On June 16, 2023, the Supreme Court in United States ex rel. Polanksy v. Executive Health Resources, affirmed the Third Circuit’s deferential standard regarding the government’s ability to dismiss False Claims Act (FCA) whistleblower cases being litigated by qui tam relators.  Notwithstanding this deferential standard, the Court rejected the government’s position that it has

On June 1, 2023, in U.S. ex rel. Schutte v. SuperValu Inc., the Supreme Court clarified the state-of-mind (or “scienter”) standard under the False Claims Act (FCA), holding that a defendant’s subjective belief that a claim was false was sufficient to establish the FCA’s scienter element. In doing so, the Court rejected the Seventh

On May 3, 2023, the Seventh Circuit affirmed $10 million in insurance coverage for a False Claims Act (FCA) settlement in a case based on alleged Anti-Kickback Statute violations. Astellas US Holding, Inc. v. Federal Insurance Company concerns a settlement of an investigation into whether a pharmaceutical manufacturer’s sponsorship of patient assistance plans violated the

Last week, the Sixth Circuit closed two paths the government and relators have tried to take to expand liability for medical providers under the Anti-Kickback Statute (AKS) and False Claims Act (FCA): the meaning of “remuneration” under the AKS and the causation standard for AKS-based FCA claims.

Key Takeaways

The AKS, which prohibits referrals in

Sen. Chuck Grassley (R-Iowa) recently criticized “activist judges” for rewriting the text of the False Claims Act to achieve their own policy goals, revealing plans to reintroduce legislation that would correct “unduly restrictive” interpretations of the statute and expand liability for defendants.

Grassley — who delivered his remarks in a pre-recorded keynote speech at the

In what may lead to the biggest FCA opinion in recent history, the U.S. Supreme Court earlier this month agreed to consider two cases addressing the necessary state of mind (i.e., “scienter”) to violate the FCA.

Background

The FCA prohibits defendants from knowingly submitting false claims. That scienter standard is broader than just actual knowledge.

The First Circuit gave defendant AthenaHealth something extra to celebrate this past holiday season when on December 21, 2022, in United States ex rel. Lovell v. AthenaHealth, Inc., it denied relators’ claims for over $1 million in attorneys’ fees in an appeal involving two issues of first impression.

AthenaHealth was a consolidated appeal involving

On December 6, 2022, the Supreme Court heard oral argument in United States ex rel. Polansky v. Executive Health Resources, Inc. As previously reported, this case raises whether the government has the authority to dismiss a False Claims Act (FCA) qui tam suit after it initially declined to proceed with its own action and