The Situation: Courts have disagreed over whether Universal Health Services, Inc. v. Escobar, 136 S. Ct. 1989 (2016), announced a mandatory test for implied certification liability under the False Claims Act ("FCA").
The...more
The Situation: A provision in the False Claims Act ("FCA") had clarified when Anti-Kickback Statute ("AKS") violations can make a claim false, but the provision's rule of per se falsity does not answer when a claim "result[s]...more
2/1/2018
/ Anti-Kickback Statute ,
Appeals ,
Charitable Donations ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medicare ,
Physicians ,
Relators ,
Stark Law ,
Summary Judgment
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
1/15/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Conditions of Payment ,
Failure To Disclose ,
False Claims Act (FCA) ,
Health Care Providers ,
Implied Certification ,
Material Misrepresentation ,
Materiality ,
Motion to Dismiss ,
Prescription Drugs ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar
The Situation: In Spay v. CVS Caremark Corp., the Third Circuit became the latest court of appeals to hold that, in False Claims Act litigation, scienter can be lacking when the government has knowledge of "the facts...more
11/28/2017
/ Acquiescence ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
False Statements ,
Government Knowledge Defense ,
Material Misstatements ,
Materiality ,
Medicare Part D ,
Prescription Drugs ,
Scienter ,
SCOTUS ,
Universal Health Services Inc v United States ex rel Escobar