News & Analysis as of

Fraud Universal Health Services Inc v United States ex rel Escobar

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Bradley Arant Boult Cummings LLP

Bipartisan Senate Bill Seeks To Weaken the False Claims Act’s Materiality Standard

On July 25, 2023, U.S. Senator Chuck Grassley (R-IA), introduced a bill that aims to, among other things, make it easier for the government to satisfy the False Claims Act’s materiality requirement when the government has...more

Kohn, Kohn & Colapinto LLP

Bipartisan Amendments Introduced to Further Strengthen the False Claims Act

On July 25, 2023, Senator Chuck Grassley (R-Iowa) and Senator Dick Durbin (D-IL.) introduced amendments to the False Claims Act (FCA), a law that protects the federal government from fraud, saving taxpayers billions. The FCA...more

Venable LLP

Yes, Contractors and Providers, What You Think Matters - U.S. Supreme Court Unanimously Holds That Defendants' Subjective Beliefs...

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On June 1, 2023, the U.S. Supreme Court issued a unanimous opinion in United States ex rel. Schutte v. SuperValu Inc. reversing a pair of False Claims Act (FCA) cases on review from the Seventh Circuit Court of Appeals. In...more

Foley & Lardner LLP

Managed Care & the FCA: Are Courts Getting It Right?

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Courts are grappling with unique questions in the context of managed care programs in False Claims Act (FCA) cases. But are they getting it right? Two questions trending in courts relate to: (1) materiality under the FCA when...more

ArentFox Schiff

DOJ's New Civil Cyber-Fraud Initiative and How a Pending Case Could Test Its Efficacy

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The Department of Justice recently announced a new initiative that aims to hold government contractors accountable when they fail to meet required cybersecurity standards. In announcing the “Civil Cyber-Fraud Initiative” in...more

King & Spalding

Senator Grassley Introduces Bipartisan Legislation to Change the Application of the FCA’s Materiality Standard

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On July 26, 2021, a bipartisan group of legislators led by Iowa Senator Chuck Grassley introduced a pair of bills that would represent the most significant changes to the FCA in more than a decade. In broad strokes, the...more

Sheppard Mullin Richter & Hampton LLP

“Would You Rather…” – Escobar’s Demanding Materiality Standard or Actual Causation?

According to a recent decision in United States ex rel. Scollick v. Narula, Case No. 14-cv-1339 (D.D.C. Nov. 6, 2020), the fraudulent inducement theory of False Claims Act (“FCA”) liability does not require plaintiffs to...more

Bradley Arant Boult Cummings LLP

Continued Payments by the VA Won’t Stop Qui Tam When It Comes to Purported Fraud on Veterans

In the latest instance of courts interpreting the Supreme Court’s landmark False Claims Act ruling in Universal Health Services, Inc. v. Escobar, the Eleventh Circuit recently departed from the trend of giving great weight in...more

Dorsey & Whitney LLP

Escobar in Action: Physician-owners’ fraud claims against hospital defeated in Fifth Circuit appeal for lack of materiality

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Following the passage of the Affordable Care Act (“ACA”), which placed new limits on physician-owned hospitals, St. Luke’s Health System (“System”) took action to change one of its hospital’s ownership structures through a...more

Dorsey & Whitney LLP

False Claims Act: New Developments for an Old Law

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The past 18 months have been a (relatively) wild time for the False Claims Act - on the books since 1863. In FY2018 the Department of Justice obtained more than $2.8 billion in settlements and judgments from cases involving...more

Hogan Lovells

False Claims Act: 2018 and the road ahead

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The pace of False Claims Act (FCA) litigation remained furious over the past year. Companies (and individuals) in all sectors of the economy continue to face the ever-present threat of FCA enforcement whenever they do...more

Williams Mullen

Risky Business of the False Claims Act, Part II – What Your Business Needs to Know About the FCA & How You Might Encounter It

Williams Mullen on

In Part I of our False Claims Act (FCA) blog series, we examined the evolution of the FCA and why some understanding of its parameters is important to businesses engaged in, among others, the government contracts, medical,...more

Morgan Lewis

Federal Court Strikes Massive False Claims Act Verdict Following Landmark Escobar Ruling

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The ruling in Universal Health Services, Inc. v. Escobar "rejects a system of government traps, zaps, and zingers that permits the government to retain the benefit of a substantially conforming good or service but to recover...more

Alston & Bird

Implied False Certification Liability Under the False Claims Act: How the Materiality Standard Offers Protection after Escobar

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The False Claims Act (FCA), initially enacted in 1863 during the Civil War, was sponsored by the Lincoln administration to curtail the rampant fraud and excessive profiteering being perpetuated by government contractors, who,...more

Manatt, Phelps & Phillips, LLP

Health Update - November 2017

Fraud and Abuse 2017: Understanding Trends and Avoiding Actions - Editor’s Note: In a recent webinar for Bloomberg BNA, Manatt examined game-changing fraud and abuse trends and cases—and revealed strategies for avoiding...more

Arnall Golden Gregory LLP

“No Fraud at All:” Fifth Circuit Reverses $663 Million False Claims Act Jury Verdict Based on Government’s Actual Knowledge

On September 29, 2017, in United States ex rel. Harman v. Trinity Indus. Inc. (“Trinity”), the Fifth Circuit Court of Appeals reversed a $663 million jury verdict in a False Claims Act (FCA) case brought against Trinity...more

Robins Kaplan LLP

Your Daily Dose of Financial News

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Activist investor Carl Icahn has taken a sizeable stake in Bristol-Myers Squibb, a move that reportedly caught execs at the drugmaker unawares and sets the stage for a potential sale....more

McCarter & English, LLP

Universities Are Prime Targets for False Claims Act Liability

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Colleges and universities receive billions of dollars in federal funds, whether through research grants or student financial aid, or even by billing Medicare or Medicaid for services rendered at academic medical centers. As a...more

Skadden, Arps, Slate, Meagher & Flom LLP

"Escobar and the Implied Certification Theory: Initial Cases Raise the Bar on Materiality in False Claims Act Litigation"

On June 16, 2016, the U.S. Supreme Court in Universal Health Services, Inc. v. United States ex rel. Escobar1 (Escobar) unanimously upheld the implied certification theory of False Claims Act (FCA) liability and strengthened...more

Troutman Pepper

Materiality Is the New Condition of Payment: The Implied False Certification Theory After Escobar

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The Supreme Court has made it clear that, even at the pleadings stage, relators (or the government) must plead facts to support materiality with plausibility and particularity. For False Claims Act (FCA) defendants who...more

Sherman & Howard L.L.C.

SCOTUS Gives Fed Contractors Mixed Bag

Last week the U.S. Supreme Court issued an opinion that refines and re-defines liability for contractors accused of defrauding the Federal Government under the False Claims Act (“FCA”) in Universal Health Services, Inc. v....more

McAfee & Taft

Supreme Court ruling potentially expands false claims liability for healthcare providers

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In a much-anticipated decision, the U.S. Supreme Court ruled recently that the implied false certification theory may form the basis for liability under the False Claims Act (FCA), resolving a split of among the federal...more

Hinshaw & Culbertson LLP

Supreme Court Case Expands False Claims Act Liability

Summary of Decision - On June 16, 2016, the United States Supreme Court decided a case which could have significant impact on healthcare providers. In Universal Health Services Inc. v Escobar, the Court expanded...more

King & Spalding

Universal Health Services v. Escobar

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On Thursday of last week, the Supreme Court for the first time addressed the “implied certification” theory of liability under the False Claims Act. The Court ruled unanimously that the theory is valid in certain...more

Mintz

Supreme Court Adopts Implied False Certification Theory in Universal Health Services v. United States ex rel. Escobar But Imposes...

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On June 16, 2016, a unanimous Supreme Court issued its long-awaited decision in Universal Health Services v. United States ex rel. Escobar (“Escobar”). The Court ruled that under certain circumstances the theory of “implied...more

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