Trinity HomeCare settlements offer a glimpse of future FCA litigation

Compared to other notable False Claims Act (FCA) settlements that can reach billions of dollars, the recent $2.5 million settlement between the New York State Attorney General and Trinity HomeCare might seem small--but the circumstances surrounding the case highlight trends in FCA enforcement, according to the Health Law & Policy Matters blog.

Mintz Levin attorney Ellyn L. Sternfield writes that Trinity HomeCare's recent settlement shows that more cases are moving forward without the government's help, particularly in cases involving both federal and state FCA violations.

More FCA cases are likely to be confined to one state or a single region because prosecutors are leaning on specific state laws to build a case. For example, in the Trinity settlement prosecutors cited New York Medicaid Program preconditions for billing specialty drugs, according to Sternfield. 

Sternfield adds that multiple cases against the same group of defendants are also likely. In this case, both Option Care and Walgreens were rolled into the $2.5 million settlement through acquisitions of Trinity HomeCare. Less than two weeks later, Trinity HomeCare entered into another $22.4 million settlement with the N.Y. Attorney General, this time for a different specialty drug.

"While there still may be an occasional mega-FCA settlement out there, I expect to see many more of these smaller, state-specific FCA cases being filed and pursued, especially if the case involves some of the same factors present in the Trinity case," Sternfield concluded. 

For more:
- read the post

Related stories:
Walgreen-owned pharmacy settles Medicaid fraud claims for $22.4 million
High costs for specialty drugs hit patients, payers
Federal False Claims Act scrutiny shows no signs of letting up
FCA risk management policies most effective when paired with appropriate enforcement
As fraud crackdown grows, so does need for corporate compliance

Suggested Articles

The HHS OIG is asking for an additional $23.7 million to support fraud oversight that has benefited from an emphasis on data analytics.

A New York surgeon was sentenced to 13 years in prison for fraud and more physician practice news from around the web.

A federal judge has ruled that the U.S. government’s remaining fraud case against UnitedHealth can move forward.