A recent Ninth Circuit decision did not foreclose the government’s case because the government alleged incentives to increase both the value and volume of prescriptions, regardless of patient need.
The federal government sufficiently pleaded violations of the Anti-Kickback Statute (AKS), 42 U.S.C. § 1320a-7b(b), in connection with an allegedly unlawful referral scheme for compounded prescriptions, held the federal district court in Las Vegas, Nevada. The complaint contained sufficient factual matter about unnecessary medications, accepted as true, to state a facially plausible and particularized claim. The complaint contained enough details of false claims, paired with reliable indicia, to draw an inference that false claims were actually submitted and to provide sufficient notice to defend. Among other details, the pharmacy and its owners allegedly had scienter to the extent they did not collect TRICARE and CHAMPVA copays. The complaint also pleaded a quid pro quo arrangement providing the necessary link element under the AKS. Congruent with a recent Ninth Circuit decision, the government alleged incentives to increase both the value and volume of prescriptions, regardless of patient need. Apart from dismissal of the unjust enrichment claim, where the AKS provides an adequate remedy at law, the court denied the responding pharmacy parties’ motion to dismiss (United States of America v. PCPLV LLC, No. 2:21-cv-00184-GMN-DJA (D. Nev. Jan. 13, 2026)).
Background. The federal...
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