Materiality

News & Analysis as of

Distinguishing ‘collateral lies’ from the fraudulent claims rules in insurance contracts: the lie is dishonest but the claim is...

In Versloot Dredging BV and another v HDI Gerling Industrie Versicherung AG and others [2016] UKSC 45, handed down, last month, the Supreme Court ruled that a “collateral lie” made during the course of an insurance claim...more

Tenth Circuit Holds that the False Claims Act’s Materiality Requirement Has Teeth in Granting Summary Judgment to Government...

On April 22, 2016, in a decision issued before the Supreme Court’s Escobar opinion, the Tenth Circuit addressed the question of what a relator must show to meet the materiality requirement in an implied false...more

Health Update - July 2016

The Vulnerability of Healthcare Information - According to a report the Brookings Institute issued in May 2016, 23% of all data breaches occur in the healthcare industry. Nearly 90% of healthcare organizations had some...more

Representations & Warranties Insurance: Understanding the Underwriting Process, Timeline, and Key Coverage Terms

The use of representations and warranties insurance is becoming increasingly commonplace in M&A transactions, particularly in competitive auction processes where use of the product has become almost ubiquitous. While much has...more

U.S. Supreme Court Rules in Favor of Implied Certification Using a Fact-Intensive Materiality Standard

The legal landscape for False Claim Act (“FCA”) cases recently shifted when the United States Supreme Court announced its decision in Universal Health Services, Inc. v. U.S. ex rel Escobar, No. 15-7, 2016 WL 3317565 (U.S....more

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

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

Proposed SEC Rules Modernize Mining Disclosures Using Canadian Rules as the Gold Standard

On June 16, 2016, the U.S. Securities and Exchange Commission proposed a set of comprehensive mining disclosure rules with the stated intent of “aligning such rules with current industry and global regulatory practices and...more

Understanding the SEC’s Proposed New Mining Disclosure Rules: Questions and Answers

On June 16, 2016, the SEC proposed a major overhaul of the disclosure requirements for companies that are engaged in material mining operations, including royalty companies. The proposed rules would replace the SEC’s...more

Risk and Uncertainty for Health Care Providers and Government Contractors in the Wake of Universal Health Services v. Escobar

The Supreme Court’s decision in the closely watched case of Universal Health Services, Inc. v. United States ex rel. Escobar, decided on June 16, 2016, provides a long-awaited interpretation of the False Claims Act (“FCA”)...more

An Expanding Universe of Healthcare Provider Liability: The United States Supreme Court Endorses “Implied False Certification”...

Seyfarth Synopsis: In Universal Health Services Inc. v. U.S. et al. ex rel. Escobar et al., the United States Supreme Court found a healthcare provider liable under the False Claims Act (“FCA”) for material omissions on...more

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

Implied Certification, Escobar, and the Impact on Healthcare Providers

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

In Wake of Escobar, Cases Return to Circuit Courts

On Monday, the U.S. Supreme Court issued summary dispositions vacating the judgments in three cases brought under the False Claims Act (“FCA”). The Court remanded the cases back to their respective circuit courts for...more

Health Care Providers Operating in a Material World

Health care providers beware – the United States Supreme Court may have just equipped federal authorities with another tool for pursuing false or fraudulent claims billed to Medicare or Medicaid under the False Claims Act...more

Supreme Court Validates “Implied Certification” Liability Under False Claims Act

The U.S. Supreme Court issued its decision on June 16, 2016, in Universal Health Services v. United States ex rel. Escobar, No. 15-7, a case the government contractor and health care communities hoped the Court would use to...more

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

Supreme Court Recognizes Implied Certification Claims, With Limits

On June 16, 2016, the Supreme Court issued an opinion in Universal Health Services v. United States ex rel. Escobar, a case in which the court evaluated the viability of the “implied certification” theory of liability under...more

Supreme Court Endorses Implied Certification Theory under False Claims Act—“At least in some circumstances”

On June 16, 2016, the Supreme Court of the United States issued a unanimous opinion addressing the scope and reach of the False Claims Act (“FCA”). Universal Health Services, Inc. v. United States et al. ex rel. Escobar et...more

Supreme Court ruling potentially expands false claims liability for healthcare providers

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

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

Universal Health Services: contractors take note - Supreme Court approves implied certification theory of False Claims Act...

In a unanimous ruling handed down last week, the US Supreme Court settled an existing circuit split in favor of those seeking to expand the False Claims Act’s reach by recognizing the “implied certification” theory as a valid...more

Health Care Provider Alert: Supreme Court Issues Landmark Ruling on False Claims Act

The Supreme Court has reached a significant decision that will substantially affect health care billing, but in an effort to breed uniformity, the Court appears to have actually facilitated even greater uncertainty. Last...more

Universal Health Services v. Escobar

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

SCOTUS Upholds Implied Certification for Some Cases But Imposes “Rigorous Materiality Requirement” for FCA Liability

The decision in Universal Health upholds implied certification but strengthens False Claims Act defendants’ ability to mount a materiality defense. On June 16, 2016 the U.S. Supreme Court issued a unanimous decision in...more

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

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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