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How did a clerkship with Judge Merritt change the way Chris Climo approaches the practice of law? Find out more>

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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

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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: Express Certification

Inside the FCA Blog

Publications

June 1, 2017

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 are taking a closer look at recent legal developments involving the FCA. This week, we examine recent court decisions following Escobar that considered the express certification theory of FCA liability.

While Escobar focused on implied certification liability, its guidance as to the FCA's materiality requirement should apply equally to FCA cases where falsity is premised on an express certification. See U.S. ex rel. Thomas v. Black & Veatch Special Projects Corp., 820 F.3d 1162, 1174 (10th Cir. 2016) (pre-Escobar decision explaining that "[a]lthough express and implied claims differ, both nonetheless share some common elements, including a materiality requirement"); United States v. Fulton Cnty., Ga., 2016 WL 4158392, at *5 (N.D. Ga. Aug. 5, 2016) (post-Escobar decision stating that "[t]he misrepresentation, whether express or implied, must be material to the other party's course of action").

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


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