§Why CasetextPricing

Schubert v. All Children's Health System, Inc. et al

MOTION to Dismiss Third Amended Complaint Dkt. 45

33 Cited authorities

  1. Edwards v. Prime Inc.

    602 F.3d 1276 (11th Cir. 2010)   Cited 1,026 times   4 Legal Analyses
    Holding that legal conclusions about hypothetical facts are dicta

  2. U.S. ex Rel. Clausen v. Laboratory Corp.

    290 F.3d 1301 (11th Cir. 2002)   Cited 822 times   14 Legal Analyses
    Holding Rule 9(b) applies to False Claims Act claims

  3. Oxford Asset Management, Ltd. v. Jaharis

    297 F.3d 1182 (11th Cir. 2002)   Cited 762 times
    Holding conclusory allegations are insufficient to state a claim

  4. United States ex rel. Nathan v. Takeda Pharms. N. Am., Inc.

    707 F.3d 451 (4th Cir. 2013)   Cited 457 times   9 Legal Analyses
    Holding that the district court did not abuse its discretion in denying plaintiff leave to file a fourth amended complaint after repeated prior dismissals for failure to sufficiently plead his claim

  5. Corsello v. Lincare, Inc.

    428 F.3d 1008 (11th Cir. 2005)   Cited 540 times   2 Legal Analyses
    Holding that trial court did not err in denying relator's request to file an amended complaint where there was a repeated failure to cure deficiencies in three prior complaints

  6. Hopper v. Solvay Pharmaceuticals

    588 F.3d 1318 (11th Cir. 2009)   Cited 237 times   5 Legal Analyses
    Holding a complaint deficient when it "d[id] not link the alleged false statements to the government's decision to pay false claims."

  7. U.S. v. Salina Regional Health Center, Inc.

    543 F.3d 1211 (10th Cir. 2008)   Cited 234 times   10 Legal Analyses
    Holding a hospital’s failure to comply perfectly with Medicare regulations does not automatically generate FCA liability

  8. U.S. v. RF Properties of Lake County, Inc.

    433 F.3d 1349 (11th Cir. 2005)   Cited 200 times   3 Legal Analyses
    Holding that Rule 9(b) was satisfied where the relator was a nurse practitioner in the defendant's employ who was required to bill under a doctor's provider number and whose conversations about the defendant's billing practices with the office manager formed the basis for the relator's belief that fraudulent claims were actually submitted to the government

  9. United States v. Medco Health Solutions, Inc.

    671 F.3d 1217 (11th Cir. 2012)   Cited 161 times   1 Legal Analyses
    Holding that relator plead compliance certification with particularity by identifying the specific documents and statements alleged to be false, along with who made them, how they were used, and when they were submitted

  10. U.S. ex Rel. Lamers v. City of Green Bay

    168 F.3d 1013 (7th Cir. 1999)   Cited 192 times   1 Legal Analyses
    Holding public-disclosure bar did not apply where relator “walked the streets” as a “private investigator” observing the school bus operations at issue

  11. Section 3729 - False claims

    31 U.S.C. § 3729   Cited 6,768 times   630 Legal Analyses
    Holding liable "any person" who knowingly causes false claims to be presented

  12. Section 3730 - Civil actions for false claims

    31 U.S.C. § 3730   Cited 5,403 times   430 Legal Analyses
    Granting the government primary responsibility for conducting suit

  13. Section 1395y - Exclusions from coverage and medicare as secondary payer

    42 U.S.C. § 1395y   Cited 1,302 times   66 Legal Analyses
    Granting the government subrogation rights

  14. Section 1396b - Payment to States

    42 U.S.C. § 1396b   Cited 617 times   5 Legal Analyses
    Setting forth, inter alia, requirements of state Medicaid fraud units

  15. Section 1395c - Description of program

    42 U.S.C. § 1395c   Cited 501 times
    Referring to 42 U.S.C. § 402, 414

  16. Section 1395nn - Limitation on certain physician referrals

    42 U.S.C. § 1395nn   Cited 419 times   134 Legal Analyses
    Approving of compensation rates that " do not exceed fair market value"

  17. Section 411.354 - Financial relationship, compensation, and ownership or investment interest

    42 C.F.R. § 411.354   Cited 35 times   53 Legal Analyses
    Defining a financial relationship to include direct or indirect relationships

  18. Section 411.353 - Prohibition on certain referrals by physicians and limitations on billing

    42 C.F.R. § 411.353   Cited 23 times   27 Legal Analyses

    (a)Prohibition on referrals. Except as provided in this subpart, a physician who has a direct or indirect financial relationship with an entity, or who has an immediate family member who has a direct or indirect financial relationship with the entity, may not make a referral to that entity for the furnishing of DHS for which payment otherwise may be made under Medicare. A physician's prohibited financial relationship with an entity that furnishes DHS is not imputed to his or her group practice or

  19. Section 435.1002 - FFP for services

    42 C.F.R. § 435.1002   Cited 2 times

    (a) Except for the limitations and conditions specified in §§ 435.1007 , 35.1008 , 435.1009 , and 438.814 of this chapter, FFP is available in expenditures for Medicaid services for all beneficiaries whose coverage is required or allowed under this part. (b) FFP is available in expenditures for services provided to beneficiaries who were eligible for Medicaid in the month in which the medical care or services were provided except that, for beneficiaries who establish eligibility for Medicaid by deducting

  20. Section 435.1012 - Requirement for maintenance of optional State supplement expenditures

    42 C.F.R. § 435.1012

    (a) This section applies to States that make optional State supplement payments under section 1616(a) of the Act and mandatory supplement payments under section 212(a) of Pub. L. 93-66 . (b) FFP in Medicaid expenditures is not available during any period in which the State does not have in effect an agreement with the Secretary under section 1618 of the Act to maintain its supplementary payments. 42 C.F.R. §435.1012 43 FR 45204, Sept. 29, 1978, as amended at 55 FR 48609, Nov. 21, 1990. Redesignated