Mintz’s Health Care Enforcement Defense Group Publishes Latest Qui Tam Update

Last week, Mintz’s Health Care Enforcement Defense Group published a new Qui Tam Update, which analyzes 60 health care-related False Claims Act qui tam cases unsealed in December 2017 and January 2018 and the trends they reflect:

• The government intervened in 14% of those unsealed cases (a figure that is consistent with the longer-term trends we have seen over the prior twelve months).
• Of the 60 unsealed cases, only 28 were being litigated (at least initially). The remaining 32 cases were docketed as closed or dismissed.
• The 60 unsealed cases were filed in 38 different courts. Jurisdictions with the most unsealed cases included:
  • The Central District of California (which includes Los Angeles) with six cases;
  • The Middle District of Florida (which includes Jacksonville, Orlando, and Tampa) with 4 cases; and
  • The District of Connecticut and Eastern District of Louisiana (New Orleans), each with 3 cases.
• The most frequently targeted types of defendants included:
  • Pharmaceutical companies, hospitals, and healthcare systems, with each accounting for 9 of the 60 unsealed cases.
  • Physicians and physician group practices, which were targeted in 7 cases.
  • Home health and hospice providers, which were the subject of 6 cases.
  • Outpatient clinics, which were defendants in 5 cases.
• Former employees were again the most frequent relator type, accounting for 23 of the 60 unsealed cases. Expert witnesses brought 7 cases and current employees brought 2 cases.
• Only one of the cases was unsealed within the 60-day period specified by statute. That case was under seal for 55 days.
• The longest time a case was under seal was almost eight-and-a-half years. Average time under seal for this cohort was 700 days, though half of these cases were unsealed in 16 months or less, and 23 of these 60 cases were unsealed in less than a year.

This Update also includes an in-depth analysis of three cases, which involve allegations regarding (1) arrangements between a hospital and physician group practice and their employed physicians that were designed to increase the volume of referrals in violation of the Anti-Kickback Statute, the Stark Law, and the False Claims Act; (2) submission of claims by a psychiatric care provider (and managed care company) in violation of the False Claims Act due to the underlying care not meeting regulatory requirements applicable to supervision of and qualifications for psychiatric care staff (these allegations are similar to those made in Universal Health Services, Inc. v. United States ex rel. Escobar); and (3) sales and marketing practices by a compounding pharmacy that ran afoul of the Anti-Kickback Statute (the private equity group with a majority ownership position in this compounding pharmacy was also named as a defendant).

You can access the full update HERE.

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