Close X
Attorney Spotlight

What is Shannon Wiley looking forward to at this year's Asembia Specialty Pharmacy Summit? Find out more>


Close X


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

Download the Healthcare Fraud & Abuse Review 2017, authored by Bass, Berry & Sims

The Healthcare Fraud & Abuse Review 2017 details all healthcare-related False Claims Act settlements from last year, organized by particular sectors of the healthcare industry. In addition to reviewing all healthcare fraud-related settlements, the Review includes updates on enforcement-related litigation involving the Stark Law and Anti-Kickback Statute, and looks at the continued implications from the government's focus on enforcement efforts involving individual actors in connection with civil and criminal healthcare fraud investigations.

Click here to download the Review.

FCA Deeper Dive: Rule 9(b) and the Pleading of the Alleged Fraud Scheme

Firm Publication


March 2, 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 recent court decisions considering the level of specificity required of a relator under Rule 9(b) in pleading the alleged FCA fraud scheme.

While analyzing the circumstances of fraud is necessarily a case-by-case analysis, courts have applied decidedly different approaches to examining certain components of a fraudulent scheme, including the "who" and "when" requirements.

Several cases demonstrated the nuances in pleading the appropriate "who" with particularity in FCA complaints against a corporation. In United States v. Sanford-Brown, Ltd., 788 F.3d 696 (7th Cir. 2015), which involved claims against a college and its corporate parent, the Seventh Circuit held that allegations against the "Defendants" in general were insufficient to allow claims against the parent company to proceed.

With regard to the particularity required when identifying individuals who were involved in perpetuating a fraud alleged against a corporation, district courts have reached different results. In U.S. ex rel. Modglin v. DJO Global Inc., 2015 WL 4111709 (C.D. Cal. May 8, 2015), a district court held it was insufficient to identify relevant actors as employees or "personnel" of the defendant company; rather, "[a]t a minimum, relators must identify the [relevant individuals] by their job titles and/or responsibilities." In U.S. ex. rel. Cieszyksi v. LifeWatch Services, Inc., 2015 WL 6153937 (N.D. Ill. Oct. 19, 2015), however, the district court held the complaint sufficiently identified "LifeWatch generally as the entity responsible" and did not need to "identify by name or position each person involved in submitting the alleged false claims." See also U.S. ex rel. Gates v. Austal, U.S.A. LLC, 2015 WL 5782284 (S.D. Ala. Aug. 10, 2015) (complaint dismissed for failure to identify specific claim when relators did not identify who submitted relevant cost reports and invoices).

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


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.