On Thursday, the U.S. Supreme Court issued a decision that recognizes implied certification as a viable theory under which to pursue False Claims Act cases against healthcare providers. Implied certification can impose liability if a contractor has engaged in a lie by omission, for instance, failing to disclose its noncompliance.
In the case, Universal Health Services v. Escobar, the court ruled that companies are subject to False Claims Act liability and the implied certification theory, but only if: (1) claims from healthcare providers request payment and make “specific representations about the goods or services provided” and (2) an organization’s failure to disclose noncompliance with “material” requirements would equate to “misleading half-truths.”
This case could result in a significant increase in False Claims Act cases being pursued against healthcare providers.
Robert S. Iwrey, Esq., a founding partner of The Health Law Partners, P.C., practices in all areas of healthcare law and devotes a substantial portion of his practice assisting clients in government investigations including the defense of qui tam actions, third party payor audits, DEA registrations, state licensing, pharmacy legal matters, and compliance. For more information regarding this article, please contact Robert S. Iwrey, Esq. at (248) 996-8510 or (212) 734-0128 or firstname.lastname@example.org.