Partners Eric W. Sitarchuk and Jaclyn Unis Whittaker will participate on panels at the American Conference Institute’s (ACI’s) 10th Annual Advanced Forum on False Claims and Qui Tam Enforcement. A faculty of government speakers and leading defense, in-house, and relator’s counsel will gather to address the critical and emerging issues of the US Department of Justice’s (DOJ’s) latest actions relating to False Claims Act (FCA) actions.
2023 Judicial Round-up: Recent Critical Developments in the Courts Impacting False Claims Act and Qui Tam Litigation: Part 2: The Federal Courts Divided: Emerging Battles Over “Objective Reasonableness,” Materiality and Causation
Eric Sitarchuk | Monday, January 23, 2023 | 10:45 am ET
Topics will include:
Scienter and Materiality
- Examining the latest circuit court decisions regarding the scienter standard, in particular the question of “objective reasonableness”
- Identifying what is required for the purposes of pleading the objective reasonableness defense given the current inconsistency in case law
- How are courts defining “authoritative guidance” in cases where it is alleged the defendant was warned against their incorrect interpretation?
- Exploring developing case law on the materiality element post-Escobar and the implications for practitioners
Standard of Causation in FCA/AKS Cases
- Analyzing the implications of the recent Eighth Circuit decision in United States ex rel. Cairns v. D.S. Medical LLC (July 26, 2022) and other recent decisions regarding causation in FCA/Anti-Kickback Statute (AKS) cases
- Reviewing significant causation defenses this case offers to defendants in FCA cases, as well as its impact on relator and government pleadings
- Incorporating takeaways from this ruling into your future litigation strategies
FCA Spotlight on Healthcare and Life Sciences Industries: Spotlight on FCA Enforcement Involving Medicare Advantage Plans and the Anti-Kickback Statute
Jaclyn Whittaker | Tuesday, January 24, 2023 | 11:15 am ET
Topics will include:
- Analyzing the latest DOJ investigations, enforcement activity, and settlements involving Medicare Advantage (MA) plans in connection to:
- Offering kickbacks to healthcare professionals
- Risk adjustment fraud
- Inaccuracy of star rating data
- Inappropriate restriction of beneficiary access to medically necessary care
- Submitting inaccurate information about the health status of MA plan beneficiaries
- Examining the theories of liability that formed the basis of the most recent settlements in the MA space—what are the key takeaways from recent settlements?
- What does the most recent activity project about anticipated future FCA enforcement in the MA space?
- Assessing the impact of Office of the Inspector General for the US Department of Health and Human Services’ revisions to the AKS regulations on recent false claims activity
- Lessons learned from important FCA AKS cases in the last year