On September 9, 2019, the Eleventh Circuit held in US v. AseraCare, Inc., No. 16-13004, that a reasonable difference of medical opinion is insufficient to establish falsity under the False Claims Act. AseraCare contrasts with two recent decisions from the Sixth and Tenth Circuits—US v. Paulus, 894 F.3d 267 (6th Cir. 2018), and US ex rel. Polukoff v. St. Mark’s Hospital, 895 F.3d 730 (10th Cir. 2018), which seemed to lighten DOJ’s burden in medical necessity cases. Instead, AseraCare takes the more reasoned position that DOJ cannot establish FCA liability “if the underlying clinical judgment does not reflect an objective falsehood.”
Regulations, Compliance, & Enforcement
Trending Now
New Bill Would Tighten Fraud Screening Across Federal Awards • US Department of Labor Announces 2026 Virtual Seminars for Current, Prospective Federal Contractors on Prevailing Wage Requirements • Grants Compliance 101: Your Grant Project Is Moving Forward. Now What? • FTC Signals Renewed “Made in USA” Enforcement Focus Following Trump Executive Order • The New DEI Crackdown: What Federal Contractors Must Do Now
Eleventh Circuit Holds That Winning the “Battle of the Experts” Won’t Prove Falsity
Track False Claims Act cases, audit trends, and compliance best practices with our Compliance & Enforcement newsletter, delivering up-to-the-minute intelligence Monday–Saturday — Subscribe here.