On January 13, 2023, the Supreme Court granted a writ of certiorari to petitioners in two False Claims Act cases to determine whether the False Claims Act’s knowledge requirement reaches defendants who can offer an “objectively reasonable” interpretation of an ambiguous legal or contractual requirement material to government payment. The Court’s decision will likely be one of the most significant FCA decisions in decades, and it will have important implications for government contractors and healthcare providers whose businesses require compliance with complex and sometimes opaque regulatory regimes.
The FCA provides for liability for a defendant that “knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval.” 31 USC § 3729 (a)(1). Knowingly is defined in the act as acting with (1) “actual knowledge” of the falsity, (2) “deliberate ignorance of the truth”, or (3) “reckless disregard of the truth”. 31 USC § 3729 (b)(1). Two recent Seventh Circuit decisions, U.S. ex rel. Schutte v. SuperValu Inc.[1]and U.S., Ex Rel. Proctor v. Safeway, Inc.,[2] held that the defendants were not liable under the FCA because they did not act “knowingly” since they had offered in litigation “objectively reasonable” (if not accurate) interpretations of the complex Medicare and Medicaid prescription drug pricing schemes at issue (involving accurate reporting of “Usual and Customary” pricing to ensure government payors receive the benefits of discounts...
Patricia White, 70, of Old Greenwich, received a nine-month prison sentence for submitting false claims for unclaimed properties to around 30 state treasuries. HARRISBURG, Pa. — Months after her br...