UNITED STATES, et al., ex rel. TRACY SCHUTTE, et al., Petitioners v. SUPERVALU INC., et al.UNITED STATES, et al., ex rel. THOMAS PROCTOR, Petitioner v. SAFEWAY, INC., 598 U.S. 739

Summary

HOLDINGS: [1]-In actions alleging that pharmacy operators violated the False Claims Act (FCA) by overcharging Medicare and Medicaid programs when seeking reimbursement for prescription drugs, the FCA's scienter requirement under 31 U.S.C.S. § 3729(a) referred to the operators' knowledge and subjective beliefs, not to what an objectively reasonable person may have known or believed; [2]-Ambiguity as to the meaning of "usual and customary" charges for purposes of Medicaid and Medicare reimbursement was not alone sufficient to preclude a finding that the operators knew their claims were false. If the operators actually knew what the phrase meant or were aware of an unjustifiably high risk that the phrase referred to their discounted prices, then the operators may have known that their claims were false.