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Expert Analysis

Can 'Bundle' Payment Plans Shield Against FCA Liability?

By Maurice Bellan and Aleesha Fowler ( January 28, 2019, 5:18 PM EST) -- On Dec. 11, 2018, the United States Attorney's Office for the District of New Jersey submitted a statement of interest to a federal court, asking the court to rule on a specific question of law that implicates the scope of the materiality standard in False Claims Act jurisprudence: Whether a pharmaceutical company that violates the anti-kickback statute, or AKS, and causes a hospital to submit reimbursement claims for non-covered uses of a drug, can be held liable under the FCA if the federal government pays for the drug through a flat, bundled payment. . . .

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