News & Analysis as of

Material Misrepresentation Medicaid

Morgan Lewis

Federal Court Strikes Massive False Claims Act Verdict Following Landmark Escobar Ruling

Morgan Lewis on

The ruling in Universal Health Services, Inc. v. Escobar "rejects a system of government traps, zaps, and zingers that permits the government to retain the benefit of a substantially conforming good or service but to recover...more

Alston & Bird

Implied False Certification Liability Under the False Claims Act: How the Materiality Standard Offers Protection after Escobar

Alston & Bird on

The False Claims Act (FCA), initially enacted in 1863 during the Civil War, was sponsored by the Lincoln administration to curtail the rampant fraud and excessive profiteering being perpetuated by government contractors, who,...more

Manatt, Phelps & Phillips, LLP

Escobar's Impact: Recent Application of "Materiality" in Ninth Circuit

Last year, a unanimous U.S. Supreme Court decided Universal Health Services, Inc. v. United States ex rel. Escobar (Escobar), 136 S.Ct. 1989 (2016), creating important implications for Federal False Claims Act (FCA) cases...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

WilmerHale

Materiality Under FCA: The Lower Courts Grapple With Escobar’s Meaning

WilmerHale on

The Supreme Court’s decision in Universal Health Services v. Escobar ex rel. United States sought to clarify the standard for materiality under the False Claims Act, but lower courts have already begun to adopt different...more

McCarter & English, LLP

Universities Are Prime Targets for False Claims Act Liability

McCarter & English, LLP on

Colleges and universities receive billions of dollars in federal funds, whether through research grants or student financial aid, or even by billing Medicare or Medicaid for services rendered at academic medical centers. As a...more

Bass, Berry & Sims PLC

On Remand, First Circuit Finds Violations in Escobar Were Material

Bass, Berry & Sims PLC on

In June, the Supreme Court issued Universal Health Services, Inc. v. U.S. ex rel. Escobar, a landmark opinion in which the Supreme Court addressed the standard for pleading materiality in FCA implied certification cases. 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

WilmerHale

Pratt's Government Contracting Law Report

WilmerHale on

In a unanimous decision, the U.S. Supreme Court recently upheld the “implied certification” theory of liability under the False Claims Act, while emphasizing that only material misrepresentations are actionable. In this...more

Troutman Pepper

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

Troutman Pepper on

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

Parker Poe Adams & Bernstein LLP

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

Dorsey & Whitney LLP

Implied Certification, Escobar, and the Impact on Healthcare Providers

Dorsey & Whitney LLP on

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

Poyner Spruill LLP

Health Care Providers Operating in a Material World

Poyner Spruill LLP on

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

Stinson LLP

Contactors Beware: New Supreme Court Decision on False Claims Act

Stinson LLP on

The Supreme Court recently issued a decision in Universal Health Services v. United States ex rel. Escobar, and construction contractors should take note in order to better understand the broad reach of liability and hefty...more

Sherman & Howard L.L.C.

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

Akerman LLP - Health Law Rx

What does the Escobar Decision Mean for Healthcare Providers?

On June 16, 2016, the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel Escobar, No. 13-317, — S. Ct. — (June 16, 2016), confirmed that the implied certification theory may serve as a basis for...more

McAfee & Taft

Supreme Court ruling potentially expands false claims liability for healthcare providers

McAfee & Taft on

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

Hinshaw & Culbertson LLP

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

Polsinelli

Supreme Court Rejects Government's FCA Implied Certification Theory

Polsinelli on

The Supreme Court of the United States in Universal Health Services, Inc. v. Escobar et al., weighed in on and embraced the implied certification theory of liability within the False Claims Act (FCA)....more

King & Spalding

Universal Health Services v. Escobar

King & Spalding on

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

Mintz

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

Mintz on

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

Epstein Becker & Green

Supreme Court Rejects Government’s Expansive View of FCA Liability but Endorses Implied Certification Theory (with Limits)

Epstein Becker & Green on

On June 16, 2016, the Supreme Court of the United States rendered a unanimous decision in the highly anticipated False Claims Act (“FCA”) case of Universal Health Services, Inc. v. United States ex rel. Escobar.[1] In its...more

Morrison & Foerster LLP

Universal Health: The Supreme Court Approves Implied Certification; Focus on Materiality Provides a Mixed Blessing to Defendants...

On June 16, 2016, a unanimous Supreme Court blessed the implied false certification theory of False Claims Act (FCA) liability, resolving a circuit split on the theory’s legitimacy. The Court held that implied certification...more

Skadden, Arps, Slate, Meagher & Flom LLP

"In Escobar, Supreme Court Upholds False Claims Act’s Implied Certification Theory"

On June 16, 2016, the U.S. Supreme Court in Universal Health Services v. United States ex rel. Escobar unanimously upheld the implied certification theory of False Claims Act (FCA) liability. The Court ruled that a party can...more

Mintz - Health Care Viewpoints

The Supreme Court Adopts Broad Scope of False Claims Act Liability

A unanimous Supreme Court issued its long-awaited and closely watched decision today on the scope of the False Claims Act (“FCA”), and the Court affirmed the FCA’s long reach. Universal Health Services, Inc. v. United States...more

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