On June 1, 2023, the U.S. Supreme Court issued a decision in a consolidated appeal of two healthcare qui tam cases that removes a very powerful defense from defendants’ arsenal in False Claims Act (FCA) cases. In the healthcare space, defendants have often asserted that, where an applicable legal or regulatory standard—e.g., a reimbursement regulation or Local Coverage Determination—is ambiguous and open to more than one objectively reasonable interpretation, the required FCA element of scienter (a knowing state of mind) cannot be found as long as defendants’ actions were consistent with one reasonable interpretation of the standard. While the Supreme Court’s decision closes the door on this defense, now making it harder for defendants to assert that they did not knowingly violate the FCA, the decision still leaves the window open for defendants to assert a defense based on their sincerely held subjective belief at the time claims were made that their interpretation of the applicable standard was correct. This will have an immediate impact on healthcare FCA cases.
In its unanimous decision in United States ex rel. Schutte v. SuperValu, Inc., the Supreme Court ruled that scienter under the FCA hinges not on whether there existsan objectively reasonable alternative interpretation of an applicable ambiguous legal requirement, but instead, on whether the defendants actually believed the interpretation they adopted at...
Pakistan on April 22, Thursday urged the United Nations to call upon India to restore full implementation of the Indus Waters Treaty (IWT), warning that New Delhi’s “illegal” decision to hold the ...