There are still several unsettled legal issues regarding the standards applicable to a False Claims Act (FCA) claim, such as the standard to prove causation when an FCA claim is based on a violation of the Anti-Kickback Statute (AKS). The First Circuit recently weighed in on the issue and held that “but-for” causation is the appropriate causation standard.
In addition, after 14 years of litigation, a jury in the US District Court for the Central District of Illinois found that SuperValu, Inc., is not liable under the FCA. SuperValu will have a significant impact on FCA litigation, similar to that of the US Supreme Court’s materiality decision in Universal Health Servs. v. United States ex rel. Escobar, 579 US 176, 180 (2016).
US Court of Appeals for the First Circuit
In 2010, the Department of Health and Human Services amended the AKS so that a claim for payment by a federal healthcare program that includes items or services resulting from a violation of the AKS constitutes a false or fraudulent claim for purposes of the FCA. The courts have been faced with the task of interpreting what the words “resulting from” mean when determining whether an AKS violation is a false claim under the FCA.
The Third Circuit currently requires only a mere “link” between an alleged AKS violation and a subsequent claim. The Sixth and Eighth Circuits require a but-for causation. The First Circuit in a recent case sided with the Sixth and Eighth Circuits.
The First Circuit held that there is...
Overview: A recent ruling by the First Circuit Court of Appeals deepens the False Claims Act divide among circuit courts. Subscribe today to listen to this content A recent ruling by the First C...