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In 1993, Congress amended the Communications Act, 47 U.S.C. 151–622, to allow the Federal Communications Commission (FCC) to grant electromagnetic spectrum licenses through a system of competitive bidding. The Act requires the FCC to pursue objectives required by statute, including promoting economic opportunity and competition and ensuring that new and innovative technologies are readily accessible to the American people by avoiding excessive concentration of licenses and by disseminating licenses among a wide variety of applicants, including small businesses, rural telephone companies, and businesses owned by members of minority groups and women (designated entities or “DEs”). The FCC’s principal means of fulfilling the statutory objectives for DEs is to confer bidding credits upon small and rural businesses that participate in FCC auctions. Bidding credits operate as a discount on the spectrum DEs purchase, allowing them sometimes to outbid companies that make higher bids. In 2015, the FCC issued a rule indicating that it would cap credits available in future auctions. The Third Circuit concluded the FCC acted legally when it limited the bidding credits available to DEs. The Order: preserved a significant bidding credit program; reviewed data suggesting DE participation would continue despite the proposed caps; and altered other rules to make DEs more competitive. View "Council Tree Investors, Inc. v. Federal Communications Commission" on Justia Law

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Relators filed suit under the False Claims Act (FCA), 31 U.S.C. 3729-33, alleging that Gilead made false statements about its compliance with FDA regulations regarding certain HIV drugs. The Ninth Circuit reversed the district court's dismissal of relators' complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). The panel held that relators stated a plausible claim by alleging factually false certification, implied false certification, and promissory fraud. Furthermore, relators adequately plead scienter, materiality, and that Gilead submitted false claims. The panel reversed the dismissal of the retaliation claim, holding that the Second Amended Complaint sufficiently alleged facts showing that Relator Jeff Campie had an objectively reasonable, good faith belief that Gilead was possibly committing fraud against the government; sufficient facts to show Gilead knew of Campie's protected activity; and causation. View "United States ex rel. Campie v. Gilead Sciences, Inc." on Justia Law

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This case presented for the Washington Supreme Court's review an award of attorney fees against five surety companies following a jury trial for breach of contract in a public works project. The parties litigated the issue of whether three construction firms had defaulted on a contract, thus triggering coverage under a performance bond issued by the surety companies. At issue was whether the existence of a statutory fee provision barred equitable remedies available at common law for coverage disputes and whether the trial court correctly determined that segregation between covered and uncovered fees was impossible. The Court of Appeals affirmed the award of Olympic Steamship fees and held that the trial court did not abuse its discretion in determining that the fees could not be segregated. Finding no reversible error in that judgment, the Washington Supreme Court affirmed. View "King County v. Vinci Constr. Grands Projets" on Justia Law

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In 2004, Hesperia began acquiring vacant property in its downtown for development of a Civic Plaza, with a city hall, public library, other government buildings and “complimentary retail, restaurant, and entertainment establishments.” Cinema West articulated a plan to develop a cinema immediately west of the Civic Plaza Park: the city would convey 54,000 square feet of real property to Cinema for $102,529, the property‘s fair market value; Cinema would construct a 38,000-square foot, 12-screen digital theatre; the city would construct the necessary parking lot, develop a water retention system for the theater and the parking lot, and install off-site improvements including curb, gutter and sidewalks. Cinema would execute a 10-year operating agreement with the city. The city later made a $250,000 forgivable loan to Cinema to aid with a $700,000 anticipated shortfall. As development of the theater and parking lot was nearing completion, the Electrical Workers Union requested a public works coverage determination under California‘s prevailing wage law (Lab. Code, 1720–18611 ) The State Department of Industrial Relations concluded that the project was subject to the prevailing wage requirement. The court of appeal affirmed, noting that Cinema received the benefit of a new, publicly-funded parking lot adjacent to the theater, which, though owned by the city, is Cinema‘s to use for as long as it operates the theater. View "Cinema West v. Baker" on Justia Law

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Parrino worked as a pharmacist for NRS. He was responsible for preparing medications, mainly inhalers. After leaving NRS, Parrino was contacted by the FDA and FBI, which were investigating reports that NRS was filling prescription medications for Pulmicort, a steroid used for the treatment of asthma, with a sub-potent amount of the active ingredient. Parrino cooperated and pleaded guilty to introducing misbranded drugs into interstate commerce, 21 U.S.C. 331(a), 352(a), and 18 U.S.C. 2, a strict liability misdemeanor. Parrino was sentenced to one year of probation and ordered to pay $14,098.24 in restitution for Medicaid and Medicare payments. The Department of Health and Human Services notified Parrino that it was required to exclude him from participation in any capacity in the Medicare, Medicaid, and all federal healthcare programs for at least five years, under 42 U.S.C. 1320a-7(a). Rejecting Parrino’s argument that he lacked any mens rea to commit a crime and was convicted of a strict liability misdemeanor, an ALJ and the Appeals Board upheld HHS’s decision. The Sixth Circuit affirmed dismissal of Parrino’s suit, finding that HHS’s action affected no substantive due process right because “health care providers are not the intended beneficiaries of the federal health care programs” and that the decision to exclude Parrino was “not so shocking as to shake the foundations of this country.” View "Parrino v. Price" on Justia Law

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Nightingale provided home health care and received Medicare reimbursements. The Indiana State Department of Health (ISDH) visited Nightingale’s facility and concluded that Nightingale had deficiencies that placed patients in “immediate jeopardy.” ISDH recommended that the Centers for Medicare & Medicaid Services (CMS), terminate Nightingale’s Medicare agreement. ISDH conducted a revisit and concluded that Nightingale had not complied. Before CMS terminated the agreement, Nightingale filed a petition to reorganize in bankruptcy and commenced sought to enjoin CMS from terminating its provider agreement during the reorganization, to compel CMS to pay for services already provided, and to compel CMS to continue to reimburse for services rendered. The bankruptcy court granted Nightingale relief. While an appeal was pending, ISDH again found “immediate jeopardy.” The injunction was dissolved. A Medicare ALJ and the Departmental Appeals Board affirmed termination. After failing to complete a sale of its assets, Nightingale discharged patients and closed its Indiana operations by August 17, 2016. On September 16, 2016, the district court concluded that the bankruptcy court had lacked subject-matter jurisdiction to issue the injunction and stated that the government could seek restitution for reimbursements for post-injunction services. CMS filed a claim for restitution that is pending. Nightingale separately initiated a civil rights action, which was dismissed. In consolidated appeals, the Seventh Circuit vacated the decisions. The issue of whether the bankruptcy court properly granted the injunction was moot. Nightingale’s constitutional claims were jurisdictionally barred by 42 U.S.C. 405(g). View "Nightingale Home Healthcare, Inc. v. United States" on Justia Law

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SJJC Aviation is a fixed base operator (FBO) that operates a full-service facility at the Norman Y. Mineta San Jose International Airport, which is owned by the city. In 2012 the city addressed a plan to add a second FBO on the west side of the airport and issued a request for proposals “for the development and operation of aeronautical services facilities to serve general aviation activities at the [airport].” The city awarded the lease and operating agreement to Signature and its prospective subtenant, BCH, rejecting SJJC's bid as nonresponsive. SJJC filed suit, contending that the “flawed” process of soliciting bids for the lease should be set aside. The court of appeal affirmed dismissal of the suit. SJJC lost its own opportunity to compete for the new airport FBO by submitting a manifestly nonresponsive bid. SJJC is in reality complaining of past acts by the city and is seeking a remedy that will allow it another opportunity to submit a responsive proposal. View "SJJC Aviation Services v. City of San Jose" on Justia Law

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Critical Access Hospitals are reimbursed by Medicare for the reasonable and necessary costs of providing services to Medicare patients. The Medicaid program requires states to provide additional (DSH) payments to hospitals that serve a disproportionate share of low-income patients, 42 U.S.C. 1396a(a)(13)(A)(iv). In Kentucky, DSH payments are matched at 70% by the federal government. Kentucky’s contribution to DSH programs comes from payments from state university hospitals and Kentucky Provider Tax, a 2.5% tax on the revenue of various hospitals, including Appellants, The amount of DSH payments a hospital receives is unrelated to the amount of KP-Tax it paid. During the years at issue, DSH payments covered only 45% of Appellants' costs in providing indigent care. Appellants filed cost reports in 2009 and 2010 claiming their entire KP-Tax payment as a reasonable cost for Medicare reimbursement. Previously, they had received full reimbursement; for 2009 and 2010, however, the Medicare Administrative Contractor denied full reimbursement, offsetting the KP-Tax by the amount of DSH payments Appellants received. The Provider Reimbursement Review Board and Centers for Medicare and Medicaid Services upheld the decision. The Sixth Circuit affirmed, reasoning that the net economic impact of Appellants’ receipt of the DSH payment in relation to the cost of the KP-Tax assessment indicated that the DSH payments reduced Appellants’ expenses such that they constituted a refund. View "Breckinridge Health, Inc. v. Price" on Justia Law

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Moshiri, other physicians, and hospital administrators were charged (42 U.S.C. 1320a-7b(b)) based on a kickback scheme. The former director of the podiatry residency program (Noorlag) testified that teaching contracts were a vehicle to pay physicians for referrals. Moshiri received $2,000 per month and was named as the Director of External Podiatric Office Rotations. Another doctor was named to that position at the same time. According to Noorlag, neither doctor was considered to hold that position, and neither performed the related duties. The Chair of the Counsel on Podiatric Medical Education, which oversees and certifies residency programs nationally and publishes standards, offered an expert opinion that teaching stipends are uncommon for attending physicians at residency programs and that he had never heard of such a physician being paid $2,000 per month. According to multiple witnesses, Moshiri did not conduct workshops and did not manage external rotations. Moshiri worked with residents about three times per month, while 11 other program physicians averaged 10 cases per month with residents. During the period at issue, the Hospital billed Medicare and Medicaid $482,000 for patients Moshiri treated. The Hospital’s Chief Operating Officer had recorded conversations in which Moshiri discussed his referrals. The agent who arrested Moshiri testified that Moshiri said that “the contract turned into basically paying for patients.” The Seventh Circuit upheld Moshiri’s conviction, rejecting challenges to the sufficiency of the evidence and to the expert testimony. View "United States v. Moshiri" on Justia Law

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Relator filed suit under the False Claims Act (FCA), alleging that his former employer, Abbott, violated the FCA by submitting to Medicare claims by medical providers engaged in the off-label use of Abbott's medical stents. The district court dismissed in part and the jury found against relator in part. The Fifth Circuit held that relator failed to allege details of an Anti-Kickback scheme with sufficient particularity; relator's false inducement claim was properly dismissed under the public disclosure bar; the district court did not err in limiting the time frame of the false presentment theory presented to the jury; the court rejected relator's evidentiary challenges; and the district court did not abuse its discretion in rejecting relator's proposed jury instructions. Accordingly, the court affirmed the judgment. View "United States v. Abbott Laboratories" on Justia Law