In False Claims Act (FCA) health-care investigations, a frequently asked question, among corporate officers and shareholders alike, is: When will the matter finally be resolved? Time and time again, these cases result in settlements, where the defendant company pays a substantial amount to the government—often without admitting or denying the essential allegations of the case—and agrees to be bound by a corporate integrity agreement (a CIA), all in exchange for the opportunity to announce that it has put the matter behind it.1 But the finality of these resolutions may be somewhat illusory, as the CIA, entered into to bring the matter to a close, can seed the ground for future FCA investigations.

Until recently, CIAs were seen as contractual obligations between the settling company and the government, typically with the Health and Human Services Office of the Inspector General (OIG), where the company commits to heightened compliance standards.2 A violation of the agreement—say, the settling company failing to declare certain “reportable events”—would allow the OIG to impose monetary penalties or perhaps even exclude the company from federal health-care programs,3 but did not appear to open up new lines of attack under the FCA.