On April 18, 2023, the Supreme Court of the United States heard arguments as to whether subjective intent is relevant in assessing scienter in a False Claims Act (FCA) case. The Supreme Court will assess the FCA's standard for scienter, or knowledge of wrongdoing, which is an important factor that determines countless cases. "Knowingly" is defined as "actual knowledge," "deliberate ignorance" or "reckless disregard" in the context of FCA cases. The Court will determine in this case whether the billing of medication that reasonably interpreted ambiguous policies can be considered fraudulent if the billers never believed their interpretations were correct.
The plaintiff raises the concern that an interpretation leaving out subjective intent will incentivize defense attorneys to mine the U.S. code to potentially exploit ambiguities.
This FCA case, brought by a whistleblower against retailers SuperValu and Safeway for allegedly overcharging taxpayers for generic drugs, was rejected in the Seventh Circuit as well as the lower trial court. The whistleblower, Thomas Proctor, a pharmacist at Safeway, alleged that Safeway was aware of its overbilling in prescription drug programs. Proctor alleged that Safeway would discount generic drugs for cash customers to price match other competitors. Then, it would bill the government for a higher, nondiscounted rate, thereby obtaining reimbursement in excess of the amount actually charged to the customer. Safeway would cite the higher rate...
When a company promises to save the planet by 2050, it sounds reassuring. But what if that promise comes with no real plan, no credible evidence, and no accountability? A sweeping new study reveal...