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On June 16, 2016, the U.S. Supreme Court issued a long-awaited decision addressing the

Kylie Mote

Kylie Mote

scope of liability under the False Claims Act (“FCA”).  In Universal Health Services, Inc. v. U.S. ex rel. Escobar, the Court unanimously held that the FCA may impose liability when a party falsely implies that specific services were provided in compliance with all material payment requirements.[1]  The decision is important to any healthcare provider participating in federal healthcare programs.

The FCA, generally, imposes liability upon any party who knowingly presents, or causes to be presented, false or fraudulent claims for payment to the federal government.[2]  The FCA may be enforced by the U.S. Department of Justice or by private parties (whistleblowers) who bring civil qui tam suits in “the name of the government.”[3]  Parties found liable under the FCA may be subject to treble damages and up to $10,000 per claim.[4]   

[1] Universal Health Services, Inc. v. U.S. ex rel. Escobar, 136 S.Ct. 1989 (2016)

[2] 31 U.S.C. § 3729(a)(1)(A)

[3] 31 U.S.C. § 3730

[4] 31 U.S.C. § 3729(a)

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