News & Analysis as of

Qui Tam Medicaid False Implied Certification Theory

Bricker Graydon LLP

Mental health provider faces False Claims Act lawsuit due to alleged unlicensed, untrained and unsupervised personnel

Bricker Graydon LLP on

After a federal judge denied its motion to dismiss the case, a Massachusetts mental health provider, formerly known as South Bay Mental Health Center, Inc. (South Bay), faces claims under the federal False Claims Act and the...more

Mintz - Health Care Viewpoints

Implied False Certification Theory Fails in FCA Case Against Billing Agent

A court in the Southern District of New York (“SDNY” or the “Court”) recently released an important decision applying the Supreme Court’s landmark Escobar ruling to a qui tam action involving percentage fee arrangements for...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

Manatt, Phelps & Phillips, LLP

Corporate Investigations and White Collar Defense - July 2016

“Official Acts”—What They Are… and Are Not - Why it matters: On June 27, 2016, the Supreme Court decided McDonnell v. U.S., holding that, for purposes of the federal public corruption statutes, an “official act”...more

Williams Mullen

Risk and Uncertainty for Health Care Providers and Government Contractors in the Wake of Universal Health Services v. Escobar

Williams Mullen on

The Supreme Court’s decision in the closely watched case of Universal Health Services, Inc. v. United States ex rel. Escobar, decided on June 16, 2016, provides a long-awaited interpretation of the False Claims Act (“FCA”)...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

Alston & Bird

The Supreme Court Weighs In on the Implied Certification Theory of False Claims Act Liability

Alston & Bird on

The Supreme Court has handed the Department of Justice and qui tam relators a bigger hammer to wield against government contractors with its opinion in Universal Health Services, Inc. v. United States ex rel. Escobar,...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

Patterson Belknap Webb & Tyler LLP

Supreme Court Endorses Implied Certification Theory of Liability But Establishes “Demanding” Materiality Standard Under the False...

Yesterday, the United States Supreme Court decided Universal Health Services, Inc. v. United States ex rel. Escobar et al., holding that the so-called “implied certification” theory is viable under the False Claims Act...more

Dorsey & Whitney LLP

Supreme Court Upholds Implied Certification Theory of Liability; Imposes Limitations on its Reach

Dorsey & Whitney LLP on

In a unanimous decision on June 16, 2016, the Supreme Court charted a middle course between competing interpretations of the scope of False Claims Act. Universal Health Servs., Inc. v. United States ex rel. Escobar, Case No....more

Morgan Lewis

US Supreme Court Hears Oral Argument on Viability of FCA’s Implied Certification Theory

Morgan Lewis on

In qui tam case, Supreme Court oral argument addresses practical implications of limiting the scope of the implied certification theory of liability under the FCA....more

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