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.
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
The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends.
Although DOJ brought in the second-highest number of settlements and judgments that the government has ever collected in a single year, the dollar value of
In 2022, the government continued to utilize the False Claims Act as its primary tool to combat fraud. Though the government’s recoveries at $2.2 billion were down compared to recent years, the government and whistleblowers were party to more than 350 settlements and judgments – the second-highest number of FCA settlements and judgments in a
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.
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
How much detail must a plaintiff allege to meet the heightened pleading standards that apply in an FCA case? Appellate courts have taken different approaches, but given a chance to address a seeming circuit split, the Supreme Court declined to clarify a standard.
On October 17, the Supreme Court denied the petitions for certiorari in