Universal Health Services, Inc. v. U.S. ex rel. Escobar, 136 S. Ct. 1989 (2016) was a landmark case in FCA jurisprudence. In Escobar, the Supreme Court held that the implied false certification theory can be a basis for liability under the FCA in some circumstances. The Supreme Court also held that the alleged contractual, statutory, or regulatory violation need not be expressly designated a “condition of payment” to trigger implied certification liability. 

Key Facts:

• Relator’s 17-year old stepdaughter died while in the care of a mental health facility owned by Universal.
• Universal’s facilities were investigated by the state of Massachusetts.
• Investigation uncovered that Universal had allegedly violated Massachusetts Medicaid regulations requiring mental health facility staff to have certain qualifications.
• Relator sued on 17-year old’s behalf alleging that Universal violated the FCA under an implied false certification theory.

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