The Situation: The Supreme Court's ruling in Universal Health Services, Inc. v. U.S. ex rel. Escobar, 136 S. Ct. 1989 (2016), opened the door to more materiality defenses under the False Claims Act ("FCA"), but without making...more
3/4/2020
/ Defense Strategies ,
Deficit Reduction ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
False-Certification of Conformance ,
Materiality ,
Pharmaceutical Industry ,
Physician Medicare Reimbursements ,
Relators ,
Summary Judgment ,
Universal Health Services Inc v United States ex rel Escobar
The Decision: A divided Sixth Circuit panel held that allegations of submitting late-signed supporting documents to Medicare could plead False Claims Act ("FCA") materiality and scienter.
The Reasoning: Timing regulations...more
7/16/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Certification Requirements ,
Dismissals ,
En Banc Review ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
FRCP 9(b) ,
Materiality ,
Medicare ,
Pleading Standards ,
Qui Tam ,
Scienter ,
Signatures ,
Universal Health Services Inc v United States ex rel Escobar
The Situation: The False Claims Act imposes civil liability on any person or entity that "knowingly presents, or causes to be presented" to the U.S. government "a false or fraudulent claim for payment or approval."
The...more
1/25/2018
/ Conditions of Payment ,
Failure To Disclose ,
False Claims Act (FCA) ,
False Implied Certification Theory ,
Federal Contractors ,
Health Care Providers ,
Implied Certification ,
Materiality ,
Qui Tam ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar