News & Analysis as of

Material Misrepresentation Health Care Providers

Orrick, Herrington & Sutcliffe LLP

State Attorneys General Newsletter – September 2021

Wisconsin Attorney General Hires Plaintiff’s Firm to Initiate PFAS Lawsuit Wisconsin Attorney General Josh Kaul announced that he has hired an outside plaintiff’s firm, Sher Edling LLP, to bring a lawsuit against...more

PilieroMazza PLLC

Learn from Others' Mistakes and Avoid an FCA Claim

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The recent settlement reached by International Business Machines Corporation (IBM), Cúram Software Ltd. (Cúram), and the Department of Justice provides a useful lesson for government contractors—especially contractors in the...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

Jones Day

False Claims Act's "Rigorous" Materiality Standard Enforced by Second Circuit

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The Situation: A decision by the U.S. Court of Appeals for the Second Circuit reinforces the growing body of case law regarding the strict materiality requirements of the False Claims Act. The Result: Coyne v. Amgen is...more

Sheppard Mullin Richter & Hampton LLP

Escobar: Year One

Universal Health Services, Inc. v. U.S. ex rel. Escobar, 136 S. Ct. 1989 (2016) was a landmark case in FCA jurisprudence. In Escobar, the Supreme Court held that the implied false certification theory can be a basis for...more

Saul Ewing LLP

Implied Certification Theory Loses Some of Its Fangs, but Is Another False Claims Act Theory Lurking Just Around the Corner?

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Federal courts across the country are wrestling with the uncertainty caused by the Supreme Court’s holding in Universal Health Services, Inc. v. United States ex rel. Escobar regarding the requirements to state an implied...more

Jones Day

Sixth Circuit: Technical Physician Signature Deficiencies not "Material" to Reimbursement Claims

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The District Court for the Middle District of Tennessee held on June 22, 2017, that the timing requirements related to a physician's certification of need for home health services were not "material" to the Centers for...more

Manatt, Phelps & Phillips, LLP

Escobar's Impact: Recent Application of "Materiality" in Ninth Circuit

Last year, a unanimous U.S. Supreme Court decided Universal Health Services, Inc. v. United States ex rel. Escobar (Escobar), 136 S.Ct. 1989 (2016), creating important implications for Federal False Claims Act (FCA) cases...more

Farrell Fritz, P.C.

“Implied Certification” Theory Allowed Under the False Claims Act

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The Supreme Court recently allowed liability through the implied certification theory of the False Claims Act (FCA), which was raised and upheld in Universal Health Services, Inc. v. United States ex rel. Escobar. The...more

WilmerHale

Materiality Under FCA: The Lower Courts Grapple With Escobar’s Meaning

WilmerHale on

The Supreme Court’s decision in Universal Health Services v. Escobar ex rel. United States sought to clarify the standard for materiality under the False Claims Act, but lower courts have already begun to adopt different...more

Bass, Berry & Sims PLC

On Remand, First Circuit Finds Violations in Escobar Were Material

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In June, the Supreme Court issued Universal Health Services, Inc. v. U.S. ex rel. Escobar, a landmark opinion in which the Supreme Court addressed the standard for pleading materiality in FCA implied certification cases. The...more

Burr & Forman

The Materiality Standard In False Claims Actions

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The Supreme Court decided Universal Health Services v. U.S. ex rel. Escobar on June 16, 2016 in which it ruled the implied false certification theory, previously recognized in several circuits, can form the basis for False...more

Troutman Pepper

US Supreme Court False Claims Act Decision in Escobar Has Significant Implications for Contractors

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On June 16, 2016, the U.S. Supreme Court ruled in the matter of Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016), changing the legal landscape for False Claims Act qui tam claims...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

Parker Poe Adams & Bernstein LLP

Implied False Certification Theory as Basis for FCA Liability Endorsed by Supreme Court with Limits

In a recent and highly anticipated opinion that will significantly affect healthcare providers and other government contractors, the U.S. Supreme Court unanimously ruled that the “implied false certification theory” is a...more

Dorsey & Whitney LLP

Implied Certification, Escobar, and the Impact on Healthcare Providers

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On June 16, 2016, the Supreme Court issued a unanimous decision in Universal Health Services, Inc. v. United States ex rel. Escobar upholding the “implied certification” theory of liability under the False Claims Act (“FCA”)...more

Akerman LLP - Health Law Rx

What does the Escobar Decision Mean for Healthcare Providers?

On June 16, 2016, the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel Escobar, No. 13-317, — S. Ct. — (June 16, 2016), confirmed that the implied certification theory may serve as a basis for...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

Polsinelli

Supreme Court Rejects Government's FCA Implied Certification Theory

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The Supreme Court of the United States in Universal Health Services, Inc. v. Escobar et al., weighed in on and embraced the implied certification theory of liability within the False Claims Act (FCA)....more

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