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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 FCA requires pleading and proof of an “objectively false statement,” or whether liability can be based on allegedly false opinions. While the Courts of Appeals have taken conflicting positions on these issues, the circuit split is not as deep as would appear and the variation in standards are likely to have a minimal impact on ultimate outcomes. Nevertheless, with these varying standards for establishing falsity, healthcare providers and government contractors should take proactive steps to ensure signed certifications pertinent to a claim reflect appropriate diligence and decision-making and convey reasonably and honestly held opinions.
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The Supreme Court denied a closely watched petition to review the Third Circuit s decision in
United States ex rel. Druding v. Care Alternatives, a False Claims Act (FCA) case that created a circuit split around whether and when a medical opinion can be false. [1] On the heels of this denial, health care providers should take stock of how the Third Circuit s decision lowers the bar for the government and
qui tam relators to survive summary judgment in cases involving clinical decision-making.
District Court Proceedings[2]
The relators filed a
For several years, courts have wrestled with the question of whether subjective clinical decisions regarding the type and amount of treatment patients may need can be false for purposes.
Justices Should Weigh In On FCA Objective Falsity Standard | Bradley Arant Boult Cummings LLP jdsupra.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from jdsupra.com Daily Mail and Mail on Sunday newspapers.