Healthcare Regulatory Check-Up | August 2022

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant enforcement activity between July 21 and August 20, 2022. Key updates include a case in which the US Court of Appeals for the Eighth Circuit decided that the phrase “resulting from” in the Anti-Kickback Statute (AKS) creates a but-for causal requirement between an antikickback violation and the items or services included in the claim to the government. This decision established a circuit split regarding the appropriate standard for establishing causation in False Claims Act (FCA) cases related to AKS violations. In another notable case, the US Court of Appeals for the Second Circuit upheld an unfavorable Office of Inspector General (OIG) advisory opinion and subsequent district court ruling related to a pharmaceutical manufacturer’s proposed copay assistance program. The Second Circuit held that “corrupt” intent is not required to establish an AKS violation. This issue also reviews several criminal and civil enforcement actions related to AKS violations and false claims allegations.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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