In its June 16 Universal Health Services v. Escobar decision, the U.S. Supreme Court resolved a circuit split on the viability and proper scope of the implied certification theory of legal falsity under the U.S. False Claims Act. The unanimous opinion rejected the condition of payment analysis and adopted a rigorous materiality standard for analyzing FCA cases premised on underlying regulatory or contractual violations.
With their treble damages and statutory penalties, qui tam FCA lawsuits represent a significant and growing risk for large health care providers that submit thousands or millions of Medicare and Medicaid claims per year.
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