UNITED STATES OF AMERICA, ex rel. STEVE GREENFIELD, Appellant v. MEDCO HEALTH SOLUTIONS, INC.; ACCREDO HEALTH GROUP, INC.; HEMOPHILIA HEALTH SERVICES, INC., 880 F.3d 89

Summary

HOLDINGS: [1]-Where a relator alleged that a company providing hemophiliac medicine violated the FCA since its donations to two hemophilia-related charities were kickbacks and the company falsely certified compliance with the Anti-Kickback Statute, 42 U.S.C.S. § 1320a-7b(b), while submitting Medicare claims for payment, the FCA claim failed because the relator failed to show that at least one of the federally insured patients for whom the company provided services and submitted reimbursement claims was exposed to a referral or recommendation by the charities in violation of the Anti-Kickback Statute; [2]-While the Anti-Kickback Statute prohibited kickbacks and any kickback violation was not eligible for reimbursement such that certifying otherwise violated the FCA, some connection between a kickback and a reimbursement claim was required, and temporal proximity alone was insufficient.