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United States, ex rel. Stacey L. Janssen, as Special Administrator of the Estate of Megen Corin Duffy v. Lawrence Memorial Hospital

Paid petition · United States Court of Appeals for the Tenth Circuit, No. 19-3011 · judgment February 7, 2020


Certiorari denied · October 5, 2020
Pre-decision estimate: 13% cert probability (95% interval 8%–21%)

Before the decision, about 3.1× the 4.1% base rate. The model weighted this up for a federal-government petitioner, a circuit split argued in the petition, and a Tenth Circuit decision below.

Question presented

Universal Health Services, Inc. v. Escobar, 136 S.Ct. 1989, 2002 (2016) held that “[u]nder any understanding of the concept, materiality ‘look[s] to the effect on the likely or actual behavior of the recipient of the alleged misrepresentation.’ ” (quoting 26 R. Lord, Williston on Contracts § 69:12, p. 549 (4th ed. 2003) (Williston)). The Court recognized that materiality, as employed in federal statutes including the False Claims Act, “descends from ‘common law antecedents’ ” (quoting Kungys v. United States, 485 U.S. 759, 769 (1988)), and discussed those antecedents in tort and contract law. Id. (citing Restatement (Second) of Torts § 538, at 80 and Restatement (Second) of Contracts § 162(2), and Comment c, pp. 439, 441 (1979)). The Petition presents the following questions: Whether a Medicare provider’s knowing falsifications of hospital patient arrival times, known by the hospital to be material to statutory quality reporting programs directly affecting the hospital’s Medicare reimbursement rate, are immaterial under the False Claims Act, as held by the Tenth Circuit in conflict with the Fifth, Eighth, Ninth, and Eleventh Circuits, absent additional evidence of impact on the payment behavior of the decisionmaking agency. Whether change in payment behavior of the Government is the controlling factor in determining materiality under the False Claims Act, as held by the Tenth Circuit, or whether

Counsel of record

For petitioner

For respondent
Andrew R. Ramirez
Spencer Fane LLP

Case

Conference history
Distributed for 1 conference

Proceedings

  1. Oct 05 2020
    Petition DENIED.
  2. Sep 09 2020
    DISTRIBUTED for Conference of 9/29/2020.
  3. Sep 04 2020
    Waiver of right of respondent Lawrence Memorial Hospital to respond filed.
  4. Aug 27 2020
    Petition for a writ of certiorari filed. (Response due October 5, 2020)