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What can recent FCA decisions tell us about the Seventh Circuit pleading standard for health care billing fraud claims? | Thompson Coburn LLP

To embed, copy and paste the code into your website or blog: False Claims Act (“FCA”) complaints are subject to the heightened pleading requirements of Rule 9(b), Universal Health Servs., Inc. v. United States, 136 S. Ct. 1989, 2004, 195 L. Ed. 2d 348 (2016). But circuits are split on whether that requirement should be relaxed for relators, or whistleblowers, who lack direct access to the alleged fraud.  The Fourth, Eighth, and Eleventh circuits seemingly apply Rule 9(b) more rigidly, while the First, Third, Fifth, Sixth, Seventh, Ninth and Tenth circuits have a more flexible approach. In 2019, the U.S. Supreme Court was expected to resolve this split, but before the Court issued its decision, the parties settled, leaving the circuit split in place. In this article, we examine recent decisions that illustrate a possible shift in the Seventh Circuit’s pleading standard.

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