Year in Review 2018Last year, CVS Health Corp. (NYSE: CVS) announced it would purchase health insurer Aetna Inc. (NYSE: AET) for $67.5 billion, a transaction that would be one of the biggest healthcare mergers in the past decade. The transaction raises an intriguing question: is this the beginning of a transformational shift in healthcare?

Recently, members of our healthcare group authored the Healthcare Transactions: Year in Review outlining 2017 M&A activity and drivers in the following hot healthcare sectors:

• Managed Care
• Hospitals
• Post-Acute Care—Home Health & Hospice
• Ambulatory Surgery Centers (ASCs)
• Healthcare Information Technology (HIT)
• Behavioral Health
• Physician Practice Management

Read now

FCA Deeper Dive: When Public Disclosures Bar FCA Claims

Firm Publication

Publications

January 13, 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.

The FCA's public disclosure bar prevents a relator from filing a qui tam complaint based on information previously disclosed to the public, thereby dissuading parasitic lawsuits based on publicly available information. In cases considering the scope of the public disclosure bar, courts have continued to examine the issue of how or to whom information must be disseminated in order to constitute a "public disclosure," which often has resulted in a narrowing of the public disclosure bar's scope in a given case. Such cases marked a shift away from decisions favorable to FCA defendants toward a more nuanced and specific application of the public disclosure bar.

Determining what disclosures are sufficient to bar FCA allegations most often has arisen in the context of analyzing disclosures made to government or regulatory entities. U.S. ex rel. Wilson v. Graham County Soil & Water Conservation Dist., 777 F.3d 691 (4th Cir. 2015), involved allegations of fraud against the government with respect to an Emergency Watershed Protection Program. The district court found that the relator's allegations were previously publicly disclosed in an audit report prepared by county auditors and in an investigation report prepared by the USDA and dismissed the relator's complaint. The Fourth Circuit reversed the district court on the grounds that the reports at issue were not "publicly" disclosed because they were disclosed only to governmental agencies. The Fourth Circuit held that "a 'public disclosure' requires that there be some act of disclosure outside the government." The Fourth Circuit noted that "the Government is not the equivalent of the public domain" and that "nothing in the record suggests that either report actually reached the public domain. Notably, the Fourth Circuit clarified that the fact that the reports were accessible to the public through public information laws did not affect its analysis because the reports were never actually requested by or disclosed to the public.

Inside the FCA blog

 

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.

 

 


Related Professionals

Related Services

Notice

Visiting, or interacting with, this website does not constitute an attorney-client relationship. Although we are always interested in hearing from visitors to our website, we cannot accept representation on a new matter from either existing clients or new clients until we know that we do not have a conflict of interest that would prevent us from doing so. Therefore, please do not send us any information about any new matter that may involve a potential legal representation until we have confirmed that a conflict of interest does not exist and we have expressly agreed in writing to the representation. Until there is such an agreement, we will not be deemed to have given you any advice, any information you send may not be deemed privileged and confidential, and we may be able to represent adverse parties.