The 11th Circuit’s long-awaited AseraCare opinion requires more than mere disagreement regarding clinical judgment to prove falsity under the False Claims Act.
The 11th Circuit rejected the government’s theory of falsity in its long-running False Claims Act (FCA) case against long-term care provider AseraCare Inc. The 11th Circuit affirmed the lower court’s ruling that mere clinical disagreement was insufficient to establish falsity under the FCA. The court kept the case alive, however, by remanding to provide the government an opportunity to present additional evidence of falsity. The 57-page opinion persuasively explains why a disagreement regarding “clinical judgment does not reflect an objective falsehood” and should help FCA defendants prevail in cases premised on a post hoc review of a provider’s clinical judgment.
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