"Presentment" Defense Rejected In Medicare FCA Case
Client Alert | 1 min read | 01.05.06
The developing case law interpreting the False Claims Act's imposition of liability on anyone who "knowingly presents, or causes to be presented" a false claim to the federal government should especially interest any company whose "government" business involves directly invoicing someone other than the government itself -- e.g., a grantee, a state or local government, a fiscal intermediary, or a prime contractor -- even though federal funds may ultimately be included in the payment. Another recent decision in this line, United States v. Squire , 2005 WL 3470297 (N.D. Illinois Dec. 12, 2005), denied a Medicare provider's motion to dismiss, holding that the provider may "cause" a false claim to be "presented" by means of a convoluted pathway, where the provider's requests for payment are submitted directly to a "fiscal intermediary" (administrative services contractor) which determines the correct amount of the provider's compensation and then authorizes a commercial bank to draw down a daily total from the Medicare trust funds held by the Federal Reserve Bank, a daily total which includes -- among a great many other things -- an amount used to compensate the provider.
Insights
Client Alert | 3 min read | 11.21.25
On November 7, 2025, in Thornton v. National Academy of Sciences, No. 25-cv-2155, 2025 WL 3123732 (D.D.C. Nov. 7, 2025), the District Court for the District of Columbia dismissed a False Claims Act (FCA) retaliation complaint on the basis that the plaintiff’s allegations that he was fired after blowing the whistle on purported illegally discriminatory use of federal funding was not sufficient to support his FCA claim. This case appears to be one of the first filed, and subsequently dismissed, following Deputy Attorney General Todd Blanche’s announcement of the creation of the Civil Rights Fraud Initiative on May 19, 2025, which “strongly encourages” private individuals to file lawsuits under the FCA relating to purportedly discriminatory and illegal use of federal funding for diversity, equity, and inclusion (DEI) initiatives in violation of Executive Order 14173, Ending Illegal Discrimination and Restoring Merit-Based Opportunity (Jan. 21, 2025). In this case, the court dismissed the FCA retaliation claim and rejected the argument that an organization could violate the FCA merely by “engaging in discriminatory conduct while conducting a federally funded study.” The analysis in Thornton could be a sign of how forthcoming arguments of retaliation based on reporting allegedly fraudulent DEI activity will be analyzed in the future.
Client Alert | 3 min read | 11.20.25
Client Alert | 3 min read | 11.20.25
Client Alert | 6 min read | 11.19.25
