False Claims Act Watch: California Federal Judge Dismisses DOJ Complaint Alleging Medicare Advantage Fraud
Pratt’s Government Contracting Law Report
January 2018
Partner Jaimie Nawaday authored the Pratt’s Government Contracting Law Report article “False Claims Act Watch: California Federal Judge Dismisses DOJ Complaint Alleging Medicare Advantage Fraud,” a look at the U.S. Department of Justice’s first ever intervention in a False Claims Act suit alleging Medicare Advantage fraud.  On October 5, a California federal judge dismissed a complaint that several healthcare providers submitted knowingly flawed data to avoid negative payment adjustments and keep overpayments to which they were not entitled. The decision marked a high-profile setback for the DOJ. The article explains the background of the case — United States ex rel. Swoben v. Scan Health Plan, et al. — the complaint, the government’s intervention and next steps.