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.
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