Ambiguity Remains After Escobar
Client Alert | 1 min read | 11.09.16
In U.S. ex rel. Nelson v. Sanford-Brown Ltd. (Oct. 24, 2016), the Seventh Circuit, applying the materiality standard articulated by the Supreme Court in Escobar (discussion available here), held that the relator’s allegations that the college inflated grades and job placement figures and paid bonuses to employees for recruitment to fraudulently obtain federal student aid money failed because there was no evidence that the college had made any express or implied representations with its claims for payment or evidence that the government’s payment decision would likely have been different had it known of the alleged misrepresentations. In contrast, the Eighth Circuit in U.S. ex rel. Miller v. Weston Educ. Inc. (Oct. 19, 2016) held that similar allegations withstood summary judgment (as noted by C&M here), suggesting that the Supreme Court’s decision in Escobar may not have resolved the circuit split on implied certification after all.
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Bipartisan Coalition of State AGs Backs Federal PBM Transparency Rule
In mid-April, a bipartisan coalition of 45 State Attorneys General (AG) submitted a formal letter to the U.S. Department of Labor (DOL) expressing their collective support for a proposed rule (Improving Transparency into Pharmacy Benefit Manager Fee Disclosure, or RIN 1210-AB37), which would — if enacted — impose new disclosure obligations on pharmacy benefit managers (PBM) regulated under the Employee Retirement Income Security Act of 1974 (ERISA).
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Crowell Tracker of Court Rulings on Legal Privilege and Artificial Intelligence Tools
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