News & Analysis as of

Objective Falsity False Claims Act (FCA)

Health Care Compliance Association (HCCA)

The compliance lessons in the wake of the Supreme Court decision in U.S. ex rel Schutte v. SuperValu, Inc.

The False Claims Act (FCA) permits private individuals to bring lawsuits in the name of the United States—called qui tam—against those they believe have defrauded the federal government: 31 U.S.C. § 3730(b). The FCA thereby...more

Bradley Arant Boult Cummings LLP

False Claims Act - 2023 Year in Review

As we do every year, this issue revisits the key cases and other developments from the year gone by. And by most metrics, 2023 was a notable year for the False Claims Act (FCA). We start with the numbers: The Department...more

Bradley Arant Boult Cummings LLP

Bipartisan Senate Bill Seeks To Weaken the False Claims Act’s Materiality Standard

On July 25, 2023, U.S. Senator Chuck Grassley (R-IA), introduced a bill that aims to, among other things, make it easier for the government to satisfy the False Claims Act’s materiality requirement when the government has...more

Bass, Berry & Sims PLC

Controlled Substances Act and False Claims Act Collide

Bass, Berry & Sims PLC on

The United States recently intervened in a False Claims Act lawsuit accusing Rite Aid of defrauding federal healthcare programs by seeking reimbursement for opioids the pharmacy allegedly dispensed in violation of the...more

Latham & Watkins LLP

Supreme Court Holds FCA Liability Hinges on Defendants’ Subjective Beliefs as to Falsity

Latham & Watkins LLP on

The Court unanimously held that a defendant’s subjective belief is relevant to scienter under the False Claims Act, even when a defendant’s conduct is consistent with an objectively reasonable interpretation of the law. ...more

Venable LLP

Yes, Contractors and Providers, What You Think Matters - U.S. Supreme Court Unanimously Holds That Defendants' Subjective Beliefs...

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On June 1, 2023, the U.S. Supreme Court issued a unanimous opinion in United States ex rel. Schutte v. SuperValu Inc. reversing a pair of False Claims Act (FCA) cases on review from the Seventh Circuit Court of Appeals. In...more

WilmerHale

Supreme Court Holds That False Claims Act Requires Subjective Inquiry

WilmerHale on

On June 1, 2023, the Supreme Court decided a pair of closely watched False Claims Act (FCA) cases, U.S. ex rel. Schutte v. SuperValu Inc., No. 21-1326, and U.S. ex rel. Proctor v. Safeway, Inc., No. 22-111....more

WilmerHale

High Court Hears Important Case on False Claims Act’s Scienter

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On April 18, the Supreme Court heard oral argument and what has been billed as the most important False Claims Act (FCA) case in a decade. Since the FCA was enacted in the Civil War era, it has been the primary tool for the...more

Holland & Knight LLP

"Hard Cases:" Supreme Court Hears Arguments on FCA Scienter Issue

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The U.S. Supreme Court on April 18, 2023, heard oral arguments on a critical issue in False Claims Act (FCA) cases – the defendant's state of mind (i.e., scienter). The statute ascribes liability to anyone who "knowingly"...more

Kohn, Kohn & Colapinto LLP

The Government’s Ability to Combat Fraud is on the Line in False Claims Act Supreme Court Case

Oral arguments are scheduled for April 18, 2023, in the Supreme Court case combining two Seventh Circuit Court of Appeals cases U.S. ex rel. Schutte v. SuperValu, Inc. (“SuperValu”) and U.S. ex rel. Thomas Proctor v. Safeway,...more

WilmerHale

Supreme Court To Decide Significant Case on False Claims Act's Scienter Standard

WilmerHale on

On January 13, 2023, the Supreme Court granted certiorari in a pair of consolidated cases from the Seventh Circuit that could result in one of the most consequential False Claims Act (FCA) decisions since the FCA was amended...more

Bass, Berry & Sims PLC

Medicare Advantage Plan Highlights Distinction for FCA Purposes between Clinically Inaccurate Diagnoses and Clinically Accurate...

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In a September 2022 filing in U.S. ex rel. Osinek v. Kaiser Permanente, the Kaiser Permanente consortium defendants (Kaiser) highlighted the distinction between clinically inaccurate diagnoses (factual falsity) and clinically...more

Venable LLP

Eighth Circuit Curtails False Claims Act Liability Premised on Anti-Kickback Statute Violations

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​​​​​​​Last week the Eighth Circuit Court of Appeals offered defendants in False Claims Act cases based on Anti-Kickback Statute (AKS) violations a significant new defense in its holding in United States ex rel. Cairns v....more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: What Is a False Claim?

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The False Claims Act, despite its name, does not define what it means for a claim to be “false” or “fraudulent.” This post examines the primary ways courts have interpreted the False Claims Act’s falsity element and discusses...more

Bass, Berry & Sims PLC

False Claims Act Fundamentals: Elements of the False Claims Act

The False Claims Act, 31 U.S.C. § 3729, et seq. is the federal government’s primary and most effective tool for fighting fraud. This post provides an overview of the elements that plaintiffs must satisfy to establish...more

Venable LLP

The Fourth Circuit enforces Safeco's rigorous, objective scienter requirement for Civil False Claims in Sheldon

Venable LLP on

On January 25, in United States ex rel. Sheldon v. Allergan, No. 20-2330 (4th Cir., Jan. 25, 2022), the United States Court of Appeals for the Fourth Circuit upheld a lower-court dismissal of a False Claims Act (FCA) case...more

Jones Day

Supreme Court Declines to Resolve Circuit Split on Falsity Under the FCA

Jones Day on

The Situation: In March 2020, the Third and Ninth Circuits held, in two cases in which the government had declined to intervene, that a mere difference of medical opinion may be enough to satisfy the falsity element of the...more

Snell & Wilmer

California Construction Law Update for 2021

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In the 2020 COVID-19 year, there were not that many construction-related cases decided by the California Courts of Appeal, and none by the California Supreme Court. However, there were a number of interesting cases that raise...more

McDermott Will & Emery

[Webinar] Providers and Healthcare Enforcement in 2021: Biden, COVID-19 and FCA Updates Impacting Your Business - April 12th, 1:00...

The large volume of relief funding distributed by the government in connection with the COVID-19 pandemic will be the source of enforcement and regulatory scrutiny for years to come. During this webinar – the first in a...more

Jackson Lewis P.C.

SCOTUS Declines To Decide Whether Objective Falsity Is Required To Establish Liability Under FCA

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The question of whether the False Claims Act (FCA) requires a showing of objective falsity will continue to divide the circuit courts following the U.S. Supreme Court’s decision not to address the issue. To establish...more

Dorsey & Whitney LLP

Supreme Court Declines to Resolve Circuit Split Regarding Standard for “Falsity” in FCA Claims

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On February 22, 2021, the United States Supreme Court declined to resolve a circuit split regarding the proper standard under which False Claims Act (“FCA”) claims in the medical context should be reviewed. See Care...more

Wiley Rein LLP

Can Anyone Say What’s False Anymore? SCOTUS Denial of Cert Leaves Uncomfortable Uncertainty and Strategic Opportunities

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It should surprise absolutely no one that “falsity” is a core element of the False Claims Act – it is the FALSE Claims Act, after all. However, it may come as a surprise that there is substantial disagreement over what...more

McGuireWoods LLP

U.S. Supreme Court Declines to Clarify False Claims Act Falsity Standard

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The U.S. Supreme Court recently declined to address a circuit split regarding the standard for establishing that a statement material to a claim for payment is false under the False Claims Act (FCA); specifically, whether the...more

Nelson Mullins Riley & Scarborough LLP

Supreme Court Declines Request to Address False Claims Act Liability For Medically Unnecessary Services

The Supreme Court of the United States declined to take up two circuit court decisions on whether “objective falsity” is a requirement for False Claims Act (FCA) liability. The two cases, United States v. Care Alternatives...more

ArentFox Schiff

Investigations Newsletter: Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act

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Supreme Court Declines to Review Issue of “Objective Falsity” Under False Claims Act - On February 22, 2021, the United States Supreme Court denied petitions for certiorari in a case that could have addressed the issue of...more

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