1. Home
  2. |Insights
  3. |Implied False Certification Split Widens

Implied False Certification Split Widens

Client Alert | 1 min read | 06.12.15

In U.S. v. Sanford-Brown, Ltd. (June 8, 2015), the Seventh Circuit rejected the implied false certification theory of False Claims Act liability, holding that alleged noncompliance with Title IV restrictions incorporated into a program participation agreement (PPA) for the Department of Education's subsidies program was insufficient to trigger FCA liability absent evidence that the defendant's application to establish initial Title IV eligibility was fraudulent. Although the majority of circuits have expressly adopted some form of the implied false certification theory of liability, the court joined the Fifth Circuit as the holdouts in rejecting the theory, explaining that "it would be . . . unreasonable for us to hold that an institution's continued compliance with the thousands of pages of federal statutes and regulations incorporated by reference into the PPA are conditions of payment for purposes of liability under the FCA."


Insights

Client Alert | 7 min read | 06.26.26

Federal Roundup: Updates for PBMs and Medicare Advantage Organizations

In June 2026, federal regulators and lawmakers continued their efforts to improve drug affordability through targeted reforms. These recent developments will primarily impact pharmaceutical manufacturers, managed care organizations, and pharmacy benefit managers (PBM) serving Medicare Part D program members. PBMs, Medicare Advantage organizations, and Part D sponsors should monitor these changes in the interest of maintaining compliance and providing input on regulatory proposals that may influence their business operations or compensation structures in the future....