Allison Engine Co. v. U.S. ex Rel. Sanders

Holding that an action under subsection requires a relater to allege "that the defendant intended that the false record or statement be material to the Government's decision to pay or approve the false claim"

U.S. ex Rel. Grubbs v. Kanneganti

Holding that defendants received adequate notice in a False Claims Act case where the complaint alleged a scheme to submit false claims and enough details that the defendants—who "will be in possession of the most relevant records, such as patients’ charts, doctors’ notes, and internal billing records"—could adequately investigate and defend the claims

Atkins v. McInteer

Holding that denial of leave to amend was not an abuse of discretion where the relator “failed to include the proposed amendment or the substance thereof” with his request

Luce v. Edelstein

Holding that the plaintiff's failure to connect allegations of fraudulent representations to particular defendants, attributing representations simply to the “defendants,” could not satisfy Rule 9(b)'s particularity requirement

Mikes v. Straus

Holding that false certification theory applies when "governing federal rules . . . are a precondition to payment"

United States v. Neifert-White Co.

Holding that the term "claim" was not limited to claims submitted for payments due and owing from the government, but included claims for favorable action by the government upon applications for loans

U.S. v. Envirocare of Utah

Holding that a false certification claim satisfied the requirements of Rules 8 and 9(b) based on the complaint's extensive allegations as to the who, what, when, where, and how of the alleged false certifications, including details about each specific violation

Wexner v. First Manhattan Co.

Holding that "[d]espite the generally rigid requirement that fraud be pleaded with particularity, allegations may be based on information and belief when facts are peculiarly within the opposing party's knowledge," but noting that "[t]his exception to the general rule must not be mistaken for license to base claims of fraud on speculation and conclusory allegations"

U.S. ex Rel. Totten v. Bombardier Corp.

Holding that claim against Amtrak not presented to the Government and noting that “[t]he word ‘provides' in Section 3729(c), when appropriately limited to the present tense, squares neatly with a presentment requirement. False Claims Act liability will attach if the Government provides the funds to the grantee upon presentment of a claim to the Government.”

U.S. v. Dauray

Holding that we interpret statutes to prevent absurd results

Rule 9 - Pleading Special Matters

Requiring that fraud be pleaded with particularity

Section 3729 - False claims

Holding liable "any person" who knowingly causes false claims to be presented

Section 1320 - Approval of certain projects

Proscribing fraud related to federal health care programs

Section 1320a-7k - Medicare and Medicaid program integrity provisions

In section 1320a-7k(d)(3), it establishes that failure to report and return a known overpayment within sixty days of discovering it violates the False Claims Act, 31 U.S.C. § 3729 et seq., which carries the potential for treble damages and other serious penalties, see id. § 3729(a)(1).

Section 422.326 - Reporting and returning of overpayments

Defining "overpayment" as "any funds that [a Medicare Advantage insurer] has received or retained under [the Medicare Advantage program] to which the [Medicare Advantage insurer], after applicable reconciliation, is not entitled"

Section 423.360 - Reporting and returning of overpayments