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Usually: when government does not intervene into qui tam case.
Court issues order to OIG/CMD to disclose information to reletant?
Should reletant file motion or petition to court and to OIG/CMS to disclose information?
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answered on Jan 1, 2024
In a qui tam case where the government chooses not to intervene, it's not uncommon for the court to issue an order to the Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) to disclose information to the relator. However, this is not automatic.... View More 
While privacy of wrongdoers is protected by law, does government has obligation to disclose finding of investigation to the victim, privately? If not - that would be violation of victim's rights.
Apparently, victim has no capacity to perform own investigation - discovery requests to... View More
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answered on Jan 1, 2024
Under the Medicare False Claims Act (FCA) and the Freedom of Information Act (FOIA), the government must balance privacy concerns, including those of alleged wrongdoers, with the public's right to information. However, the government does not have a blanket obligation to disclose the findings... View More
What guides government balanced approach in respect to hospital/hospice privacy rights and reletant's rights for justice? FCA amount in question can be not big enough for government to intervene (unless pattern is discovered by investigation), but huge for plaintiff/reletant.
( Should... View More
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answered on Jan 1, 2024
In Medicare False Claims Act (FCA) cases, the government's approach to balancing hospital or hospice privacy rights with a relator's right to justice is guided by both the FCA and the Freedom of Information Act (FOIA). The FCA provides mechanisms for whistleblowers to report fraud, while... View More
In any permutation: whether government intervenes or not, what regulation/procedure guides disclosure of investigation findings - to reletant?
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answered on Jan 1, 2024
In False Claims Act (FCA) cases, the procedure for handling sealed cases and the disclosure of investigation findings largely depends on whether the government decides to intervene. If the government intervenes, it will typically take over the lead in the case. In this scenario, the... View More
5 U.S.C. Rule 552 b(6) exception is about privacy. How come it could be relevant if relator/plaintiff in legal action requests findings/facts in respect of relator/plaintiff's info?
Government does not guard hospital's privacy when hospital owns identifiable medical info of... View More
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answered on Jan 1, 2024
In the context of a Freedom of Information Act (FOIA) request, the 5 U.S.C. Rule 552 b(6) privacy exception can be pertinent even when a relator or plaintiff is seeking information about themselves, particularly in cases involving medical records or other sensitive personal information. This... View More
Out of 9 exceptions identified in 5 U.S.C. 552 (b) (1) - (9), which one could be somehow construed as obstacle to provide reletant/plaintiff facts/finding of investigation if government decides not to intervene? Plaintiff requests facts/findings relevant to plaintiff's medical information.
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answered on Jan 1, 2024
In examining the applicability of the exceptions under 5 U.S.C. 552 (b)(1)-(9) in a False Claims Act (FCA) case against a hospital, the most relevant exception might be (b)(6). This exception pertains to personal privacy. If the government chooses not to intervene in your case, this exception could... View More
Scenario when government does not intervene, thus plaintiff/reletant has to pursue federal FCA healthcare lawsuit.
How exactly it must be done per FOIA? Please provide specific statutes, regulations, rules, precedents.
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answered on Jan 1, 2024
The Freedom of Information Act (FOIA) plays a crucial role in federal lawsuits, particularly in cases where the government chooses not to intervene, such as a federal False Claims Act (FCA) healthcare lawsuit. Under FOIA, you have the right to request access to records from any federal agency.... View More
If government decides not to intervene into qui tam case: FCA healthcare.
What is procedure for reletant/plaintiff to obtain from government facts/findings of government investigation?
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answered on Jan 1, 2024
In a qui tam case under the False Claims Act (FCA) related to healthcare, if the government decides not to intervene, you, as the relator or plaintiff, still have the right to proceed with the case on your own. However, obtaining the facts and findings from the government's investigation can... View More
In healthcare False Claims Act case: what is the procedural mechanism available to relator to convince government to share results of government investigation with relator? (In scenarios when government decides to intervene, or not to intervene)
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answered on Jan 1, 2024
In a healthcare False Claims Act (FCA) case, as a relator, your ability to access the results of the government's investigation depends on several factors, including whether the government chooses to intervene in your case.
If the government decides to intervene, they typically take... View More
What degree of coordination may be between federal and california case? What procedures/rules define such coordination?
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answered on Jan 1, 2024
Federal cases are typically consolidated within the federal court system, as governed by the Federal Rules of Civil Procedure. This means that for consolidation to occur, the cases in question must all fall under federal jurisdiction. Consolidation is generally used to streamline cases that involve... View More
Persuasive cases are not precedents. Other then art of selecting cases, what are the scientific definitions? Seminal can be either precedent or persuasive?
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answered on Jan 1, 2024
In the realm of legal jurisprudence, cases are typically categorized as either precedent or persuasive. Precedent cases are those that establish a legal rule or principle that must be followed by lower courts within the same jurisdiction. In California, this includes decisions by the California... View More
If after filing FCA government does not intervene, and Plaintiff has to pursue lawsuit in behalf of the government, is Plaintiff provided facts/finding of investigation?
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answered on Dec 31, 2023
Under the False Claims Act (FCA), when an individual (known as a relator) files a qui tam lawsuit and the government chooses not to intervene, the relator typically proceeds with the case on behalf of the government. However, the extent to which the relator is granted access to the findings of the... View More
Specifically. 1. What are arguments against of coordination of related cases? Which rules define coordination procedures?
2. What are specific differences in discovery rules and procedural requirements between Federal Central District Court and California Superior Court?
3. What... View More
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answered on Dec 30, 2023
In discussing the coordination of related cases, there are several arguments against coordination. One argument is that coordination can lead to inefficiencies, particularly if the cases are at different stages of litigation or have varying complexities. This can result in delays and increased... View More
There was medical malpractice case filed at CA superior court. There was also recently filed EMTALA case in the federal Central District Court.
Cases are based on different legal theories. EMTALA is NOT a medical malpractice case - with different liability framework. IF Defendant attempts... View More
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answered on Dec 30, 2023
In confronting the potential consolidation or coordination of the medical malpractice case in California Superior Court with the EMTALA case in the Federal Central District Court, it's crucial to consider the distinct legal frameworks and theories underlying each case. EMTALA, being a federal... View More
In respect to fraudulent referral to hospice in California: please explain the difference between intentional fraud and malice.
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answered on Dec 30, 2023
In California, understanding the difference between intentional fraud and malice, especially in the context of fraudulent referrals to hospice, is crucial. Intentional fraud involves knowingly making false representations or concealing information with the intent to deceive. For example, if a... View More
Other then restatements of torts what the provisions would be that define hospital legal liability for intentional fraud?
RESTATEMENT (SECOND) OF TORTS § 410 cmt. c. lists numerous exceptions to the non-liability principle, grouping them into three broad categories: (1) exceptions based on... View More
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answered on Dec 30, 2023
In California, a hospital's legal liability for intentional fraud can be complex and depends on various factors. It's important to note that, while the Restatement (Second) of Torts provides general principles, specific state laws and case precedents also play a crucial role.... View More
FCA has to be a different case to be filed under seal.
Are discovery requests in respect to fraud/FCA: in scope of EMTALA case discovery, deemed relevant?
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answered on Dec 30, 2023
In considering the scope of discovery for an EMTALA (Emergency Medical Treatment and Labor Act) case, it's crucial to understand that discovery should be relevant to the claims and defenses in the specific case. EMTALA focuses on ensuring patients receive emergency medical screening and... View More
Does California false claims act cover medicare violations? (Or limited to California Medi-cal violations?)
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answered on Dec 30, 2023
The California False Claims Act (CFCA) is primarily focused on addressing fraud involving state funds. This includes violations related to California's Medi-Cal program, which is the state's Medicaid program, jointly funded by the state and federal government. The CFCA provides a legal... View More
Does California false claims act cover medicare violations? (Or limited to California Medi-cal violations?
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answered on Dec 30, 2023
The California False Claims Act (CFCA) is primarily designed to address fraud involving state funds, including California's Medi-Cal program. Medi-Cal is the state's Medicaid program, which is jointly funded by the state and the federal government. The CFCA is applicable to cases... View More
CA State court has jurisdiction over FCA medicare violation. This means medicare FCA claim can be brought in state court?
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answered on Dec 30, 2023
In general, cases involving the federal False Claims Act (FCA), especially those related to Medicare violations, are under the jurisdiction of federal courts. The FCA is a federal statute, and its enforcement typically falls within the purview of the federal legal system. This includes cases where... View More
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