Alex Major is quoted in a Law360 examination of high-profile False Claims Act legal decisions to anticipate in 2019, some of which will focus on revisiting the issue of materiality to resolve a growing circuit split.
The Supreme Court in Universal Health Services, Inc. v. United States ex rel. Escobar supported the implied certification doctrine, which states that parties can be held liable for implicitly certifying that they have complied with all relevant requirements when submitting claims for government reimbursement, even if they are not directly tied to payment so long as the alleged false claims is “material” to the government’s decision to pay. 2019 will see further refining in this area of the law where biopharmaceutical company Gilead Sciences is accused of concealing information about sourcing and contamination of HIV drugs, and a case involving a senior living community chain alleged to have filed certifications of medical necessity outside of the specified window. Describing the current situation at the circuit court level and below as a confused “logjam,” Alex Major also commented that “the simple fact that the questions are out there demands there be answers.”