Material Lives: Amending the False Claims Act to Restore Qui Tam Medicaid Enforcement and Protect Our Most Vulnerable Communities

Authors

C. Deen, Washington and Lee University School of LawFollow

Abstract

In 2016, the Supreme Court granted cert. in Universal Health Services, Inc. v United States ex rel. Escobar to resolve a circuit split on implied certification under the False Claims Act. The Court’s opinion also addressed the issue of materiality under the False Claims Act. The “rigorous standard” expounded by the Court raised the standard of materiality beyond simple contractual or regulatory noncompliance. This heightened standard represents a significant departure from previous jurisprudence. Moreover, the heightened standard frustrates the repeatedly expressed will of Congress to empower qui tam whistleblowers to prosecute fraud perpetrated on the government. The primary focus of this Note is the effect this new materiality standard will have on Medicaid qui tam actions. This Note proposes that post-Escobar Congress should amend the False Claims Act’s materiality definition to return the act to the original intention of its drafters. This will allow potential Medicaid fraud perpetrators to again fully face the threat of qui tam enforcement envisioned by Congress, preventing potentially disastrous effects on the United States’ most vulnerable communities.

Recommended Citation

C. Deen, Material Lives: Amending the False Claims Act to Restore Qui Tam Medicaid Enforcement and Protect Our Most Vulnerable Communities, 27 Wash. & Lee J. Civ. Rts. & Soc. Just. 273 (2020).
Available at: https://scholarlycommons.law.wlu.edu/crsj/vol27/iss1/8