News & Analysis as of

Conditions of Payment Health Care Providers Healthcare Fraud

Farrell Fritz, P.C.

New York Court of Appeals Rules that an Insurer May Withhold Payments to a Medical Service Corporation Improperly Controlled by...

Farrell Fritz, P.C. on

On June 11, the New York Court of Appeals, in Andrew Carothers, M.D., P.C. v. Progressive Insurance Company, 2019 NY Slip Op 04643, decided that an insurer may withhold payment for services provided by a medical services...more

Akerman LLP - Health Law Rx

Florida Federal Court: Escobar Requires Reversal of $348 Million False Claims Act Jury Verdict

The United States District Court for the Middle District of Florida vacated a large jury verdict in a False Claims Act case against the owners and operators of nursing homes because the evidence did not satisfy the...more

Troutman Pepper

Lessons From a Year of Escobar

Troutman Pepper on

It has been one year since the U.S. Supreme Court’s landmark ruling in Universal Health Services v. United States ex rel. Escobar, which resolved a circuit split as to the validity of the implied false certification theory...more

Farrell Fritz, P.C.

“Implied Certification” Theory Allowed Under the False Claims Act

Farrell Fritz, P.C. on

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

Burr & Forman

The Materiality Standard In False Claims Actions

Burr & Forman on

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

Troutman Pepper on

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

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