Executive Summary

Roughly two dozen states have enacted statutes barring drug manufacturers from restricting delivery of 340B-discounted drugs to a covered entity’s contract pharmacies, and the manufacturers have challenged nearly all of them mostly on preemption grounds, as well as other arguments. The Fifth and Eighth Circuits have upheld those statutes four times between them. The Fourth Circuit, on the other hand, found these state restrictions preempted in two separate cases. However, rehearing en banc has been granted, and thus both of these Fourth Circuit decisions have been vacated. While there is no operative circuit split at this moment, one could develop depending on the outcome of the Fourth Circuit rehearing or in other circuits which have not yet reached the issue. Meanwhile the district courts have overwhelmingly refused to enjoin these statutes, with one notable exception in the Western District of Oklahoma. And in August the Southern District of Mississippi held, on a full summary-judgment actual record, that how the 340B program operates in practice does not change the preemption analysis based on a facial review of the federal and state statutes.

Background: How Contract Pharmacies Became the Battleground

Congress created the 340B program in 1992. As a condition of having their products covered under Medicaid and Medicare Part B, pharma manufacturers must agree to offer certain drugs to “covered entities” — principally federally or state-funded hospitals and community health centers serving low-income patients — at no more than a statutory “ceiling price.” 42 U.S.C. §§ 256b(a)(1), 1396r-8(a)(1), (5).

The statute places four key restrictions on covered entities: a bar on duplicate 340B and Medicaid discounts, § 256b(a)(5)(A); a bar on diversion — a covered entity “shall not resell or otherwise transfer” a discounted drug “to a person who is not a patient of the entity,” § 256b(a)(5)(B); an audit obligation, requiring covered entities to let HHS and manufacturers examine their records for compliance with the first two restrictions, § 256b(a)(5)(C); and recovery liability — a covered entity that violates either ban “shall be liable” to the manufacturer for the amount improperly received, § 256b(a)(5)(D). AbbVie, Inc. v. Fitch, 152 F.4th 635, 640 (5th Cir. 2025). Congress therefore put the substantive compliance duties on covered entities but gave manufacturers the audit and recovery rights. The manufacturer is the party expected to detect the problem and pursue it. That allocation worked tolerably when the number of dispensing points was small. The manufacturers argue that this allocation stopped working when the number of contract pharmacies used by covered entities exploded.

The statute is silent about the issue of delivery, that is, how drugs get from manufacturer to patient. The Health Resources and Services Administration (HRSA), the Department of Health and Human Services unit tasked with administering the 340B program, stepped into the issue in 1996 when it limited a covered entity that lacked an in-house pharmacy to contracting with just a single outside pharmacy. In 2010 it reversed course, permitting covered entities — including those with in-house pharmacies — to contract with an unlimited number of outside pharmacies to receive and dispense drugs under the 340B program. “After the 2010 guidance, the use of contract pharmacies skyrocketed.” Sanofi Aventis U.S. LLC v. U.S. Dep’t of Health & Hum. Servs., 58 F.4th 696, 700 (3d Cir. 2023). As the Government Accountability Office noted, the number of contract pharmacies used by covered entities surged from about 1,300 at the beginning of 2010 to around 23,000 in 2019. U.S. Gov't Accountability Off., GAO-20-212, 340B Drug Discount Program: Oversight of the Intersection with the Medicaid Drug Rebate Program Needs Improvement 2 (Jan. 2020).

In 2020 manufacturers responded unilaterally, limiting 340B delivery to a covered entity’s in-house pharmacy or a single designated contract pharmacy. HHS issued an advisory opinion declaring that 340B requires delivery to any contract pharmacy a covered entity chooses. The manufacturers sued and prevailed: the Third Circuit in Sanofi and the D.C. Circuit in Novartis Pharms. Corp. v. Johnson, 102 F.4th 452 (D.C. Cir. 2024), both confirmed that 340B is silent on delivery and does not compel shipment to unlimited contract pharmacies. HHS withdrew the opinion. That is when the states stepped in, invoking their police power over healthcare and pharmacy practice to accomplish by state law what HHS could not accomplish by advisory opinion. Arkansas went first with Act 1103 in 2021 — PhRMA sued that September — and roughly two dozen states followed with materially similar statutes. The litigation now before the courts is not about what HHS may require of manufacturers. It is about what a State may require of them.

Understanding the manufacturers’ position in opposition to these state laws requires understanding how contract pharmacies actually stock 340B drugs. The D.C. Circuit’s description in Johnson, 102 F.4th at 457–58, is the one the later opinions quote:

“While some contract pharmacies maintain separate inventories of section 340B drugs, most fill prescriptions from inventories that intermingle discounted and non-discounted drugs. Only after dispensing the drugs do these pharmacies attempt to discern whether individual customers were patients of covered entities . . . . Many pharmacies outsource this determination to third-party administrators, who often receive a larger fee for every prescription deemed eligible for the discount. Once the pharmacy or the administrator categorizes a certain number of prescriptions as eligible, the pharmacy places an order to replenish its section 340B purchases. The covered entity, the pharmacy, and the third-party administrator often divvy up the spread between the discounted price and the higher insurance reimbursement rate. Each of these actors thus has a financial incentive to catalog as many prescriptions as possible as eligible for the discount.”

The replenishment model is thus simply an inventory-accounting method: dispense from a commingled inventory, determine eligibility afterward, reorder at the 340B price to backfill.

From the manufacturers’ standpoint, the proliferation of contract pharmacies accounting for 340B pricing after the fact creates an enforcement problem and affects their ability to vindicate their audit and recovery rights to police diversion and duplicate discounts. But under a replenishment system spread across an unlimited number of contract pharmacies, the manufacturer is auditing a retrospective eligibility determination made by someone else, about a dispensing event that has already happened, in an inventory where 340B and non-340B units were never physically distinguished. Every additional contract pharmacy multiplies those determinations while making each one harder to verify. Whether or not one credits the manufacturers’ estimates of the resulting abuse, the structural point is sound: Congress gave manufacturers a policing role, and the explosion in the number of contract pharmacies made that role progressively harder to perform. That is why manufacturers describe these state statutes as doing something more than regulating delivery logistics.

Action in The Circuits: Which One Held What, and Where Things Stand

As we have seen, the Third Circuit in Sanofi and the D.C. Circuit in Johnson decided whether HHS could compel unlimited contract-pharmacy delivery. The issue of whether a State may prohibit manufacturers from restricting the use of contract pharmacies was not before these courts. They are the backdrop to the split, not part of it. The potential division regarding state efforts in the contract pharmacy issue follows:

• Eighth Circuit — statutes upheld, twice. Pharmaceutical Research & Manufacturers of America v. McClain, 95 F.4th 1136 (8th Cir. 2024), affirmed summary judgment for Arkansas on Act 1103. Novartis Pharms. Corp. v. Hanaway, 180 F.4th 1097 (8th Cir. 2026), affirmed denial of a preliminary injunction against Missouri’s S.B. 751. Status: certiorari denied in McClain on December 9, 2024, 145 S. Ct. 768 (2024); no rehearing or petition reflected in the record in Hanaway as of this writing.
• Fifth Circuit — statutes upheld, twice. AbbVie v. Fitch, 152 F.4th at 640, affirmed denial of a preliminary injunction against Mississippi’s H.B. 728. AbbVie, Inc. v. Murrill, 180 F.4th 747 (5th Cir. 2026), affirmed summary judgment for Louisiana on Act 358 — a full merits record rather than a preliminary posture. Status: no rehearing en banc or certiorari petition reflected in the record as of this writing. An earlier Murrill panel opinion issued February 9, 2026; the July 6 decision is the operative one.
• Fourth Circuit — statutes likely preempted, twice — but both decisions are vacated and rehearing granted. Pharmaceutical Research & Manufacturers of America v. McCuskey, 171 F.4th 675 (4th Cir. 2026) (argued Sept. 9, 2025), reh’g en banc granted (4th Cir. June 2, 2026), affirmed a preliminary injunction against West Virginia’s S.B. 325; Judge Richardson wrote for the majority, Judge Benjamin dissented. Two weeks later, AbbVie, Inc. v. Brown, 2026 WL 1005576 (4th Cir. Apr. 14, 2026) (unpublished), reh’g en banc granted (4th Cir. June 2, 2026), vacated a district court’s denial of an injunction against Maryland’s H.B. 1056 and remanded in light of McCuskey. Those grants vacated the panel opinions. No argument date has been announced as of this writing.

Legal Analysis

The litigation over the state statutes highlights several legal and factual issues. First, while the manufacturers have raised several other legal theories, the primary challenge to these state statutes has been preemption. The first appellate court case to address the issue was McClain, 95 F.4th at 1142, which affirmed summary judgment upholding Arkansas’s Act 1103 against Pharma’s challenges. Pharma argued that Act 1103 was preempted under all three preemption doctrines – field, obstacle and impossibility — and the court rejected all three arguments. The obstacle-preemption passage is the one later courts keep returning to: Act 1103 “does not create an obstacle for pharmaceutical manufacturers to comply with 340B, rather it does the opposite: Act 1103 assists in fulfilling the purpose of 340B.” McClain, 95 F.4th at 1144–45. The reasoning is narrow — Act 1103 neither requires manufacturers to extend 340B pricing to contract pharmacies nor sets or enforces discount pricing at all. The Supreme Court denied certiorari on December 9, 2024, 145 S. Ct. 768 (2024) — at a time when no circuit had disagreed.

Second, the preemption issue highlights the prevailing view (to date) that courts have viewed the states as regulating something different than the federal statute. Murrill held that Congress left the delivery-and-distribution space conspicuously silent, defeating field, conflict and obstacle preemption, and declined to read Sanofi and Johnson as limiting state, as opposed to federal agency, authority. In this view, federal agency authority over the program and state police power over distribution conduct operate independently. Thus, states can legislate in a space a federal agency was told it could not reach by advisory opinion. AstraZeneca Pharmaceuticals LP v. Fitch, 2026 WL 2455376 (S.D. Miss. Aug. 21, 2026), adopted the formulation from Murrill, 180 F.4th at 761: the state law “does not regulate prices; it regulates conduct.” AstraZeneca argued the inverse — that price is the only thing distinguishing a 340B drug from any other drug, so a law reaching 340B drugs necessarily regulates price. The court’s answer was that the 340B statute sets the price and Mississippi’s H.B. 728 governs only where a covered entity’s patient may pick the drug up: “[t]hese drugs would cost the same amount if they were picked up at a covered entity’s in-house pharmacy.” 2026 WL 2455376, at *9. Everything else in this area turns on whether that distinction holds.

The now vacated Fourth Circuit opinions took a different view on the structure of the program. The McCuskey majority did not principally hold that West Virginia was regulating price. Its theory was that West Virginia’s S.B. 325 “springs obligations on manufacturers specifically by virtue of their participation in a federal program,” does not apply equally to all manufacturers selling drugs in the State, and therefore “targets a federal domain.” McCuskey, 171 F.4th at 689. Drawing on Buckman Co. v. Plaintiffs’ Legal Comm., 531 U.S. 341 (2001), the court reasoned that the statute injects the State into a relationship between a federal agency and its regulated entities that is “inherently federal in character.” It then treated Section 340B as spending-power legislation “much in the nature of a contract,” id., and asked whether the State had added uninvited conditions to a federal bargain.

In AbbVie Inc. v. Drummond, 2025 WL 3048930 (W.D. Okla. Oct. 31, 2025), District Judge Wyrick enjoined enforcement of Oklahoma’s H.B. 2048, codified at Okla. Stat. tit. 36, §§ 5403, 5404(B), essentially on these grounds, addressing the delivery/price distinction with a colorful analogy: if Congress required pizza parlors to sell at a 50% discount to anyone named John, and a State then required those parlors to deliver half-priced pies to anyone John designated, “could that state law possibly be described as a mere ‘delivery’ regulation? Of course not.” 2025 WL 3048930, at *5. In other words, the state statutes ostensibly about delivery sneak price through the back door, thus encroaching on 340B’s territory. Federal law does not use the term “340B drug” at all, the court observed, because the drug is the same either way — “[a]ll the 340B Program does is set the price for certain sales of drugs.” Id. at *6.

Judge Wyrick went on to address another factual question about the way contract pharmacies operate: who actually owns the drug sitting on the contract pharmacy’s shelf? This question bears directly on the replenishment model. McClain rests on the premise that contract pharmacies “do not purchase 340B drugs, and they do not receive the 340B price discounts” — the covered entity purchases and holds title, and the pharmacy merely dispenses. McClain, 95 F.4th at 1144. Drummond found the record did not establish that Oklahoma covered entities in fact retain title while the drugs sit at contract pharmacies and held that replenishment “significantly muddies the waters as to who is the actual purchaser of the 340B drugs.” Drummond, 2025 WL 3048930, at *6. If the contract pharmacy is the real purchaser, a statute compelling discounted delivery to it effectively expands the statutory list of covered entities — and contract pharmacies are not among the sixteen designated types. The title question is factual, and it has not been developed in most of these cases.

However, a recent district court opinion was unimpressed, essentially holding that facts about the actual operation of the 340B program did not preclude summary judgment finding that the Mississippi statute at issue there was not preempted. In AstraZeneca v. Fitch, the manufacturer did what Drummond suggests is necessary: it took discovery aimed at showing that Mississippi’s H.B. 728 is preempted based on how the program actually operates, and that earlier courts had incorrectly ruled about how replenishment works and who holds title. Judge Guirola granted the State summary judgment anyway, denied the cross-motion, found the motion to exclude AstraZeneca’s expert moot, and dismissed AstraZeneca’s challenge with prejudice. The reasoning is short and consequential: “The Court’s focus in this case is the language and intent of 340B and H.B. 728, not testimony and evidence related to the manner in which entities operate under those statutes.” 2026 WL 2455376, at *12. The discovery material “has not changed this determination.” Id. at *8. The escape hatch Drummond left open is, at least in this district, shut.

Holdings and Current Consensus

The Eighth Circuit held Arkansas’s Act 1103 preempted under neither field, obstacle nor FDCA impossibility theories (McClain), and held Novartis had not shown a likelihood of success on its dormant Commerce Clause or preemption claims against Missouri’s S.B. 751 (Hanaway). The Fifth Circuit held Louisiana’s Act 358 not preempted and violative of neither the Takings Clause, the Contracts Clause nor vagueness doctrine (Murrill), having earlier affirmed denial of a preliminary injunction against Mississippi’s H.B. 728 (AbbVie v. Fitch). The Southern District of Mississippi held H.B. 728 preempted by neither the 340B statute nor federal patent law, violative of neither the Contracts Clause nor the Takings Clause, and that discovery into the program’s practical operation did not alter the analysis; summary judgment for the State, claims dismissed with prejudice (AstraZeneca v. Fitch). The Western District of Oklahoma reached the opposite conclusion and enjoined Oklahoma’s statute (Drummond). The Fourth Circuit twice held these statutes likely preempted on a spending-power-bargain theory (McCuskey; Brown) — but both panel opinions are vacated pending rehearing en banc.

The consensus therefore favors the states. The Eighth Circuit has upheld these statutes twice and the Fifth Circuit twice; Judge Benjamin’s dissent in Brown catalogues at least eleven district courts that have refused to preliminarily enjoin comparable statutes, including in Colorado, Hawai’i, Maine, Mississippi, Rhode Island, Tennessee and Maryland, see Brown, 2026 WL 1005576, at *3 n.2 (Benjamin, J., dissenting); district courts within the Fifth and Eighth Circuits are following (see AbbVie Inc. v. Jackley, 2026 WL 2280929 (D.S.D. Aug. 7, 2026)); the Supreme Court declined the question in 2024; and the manufacturers’ factual theory has now failed on a full record. Drummond is the conspicuous outlier, and the West Virginia district court whose injunction the Fourth Circuit affirmed is the other.

Where We Are Now

For manufacturers, the litigation posture at the appellate level rests with the Fourth Circuit en banc ruling and the hope that it can create a circuit split interesting to the Supreme Court. The statutory arguments have lost in two circuits, the Supreme Court declined the question in 2024 when there was no split, and the fact-based theory has now failed on a developed record. What remains is the Fourth Circuit sitting en banc. However, there are several pending district court cases in other circuits which could upend the game board and potentially create new circuit splits on preemption or other issues.

For covered entities, hospital associations and their counsel, there is a durable template in the Fifth and Eighth Circuits, tempered by some risk concentrated in the Fourth, and developments to come in other circuits where similar cases are percolating.

What to Watch

First, the Fourth Circuit en banc in McCuskey and Brown — that is where this area gets decided next, and an argument date has not yet been announced. Second, AstraZeneca Pharms. LP v. Mosaic Health, Inc., No. 25-1070 (U.S.), distributed for the Supreme Court’s September 28, 2026 long conference and relisted twice; it presents an antitrust-standing question under Illinois Brick Co. v. Illinois, 431 U.S. 720 (1977), rather than preemption, but a grant could potentially put 340B contract-pharmacy economics before the Court for the first time. Third, whether the manufacturers seek certiorari from Murrill or Hanaway, a petition filed while the Fourth Circuit sits en banc would present the Court with an unusually well-developed record of disagreement.

Cases cited in this blog: AbbVie, Inc. v. Brown, 2026 WL 1005576 (4th Cir. Apr. 14, 2026), reh’g en banc granted (4th Cir. June 2, 2026) | AbbVie, Inc. v. Drummond, 2025 WL 3048930 (W.D. Okla. Oct. 31, 2025) | AbbVie, Inc. v. Fitch, 152 F.4th 635 (5th Cir. 2025) | AbbVie, Inc. v. Jackley, 2026 WL 2280929 (D.S.D. Aug. 7, 2026) | AbbVie, Inc. v. Murrill, 180 F.4th 747 (5th Cir. 2026) | AstraZeneca Pharms. LP v. Fitch, 2026 WL 2455376 (S.D. Miss. Aug. 21, 2026) | AstraZeneca Pharms. LP v. Mosaic Health, Inc., No. 25-1070 (U.S.) | Buckman Co. v. Plaintiffs’ Legal Comm., 531 U.S. 341 (2001) | Illinois Brick Co. v. Illinois, 431 U.S. 720 (1977) | Novartis Pharms. Corp. v. Hanaway, 180 F.4th 1097 (8th Cir. 2026) | Novartis Pharms. Corp. v. Johnson, 102 F.4th 452 (D.C. Cir. 2024) | Pharmaceutical Research & Manufacturers of America v. McClain, 95 F.4th 1136 (8th Cir. 2024), cert. denied, 145 S. Ct. 768 (2024) | Pharmaceutical Research & Manufacturers of America v. McCuskey, 171 F.4th 675 (4th Cir. 2026), reh’g en banc granted (4th Cir. June 2, 2026) | Sanofi Aventis U.S. LLC v. U.S. Dep’t of Health & Hum. Servs., 58 F.4th 696 (3d Cir. 2023)

John Libby is an arbitrator, mediator, and settlement counsel with LibbyADR LLC. This blog post and alert discusses published and slip-copy decisions for general informational purposes and is not legal advice.

This document covers the second quarter of 2026 (April 1 – June 30, 2026), continuing the quarterly False Claims Act case summaries. Cases are categorized by statutory provision, with Westlaw citations, courts, and decision dates after each case name.

Coverage focuses on decisions that bear on an FCA legal question—liability elements, qui tam procedure, relator awards and fees, the public-disclosure bar, and retaliation. Purely ancillary rulings in FCA cases (routine discovery, sealing, and similar) are omitted.

2026Q2 (April 1 – June 30, 2026)

31 U.S.C. § 3729(a)(1)(A) and (B) — Liability for False Claims and Statements

United States ex rel. Lynn v. City of Detroit 2026 WL 973955 (U.S.C.A, Sixth Circuit, April 10, 2026) — Affirmed dismissal of a qui tam alleging the City falsely certified compliance in its annual federal-grant Certification, where the complaint failed to plausibly allege a knowingly false presentment or statement under § 3729(a)(1)(A)-(B).

United States ex rel. Bauer v. Republic Services of Montana (Allied Waste) 2026 WL 1283968 (U.S.D.C., D. Montana, May 11, 2026) — Granted a Rule 12(b)(6) dismissal of a qui tam alleging a waste-services contractor misrepresented the products and services it billed to the federal and state governments, ending the case.

United States ex rel. Kuriyan v. Molina Healthcare of New Mexico, Inc. 2026 WL 1470124 (U.S.D.C., D. New Mexico, May 26, 2026) — Addressed the relator’s post-judgment motion to alter or amend the judgment dismissing his federal and state FCA claims against Medicaid managed-care organizations, weighing whether intervening state-law developments warranted relief from the prior dismissal.

United States ex rel. Solano v. Barton Associates, Inc. 2026 WL 1493019 (U.S.C.A, First Circuit, May 28, 2026) — Affirmed dismissal of a qui tam against a medical-staffing agency for failure to plead the alleged scheme to induce false Medicare claims with Rule 9(b) particularity.

United States ex rel. Relator LLC v. McGlauflin (DNT Construction) 2026 WL 1508877 (U.S.D.C., W.D. Texas, May 29, 2026) — Magistrate judge recommended DENYING the defendants’ motion to dismiss a Paycheck Protection Program (PPP) loan-fraud qui tam, finding the relator adequately pleaded the alleged false certifications.

United States ex rel. Kyer v. Thomas Health System, Inc. 2026 WL 1595887 (U.S.C.A, Fourth Circuit, June 4, 2026) — Affirmed dismissal of a multi-defendant hospital qui tam premised on Stark Law/Anti-Kickback-tainted physician-compensation (wRVU) arrangements, for failure to adequately plead the FCA elements across five defendants and three statutes.

United States ex rel. Craig v. Hawthorne Machinery Co. 2026 WL 1653486 (U.S.D.C., S.D. California, June 8, 2026) — Granted the defendants summary judgment against the relator on all claims, entering judgment for the defense.

United States v. Ma (Ma Acupuncture Center, P.C.) 2026 WL 1719074 (U.S.C.A, Fifth Circuit, June 15, 2026) — Affirmed the district court’s enforcement of a settlement the government and an acupuncture provider reached at pre-trial mediation in an FCA suit over inflated Veterans Affairs billings, holding the parties bound their material terms at mediation.

United States v. New Life Center for Change, Inc. (Teen University) 2026 WL 1753972 (U.S.D.C., M.D. Alabama, June 18, 2026) — Entered the parties’ joint consent judgment resolving the government’s FCA claims against a residential group home and its principal.

United States v. Gardner, D.D.S. 2026 WL 1786348 (U.S.D.C., D. New Mexico, June 22, 2026) — In the government’s FCA action against a dentist, resolved a series of motions—denying the defendant’s motions to dismiss for improper/lack of service and under Rule 60(b)(4) and imposing a $4,000 sanction—while addressing the government’s summary-judgment motion.

United States v. Crites 2026 WL 1782154 (U.S.D.C., M.D. Alabama, June 22, 2026) — Denied the pro se defendant’s Rule 59(e)/60(b) motion to set aside a roughly $31 million FCA judgment previously entered on summary judgment.

United States ex rel. Ellis v. CVS Health Corp. 2026 WL 1791002 (U.S.D.C., E.D. Pennsylvania, June 22, 2026) — Granted CVS summary judgment, rejecting a ‘worthless services’ theory premised on temperature-excursion risk to shipped biologic medications where the relator produced no evidence that any drug’s efficacy was actually impaired.

United States ex rel. Cobb v. Charleston County School District 2026 WL 1830950 (U.S.D.C., D. South Carolina, June 25, 2026) — Granted in part and denied in part the district’s motion to dismiss—dismissing the state whistleblower claim, allowing the FCA claim to proceed, and ordering the relator to file a more definite statement of the FCA claim.

United States ex rel. White v. Gainwell Technologies LLC 2026 WL 1864033 (U.S.D.C., D. Massachusetts, June 29, 2026) — Granted dismissal, concluding on fuller briefing that the relators failed to state an FCA claim against a state Medicaid fiscal agent—reversing the court’s earlier view when it had allowed the amendment.

31 U.S.C. § 3730(b) — Actions by Private Persons (Qui Tam)

United States ex rel. Nicholson v. Clarksville Pain Institute, LLC 2026 WL 908546 (U.S.D.C., M.D. Tennessee, April 2, 2026) — Granted the United States leave to amend its complaint-in-intervention in a qui tam alleging pain-clinic billing fraud, after the government partially intervened.

United States ex rel. Duell v. State of Hawaii 2026 WL 915149 (U.S.D.C., D. Hawaii, April 3, 2026) — Ordered a pro se relator to show cause why his ‘qui tam’ complaint should not be dismissed—because a non-attorney cannot prosecute an FCA action on the government’s behalf—and directed the clerk to unseal the complaint.

United States ex rel. Buxbaum v. Legal Aid Society of Rockland County 2026 WL 926728 (U.S.D.C., S.D. New York, April 6, 2026) — Dismissed a pro se plaintiff’s attempt to reframe his suit as an FCA qui tam, for lack of subject-matter jurisdiction.

United States ex rel. Compton v. HCR ManorCare, Inc. 2026 WL 1066520 (U.S.D.C., E.D. Pennsylvania, April 17, 2026) — Granted a defendant’s motion to unseal the docket in a consolidated nursing-home ‘worthless services’ qui tam, subject to the government’s opportunity to seek limited redactions.

United States ex rel. Dow v. HC2, Inc. 2026 WL 1179712 (U.S.D.C., District of Columbia, April 30, 2026) — Dismissed a qui tam for failure to prosecute where the relator—who must be represented by counsel—went nine months without replacement counsel; also ruled in part on unsealing.

United States ex rel. v. Hospice Source, LLC 2026 WL 1189202 (U.S.D.C., E.D. California, April 30, 2026) — Dismissed a qui tam with prejudice as to the relator and without prejudice as to the United States and plaintiff States under Rule 41, consistent with the FCA’s § 3730(b)(1) requirement of court and Attorney General consent.

United States ex rel. Chao v. County of Santa Clara 2026 WL 1395940 (U.S.D.C., N.D. California, May 18, 2026) — Dismissed the pro se plaintiff’s FCA qui tam and FCA retaliation claims without leave to amend.

United States ex rel. Doe v. Trustees of Columbia University 2026 WL 1533795 (U.S.D.C., S.D. New York, May 28, 2026) — On a pro se relator’s in forma pauperis and pseudonym requests in a purported qui tam, granted 60 days to retain counsel, reiterating that a non-attorney cannot pursue an FCA action pro se.

United States ex rel. Scheffler v. Golden Shovel Agency, LLC 2026 WL 1723921 (U.S.D.C., D. Minnesota, June 15, 2026) — Granted in part a motion to dismiss a CARES Act/PPP-funding qui tam but gave the relator leave to file a second amended complaint.

31 U.S.C. § 3730(d) — Award to Qui Tam Plaintiff

United States ex rel. Thrower v. Academy Mortgage Corp. 2026 WL 923856 (U.S.C.A, Ninth Circuit, April 6, 2026) — In companion appeals arising from an FCA relator’s award of attorneys’ fees, costs, and expenses, the court addressed the fee award—including when postjudgment interest begins to accrue on it—affirming the district court (see also 2026 WL 923862).

United States ex rel. Osinek v. Permanente Medical Group, Inc. (Kaiser) 2026 WL 970482 (U.S.D.C., N.D. California, April 10, 2026) — Denied a third party’s motion for a share of the settlement proceeds in the consolidated Kaiser Medicare Advantage risk-adjustment qui tam actions.

United States ex rel. Quesenberry v. Breaks Interstate Park Commission (Rockbridge Regional Library) 2026 WL 1534496 (U.S.D.C., W.D. Virginia, June 1, 2026) — Awarded the relator $3,400 of the $12,600 sought in attorneys’ fees connected to a defendant library’s default.

31 U.S.C. § 3730(e)(4) — The Public Disclosure Bar

United States ex rel. Anderson v. Saint Elizabeth Medical Center, Inc. 2026 WL 1047118 (U.S.C.A, Sixth Circuit, April 17, 2026) — Affirmed judgment on the pleadings for the hospital, holding the relator’s allegations of medically unnecessary procedures and kickbacks were substantially the same as publicly disclosed information and that he was not an original source (also failing Rule 9(b) particularity).

31 U.S.C. § 3730(h) — Relief From Retaliatory Actions

Brandt v. Federal Reserve Bank of San Francisco 2026 WL 1224044 (U.S.D.C., W.D. Washington, May 5, 2026) — Dismissed the plaintiff’s FCA retaliation claim without prejudice and granted leave to amend, while dismissing her related ‘outrage’ tort claim with prejudice.

Evans v. Individual Advocacy Group, Inc. 2026 WL 1250650 (U.S.D.C., District of Columbia, May 7, 2026) — Denied the employer’s motion to dismiss the FCA retaliation claim, allowing the theory that the plaintiff was fired for protected activity to proceed (and denying a related discovery motion as moot).

Deedrich v. Danville Redevelopment & Housing Authority 2026 WL 1398780 (U.S.D.C., W.D. Virginia, May 19, 2026) — Granted the employer summary judgment on the plaintiff’s § 3730(h) constructive-discharge retaliation claim.

Young v. Rector & Visitors of the University of Virginia 2026 WL 1557470 (U.S.D.C., W.D. Virginia, June 2, 2026) — Granted in part motions to dismiss physician-plaintiffs’ claims arising from alleged fraudulent-billing pressure, dismissing their FCA and Virginia FATA claims (and RICO claims) without prejudice.

Akindutire v. Northrop Grumman Systems Corp. 2026 WL 1661915 (U.S.D.C., D. Minnesota, June 9, 2026) — Granted the employer’s motion to compel arbitration of the plaintiff’s claims, including his FCA retaliation claim (Count III).

John Libby is an arbitrator, mediator, and settlement counsel with LibbyADR LLC. This summary is provided for general informational purposes and is not legal advice.

This post collects False Claims Act decisions from three quarters — 2025Q3 through 2026Q1 — organized by the statutory provision each decision construes. Westlaw citations, courts, and decision dates follow each case name.

Coverage focuses on decisions that bear on an FCA legal question: liability elements, qui tam procedure, relator awards and fees, the public-disclosure bar, and retaliation. Purely ancillary rulings in FCA cases (routine discovery, sealing, and similar) are omitted. Quarterly updates continue with the 2026Q2 summary.

2025Q3 (July 1 – September 30, 2025)

31 U.S.C. § 3729(a)(1)(A) and (B) — Liability for False Claims and Statements

United States ex rel. Gomez v. Koman Construction, LLC 2025 WL 2437197 (U.S.D.C., W.D. Texas August 22, 2025) — The court discussed how factually false claims misrepresent the goods or services provided, while legally false claims involve an express or implied false certification of compliance with legal or contractual obligations.

United States ex rel. Streck v. Eli Lilly and Company 2025 WL 2618821 (U.S.C.A, Seventh Circuit, September 11, 2025) — The court evaluated drug pricing calculations submitted to Medicaid, determining that excluding subsequent price increases from Average Manufacturer Price calculations contradicted the plain text of statutes, rendering the claims false as a matter of law.

United States ex rel. O’Laughlin v. Radiation Therapy Services, P.S.C. 2025 WL 2417089 (U.S.C.A, Sixth Circuit, August 21, 2025) — The court analyzed the “false certification” theory of liability. The relator alleged that the defendants billed Medicare for radiation services without the required supervision of a qualified physician. The court dismissed the claims because the relator failed to prove that compliance with state-level supervision requirements was a material prerequisite to obtaining payment from Medicare.

United States ex rel. Folse v. Napper 2025 WL 2585680 (U.S.D.C., M.D. Tennessee September 5, 2025) — This case examines how violations of the Anti-Kickback Statute (AKS) predicate FCA liability. The court emphasized the “resulting from” requirement of the statute, interpreting it as a strict but-for causation standard—meaning the submitted false claims must have actually resulted from the underlying AKS violation.

31 U.S.C. § 3729(a)(1)(C) — Conspiracy

United States ex rel. Gomez v. Koman Construction, LLC 2025 WL 2437197 (U.S.D.C., W.D. Texas August 22, 2025) — The court outlined the two requirements to state a conspiracy claim: an unlawful agreement to obtain payment for a false claim, and an overt act in furtherance of it.

United States ex rel. O’Laughlin v. Radiation Therapy Services, P.S.C. 2025 WL 2417089 (U.S.C.A, Sixth Circuit, August 21, 2025) — The court noted that the only evidence pleaded in support of the conspiracy claim was that all defendants committed FCA violations. Because the relator failed to provide sufficient proof of underlying false claims, the derivative conspiracy claim was also dismissed.

United States ex rel. Leslie Carico v. Veterans Guardian VA Claim Consulting, LLC 2025 WL 2588895 (U.S.D.C., M.D. North Carolina September 8, 2025) — The court found that a relator failed to allege any circumstances constituting fraud on the part of the defendants with respect to a conspiracy to fraudulently obtain a PPP loan.

31 U.S.C. § 3729(a)(1)(G) — Reverse False Claims

Island Industries, Inc. v. Sigma Corporation 2025 WL 2422455 (U.S.C.A, Ninth Circuit, August 21, 2025) — The court confirmed that an importer becomes liable for antidumping duties as soon as goods arrive, creating an actionable “obligation” to the government under the FCA even before the exact amount is fixed. It also held that the FCA’s reverse false claims provision can coexist alongside the Tariff Act.

31 U.S.C. § 3729(b) — Definitions of “Knowing” (Scienter) and “Material”

United States ex rel. Streck v. Eli Lilly and Company 2025 WL 2618821 (U.S.C.A, Seventh Circuit, September 11, 2025) — Evaluating scienter, the court emphasized that Congress intended to reach the “ostrich” type situation where an individual buries their head in the sand. Regarding materiality, the court found that the government’s continued payment after learning of the fraud is “evidence of immateriality” but is not on its own “dispositive”.

Island Industries, Inc. v. Sigma Corporation 2025 WL 2422455 (U.S.C.A, Ninth Circuit, August 21, 2025) — The court rejected an objective reasonableness defense to scienter, reaffirming that the FCA focuses on whether the defendant acted with actual knowledge, deliberate ignorance, or reckless disregard, not what a hypothetical reasonable person might have believed.

United States ex rel. Gomez v. Koman Construction, LLC 2025 WL 2437197 (U.S.D.C., W.D. Texas August 22, 2025) — The court interpreted the scienter standard to conclude that the relators successfully alleged that the defendants acted with actual knowledge when they submitted bids knowing they would pass the work through to non-compliant entities to illegally secure set-aside contracts.

31 U.S.C. § 3730(b) — Actions by Private Persons (Qui Tam)

United States v. Gilead Sciences, Inc. 2025 WL 2627686 (U.S.D.C., E.D. Pennsylvania September 11, 2025) — The court addressed a constitutional challenge to the FCA’s qui tam provisions. It rejected the argument that relators violate the Appointments Clause of Article II, noting that relators lack the tenure, duration, and continuous duties required to be considered “Officers of the United States”.

Joel Mahl v. City of New York 2025 WL 2696441 (U.S.D.C., E.D. New York September 22, 2025) — The court noted that because a relator brings an action on behalf of the United States, a non-attorney layperson cannot proceed pro se under the FCA.

Michael Buxbaum v. Walt Disney Co. 2025 WL 2676487 (U.S.D.C., S.D. New York September 18, 2025) — Reaffirmed that because a relator brings an action on behalf of the United States, a non-attorney pro se litigant cannot prosecute a qui tam action.

United States ex rel. STF, LLC v. True Health Diagnostics, LLC 2025 WL 2600012 (U.S.D.C., E.D. Texas September 5, 2025) — The court utilized 31 U.S.C. § 3730(b)(1), which dictates that a qui tam action may only be dismissed if the court and the Attorney General give written consent to approve a joint stipulation of dismissal.

In re Webb 2025 WL 2629846 (U.S.D.C., N.D. Ohio September 12, 2025) — The court rejected a Rule 27 petition to preserve evidence for an anticipated qui tam action, noting that the petitioner failed to identify any actionable fraudulent demand for payment that injured the federal government.

31 U.S.C. § 3730(d) — Award to Qui Tam Plaintiff

United States ex rel. Scott v. Humana Inc. 2025 WL 2603057 (U.S.D.C., W.D. Kentucky September 9, 2025) — The court analyzed a prevailing relator’s petition for attorneys’ fees and expenses following a settlement, determining it was reasonable to award out-of-town specialist rates due to the highly specialized nature of the litigation.

31 U.S.C. § 3730(e)(4) — The Public Disclosure Bar

United States ex rel. Smith v. Odom 2025 WL 2424425 (U.S.C.A, Eleventh Circuit, August 22, 2025) — The court elaborated on the “original source” exception, finding that a relator does not “materially add” to public disclosures by merely supplying background information or details that contextualize the core fraud hypothesis already available in the news media.

United States ex rel. Sorgi v. Jazz Pharmaceuticals 2025 WL 2701928 (U.S.D.C., D. Massachusetts September 23, 2025) — It barred the relator’s suit, finding that the relator lacked insider knowledge, relied entirely on information in the public domain, and merely added “color” to previously disclosed facts.

31 U.S.C. § 3730(h) — Relief From Retaliatory Actions

Evans v. Individual Advocacy Group, Inc. 2025 WL 2651242 (U.S.D.C., District of Columbia September 16, 2025) — The court interpreted the elements of a retaliation claim, holding that an employee who refused to backdate training documents to prevent her employer from defrauding a government agency had plausibly engaged in protected preventative activity.

Reinhardt v. Guidehouse Inc. 2025 WL 2603688 (U.S.D.C., District of Columbia September 9, 2025) — Discussing the scope of claims subject to mandatory arbitration, the court confirmed that employment-related whistleblower retaliation claims brought under the FCA are arbitrable.

United States ex rel. Gomez v. Koman Construction, LLC 2025 WL 2437197 (U.S.D.C., W.D. Texas August 22, 2025) — The court held that to satisfy the “protected activity” element of a retaliation claim, the relator’s conduct must raise a “distinct possibility” of an FCA action or otherwise seek to stop fraud against the government.

2025Q4 (October 1 – December 31, 2025)

31 U.S.C. § 3729(a)(1)(A) and (B) — Liability for False Claims and Statements

United States ex rel. Arehart v. U.S. Medical Management, LLC 2025 WL 3677743 (U.S.D.C., E.D. Wisconsin December 18, 2025) — The court reaffirmed that an FCA presentment claim requires pleading with particularity, dismissing the complaint for providing no details on when, how many, or by whom specific false claims were actually submitted.

Jensen v. Genesis Laboratory Management, LLC 2025 WL 3763951 (U.S.D.C., D. New Jersey December 30, 2025) — The court found that while the relators adequately pled when the fraud occurred, they failed to plead how it occurred with “reliable indicia” that false claims were actually submitted to the government.

Natasha Dixon v. Volunteers of America 2025 WL 3244391 (U.S.D.C., W.D. Louisiana November 20, 2025) — The court allowed a presentment claim to survive, noting the relator identified specific supervisors who instructed employees to falsify Medicaid assessments to ensure coverage, providing reliable indicia of fraud.

Jevarien Z. Dunlap v. Bay Area Rapid Transit 2025 WL 3146412 (U.S.D.C., N.D. California November 11, 2025) — The court identified the four general elements necessary to state a claim under § 3729(a)(1)(A)-(B).

United States ex rel. Breslow v. JP Pharma, LLC 2025 WL 3640892 (U.S.D.C., W.D. Virginia December 16, 2025) — The court found the relator adequately pled falsity regarding a patient inducement scheme where claims were submitted for medically unnecessary treatments tainted by kickbacks.

United States ex rel. Souza v. Embrace Home Loans, Inc. 2025 WL 3072653 (U.S.D.C., D. Rhode Island November 4, 2025) — The court noted that FCA liability under these sections may arise where a defendant falsely certifies compliance with a material requirement of a federal statute or regulation.

United States ex rel. Devarapally v. Ferncreek Cardiology, P.A. 2025 WL 3565506 (U.S.D.C., E.D. North Carolina December 12, 2025) — The court evaluated the “implied certification theory” for medically unnecessary laboratory tests and testimony from physicians regarding their belief of medical necessity at the time they engaged in the treatment and billing.

United States ex rel. Thomas v. Premier Home Health Care Services, Inc. 2025 WL 3002967 (U.S.D.C., S.D. New York October 27, 2025) — The court evaluated the “more relaxed” Rule 9(b) pleading standard concluding that a relator without access to specific bills must still make plausible allegations that the invoices were uniquely within the defendant’s control.

United States ex rel. Relator, LLC v. iLink Employers Company 2025 WL 3066301 (U.S.C.A, Ninth Circuit, November 3, 2025) — The court reversed a dismissal, finding the relator plausibly alleged with particularity that the defendants made false statements and submitted false certifications on federal Paycheck Protection Program (PPP) loan applications.

United States ex rel. Gentry v. Encompass Health Rehabilitation Hospital 2025 WL 3063921 (U.S.C.A, Fifth Circuit, November 3, 2025) — The court dismissed false presentment and false records claims because the relator failed to accompany conclusory allegations with details of an actually submitted false claim.

31 U.S.C. § 3729(a)(1)(C) — Conspiracy

United States ex rel. Arehart v. U.S. Medical Management, LLC 2025 WL 3677743 (U.S.D.C., E.D. Wisconsin December 18, 2025) — The court dismissed a conspiracy claim because the relator failed to adequately allege an underlying FCA violation.

Jensen v. Genesis Laboratory Management, LLC 2025 WL 3763951 (U.S.D.C., D. New Jersey December 30, 2025) — The court reiterated that without an underlying violation of the FCA, there can be no derivative liability for conspiracy.

Natasha Dixon v. Volunteers of America 2025 WL 3244391 (U.S.D.C., W.D. Louisiana November 20, 2025) — The court dismissed a conspiracy claim because it requires at least two legally distinct actors, and after one defendant was dismissed for lack of jurisdiction, no second conspirator remained.

31 U.S.C. § 3729(a)(1)(G) — Reverse False Claims

Natasha Dixon v. Volunteers of America 2025 WL 3244391 (U.S.D.C., W.D. Louisiana November 20, 2025) — The court held that potential penalties falling within a discretionary range cannot serve as the basis for an “obligation” under a reverse false claim theory.

Christopher A. Feduccia v. I.C.E. Services, Inc. 2025 WL 3251221 (U.S.D.C., D. Alaska November 21, 2025) — The court dismissed a reverse false claim related to the retention of PPP loan funds because the relator failed to plead with specificity exactly how the defendant knowingly concealed or avoided its obligation to return the funds.

United States ex rel. Thomas v. Premier Home Health Care Services, Inc. 2025 WL 3002967 (U.S.D.C., S.D. New York October 27, 2025) — The court dismissed reverse false claims because they mirrored the relator’s direct false claims, noting that reverse false claims cannot be premised on the same conduct.

31 U.S.C. § 3729(b) — Definitions of “Knowing” (Scienter) and “Material”

United States ex rel. Schutte v. SuperValu Inc. 2025 WL 3048985 (U.S.D.C., C.D. Illinois October 31, 2025) — The court reaffirmed the Supreme Court’s standard that “knowingly” focuses on subjective beliefs—whether the defendant actually knew, intentionally avoided learning, or submitted claims despite a substantial and unjustifiable risk of falsity.

United States of America and State of Minnesota ex rel. Ashley Mothershed v. Mayo Clinic Ambulance 2025 WL 3043342 (U.S.D.C., D. Minnesota October 31, 2025) — The court emphasized that a relator must show the defendant acted knowingly with respect to the particular false claim at issue.

United States ex rel. Breslow v. JP Pharma, LLC 2025 WL 3640892 (U.S.D.C., W.D. Virginia December 16, 2025) — Reaffirming Schutte, the court reiterated that the scienter element refers to defendants’ subjective beliefs, not an objectively reasonable person.

United States ex rel. Souza v. Embrace Home Loans, Inc. 2025 WL 3072653 (U.S.D.C., D. Rhode Island November 4, 2025) — The court noted that materiality is a “fact-intensive and context-specific inquiry”.

United States ex rel. Omni Healthcare Inc. v. MD Spine Solutions LLC 2025 WL 3442574 (U.S.C.A, First Circuit, December 1, 2025) — The court evaluated the scienter requirement for laboratories performing “medically unnecessary” tests, holding that a laboratory can generally rely on a doctor’s order to show that a test is medically necessary.

31 U.S.C. § 3730(b) — Actions by Private Persons (Qui Tam)

United States ex rel. Goebel v. Anchorage SNF, LLC 2025 WL 2898087 (U.S.D.C., D. Maryland October 10, 2025) — Interpreting the first-to-file bar, the court held that an earlier-filed lawsuit that alerts the government to the essential facts of a fraudulent scheme completely bars a later action, even if the new action names entirely different defendants.

Ronetta Smith v. Respiro, LLC 2025 WL 3140610 (U.S.D.C., N.D. Illinois November 10, 2025) — The court ruled that a relator’s complete failure to comply with the procedural requirements of § 3730(b)(2)—by filing on the public docket and failing to serve the government—inherently harms the government and mandates dismissal with prejudice.

Jevarien Z. Dunlap v. Bay Area Rapid Transit 2025 WL 3146412 (U.S.D.C., N.D. California November 11, 2025) — Reaffirmed that a non-attorney pro se litigant cannot prosecute a qui tam action.

United States ex rel. Gentry v. Encompass Health Rehabilitation Hospital 2025 WL 3063921 (U.S.C.A, Fifth Circuit, November 3, 2025) — Touched on constitutional issues with unaccountable private actors exercising core executive power.

Michael Hunter v. Doctor Haas 2025 WL 2830261 (U.S.D.C., D. South Dakota October 6, 2025) — Non-attorney pro se litigant cannot prosecute a qui tam action.

Terasa DeMarinis v. Southern New Hampshire University 2025 WL 3012854 (U.S.D.C., D. Massachusetts October 28, 2025) — Non-attorney pro se litigant cannot prosecute a qui tam action.

United States ex rel. Relator LLC v. Pape (The Articom Group) 2025 WL 3707557 (U.S.D.C., N.D. California December 22, 2025) — Discussed constitutional and public disclosure limits on private actions.

31 U.S.C. § 3730(d) — Award to Qui Tam Plaintiff

United States ex rel. Jahr v. Tetra Tech EC, Inc. 2025 WL 3124335 (U.S.D.C., N.D. California November 7, 2025) — The court noted that arguments regarding the extent to which relators “substantially contributed to the prosecution of the action” under § 3730(d)(1) must be made claim-by-claim with specific evidentiary support.

BNSF Railway Company v. The Center for Asbestos Related Disease 2025 WL 3004741 (U.S.D.C., D. Montana October 27, 2025) — Following a jury finding that the defendant committed 337 violations of the FCA, the court awarded the relator 25% of the total proceeds.

31 U.S.C. § 3730(e)(4) — The Public Disclosure Bar

Christopher A. Feduccia v. I.C.E. Services, Inc. 2025 WL 3251221 (U.S.D.C., D. Alaska November 21, 2025) — Confirmed that data hosted on federal websites regarding PPP loans constitute “federal reports” that trigger the public disclosure bar.

United States v. William Allan Jones 2025 WL 3240804 (U.S.D.C., N.D. California November 20, 2025) — Consistently confirmed that data hosted on federal websites regarding PPP loans constitute “federal reports” that trigger the public disclosure bar.

United States ex rel. Relator LLC v. Pape (The Articom Group) 2025 WL 3707557 (U.S.D.C., N.D. California December 22, 2025) — Evaluated whether the Small Business Administration’s website disclosing a company’s PPP loan triggered the bar, concluding it did not because the website only disclosed the misrepresented facts.

31 U.S.C. § 3730(h) — Relief From Retaliatory Actions

United States ex rel. Thomas v. Premier Home Health Care Services, Inc. 2025 WL 3002967 (U.S.D.C., S.D. New York October 27, 2025) — Distinguished retaliation claims from substantive fraud claims, holding that an FCA retaliation claim need not be plead with particularity.

United States v. Alabama Psychiatry LLC 2025 WL 3213480 (U.S.C.A, Eleventh Circuit, November 18, 2025) — Affirmed a grant of summary judgment in favor of a former employer regarding an FCA retaliation claim.

2026Q1 (January 1 – March 31, 2026)

31 U.S.C. § 3729(a)(1)(A) and (B) — Liability for False Claims and Statements

United States ex rel. Sedona Partners LLC v. Able Moving & Storage, Inc. 2026 WL 492402 (U.S.D.C., S.D. Florida February 23, 2026) — Interpreted the presentment claim requirement, ruling that a relator must offer indicia of reliability or actual submission of a false claim.

Mary Bixler Wood v. Siemens Medical Solutions USA, Inc. 2026 WL 504530 (U.S.C.A, Second Circuit, February 24, 2026) — Dismissed FCA claims because the relator failed to plead under Rule 9(b) that the allegedly malfunctioning medical devices were actually sold to or paid for by the government.

United States ex rel. Camburn v. Novartis Pharms. Corp. 2026 WL 864529 (U.S.D.C., S.D. New York March 30, 2026) — Ruled that a relator successfully pled fraud with particularity by utilizing a representative sample exhibit detailing specific doctors, the exact number of tainted claims, and exact Medicare reimbursement amounts resulting from illegal kickbacks.

Calvin Andrews v. Spokane Housing Authority 2026 WL 851989 (U.S.D.C., E.D. Washington March 27, 2026) — Briefly defined a false or fraudulent claim for payment as the imposition of civil liability on anyone who knowingly presents or uses a false record or statement material to a claim to the United States government.

United States ex rel. Scarbrough v. Alabama Cancer Care, LLC 2026 WL 208627 (U.S.D.C., N.D. Alabama January 27, 2026) — Elaborated that presentment requires specific information about the submission of claims.

United States ex rel. Adventist Health System of West v. AbbVie Inc. 2026 WL 743495 (U.S.C.A, Ninth Circuit, March 17, 2026) — Held that a relator adequately stated claims by alleging drug manufacturers fraudulently inflated drug prices in violation of the Section 340B Program.

Adam Josephs v. Amentum Services Inc. 2026 WL 183543 (U.S.D.C., D. Maryland January 23, 2026) — Addressed an interlocutory appeal request over pleading an implied false certification claim.

United States ex rel. Koehler v. United Site Services, Inc. 2026 WL 865782 (U.S.D.C., E.D. New York March 30, 2026) — In a non-intervened qui tam alleging false claims tied to a GSA Multiple Award Schedule contract for portable-restroom and related services, the court granted the defendant’s motion to dismiss the relator’s federal and state FCA claims under Rules 9(b) and 12(b)(6) for failure to plead the alleged fraud with the required particularity.

United States ex rel. Segura v. Surgical Care Affiliates, LLC 2026 WL 872445 (U.S.D.C., D. Kansas March 31, 2026) — In an FCA suit alleging that ambulatory surgery centers ran an illegal upcoding scheme, the court granted in part and denied in part the defendants’ motion to dismiss—allowing the presentment and false-statement claims under § 3729(a)(1)(A) and (B) to proceed while dismissing the conspiracy claim under § 3729(a)(1)(C) as resting on only a formulaic recitation of an agreement.

United States ex rel. Hennessey v. UPMC Altoona 2026 WL 878755 (U.S.D.C., W.D. Pennsylvania March 31, 2026) — In a qui tam alleging that UPMC hospitals fraudulently upcoded emergency-room visits billed to Medicare and Medicaid, the court granted the defendants’ motion to dismiss the amended complaint, holding the relator failed to plead the alleged fraud with Rule 9(b) particularity and failed to plausibly allege scienter.

31 U.S.C. § 3729(a)(1)(G) — Reverse False Claims

United States v. LabQ Clinical Diagnostics, LLC 2026 WL 787460 (U.S.D.C., S.D. New York March 20, 2026) — Determined that the Affordable Care Act’s requirement that a provider report and return overpayments imposes an immediate, self-executing obligation sufficient to support a reverse false claim action.

United States ex rel. Frey v. Health Management Systems, Inc. 2026 WL 637725 (U.S.C.A, Fifth Circuit, March 6, 2026) — Evaluated reverse false claims allegations, finding the summary-judgment record did not contain evidence that the defendant actually failed to bill even a single claim under its contracts.

31 U.S.C. § 3729(b) — Definitions of “Knowing” (Scienter) and “Material”

United States ex rel. Scarbrough v. Alabama Cancer Care, LLC 2026 WL 208627 (U.S.D.C., N.D. Alabama January 27, 2026) — Interpreted the FCA’s “scienter” requirement—demanding actual knowledge, deliberate ignorance, or reckless disregard—and found it adequately alleged.

United States ex rel. Sheldon v. Allergan Sales, LLC 2026 WL 706428 (U.S.C.A, Fourth Circuit, March 13, 2026) — Applying the subjective scienter standard, the court noted that the ambiguity of a statute does not defeat scienter if the defendant was subjectively aware of a substantial risk that the government interpreted the statute differently.

31 U.S.C. § 3730(b) — Actions by Private Persons (Qui Tam)

United States ex rel. Adventist Health System of West v. AbbVie Inc. 2026 WL 743495 (U.S.C.A, Ninth Circuit, March 17, 2026) — Evaluating the purpose of the qui tam provision, emphasized that a relator uses the FCA as an independent mechanism, not barred by the 340B statute lacking a private right of action.

United States v. Lockheed Martin Corporation (Ferguson) 2026 WL 656046 (U.S.C.A, Fifth Circuit, March 9, 2026) — Distinguishing the first-to-file bar, ruled it does not apply if the later complaint alleges a different mechanism or scheme of perpetrating the fraud, rather than merely adding details or new locations.

Alana Sullivan v. Murphy Medical Center 2026 WL 657192 (U.S.D.C., E.D. Tennessee March 9, 2026) — Clarified that when the government intervenes on only some claims within an action, the relator is not precluded from independently proceeding with the non-intervened claims.

Michael J. Izquierdo v. United States 2026 WL 626731 (U.S.D.C., N.D. Ohio March 6, 2026) — Reaffirmed that because a relator brings an action on behalf of the United States, a non-attorney pro se litigant cannot prosecute a qui tam action.

Adam Josephs v. Amentum Services Inc. 2026 WL 183543 (U.S.D.C., D. Maryland January 23, 2026) — Addressed an interlocutory appeal regarding constitutionality.

Corey Spaulding v. Pamela Bondi 2026 WL 189488 (U.S.D.C., D. Massachusetts January 23, 2026) — Dismissed a pro se plaintiff’s FCA complaint entirely because the plaintiff failed to comply with statutory relator procedures.

United States ex rel. McDermott v. Haworth Apothecary 2026 WL 836604 (U.S.D.C., D. New Jersey March 26, 2026) — In a qui tam action alleging a hospice-billing scheme in which the United States and New Jersey declined to intervene, the court denied the relator’s third motion for leave to amend the complaint under Rules 15 and 16 given the advanced stage of the litigation, declining to reach the defendant’s futility arguments.

United States ex rel. Pepe v. Fresenius Medical Care Holdings 2026 WL 875240 (U.S.D.C., E.D. New York March 31, 2026) — In a partially-intervened qui tam against dialysis providers, the court granted the relators’ motion for leave to file a Fifth Amended Complaint reviving previously-dismissed non-intervened claims, rejecting the defendants’ futility arguments—including their contention that the FCA public-disclosure bar barred the relators from relying on information in the government’s intervention complaint.

31 U.S.C. § 3730(d) — Award to Qui Tam Plaintiff

United States ex rel. David Perry v. First Psychiatric Planners, Inc. 2026 WL 412327 (U.S.D.C., D. Massachusetts February 13, 2026) — Interpreted § 3730(d)(3) to mean that if a relator is convicted of criminal conduct arising from his role in the underlying FCA violation, he is barred from recovering any share.

31 U.S.C. § 3730(e)(4) — The Public Disclosure Bar

United States ex rel. Scarbrough v. Alabama Cancer Care, LLC 2026 WL 208627 (U.S.D.C., N.D. Alabama January 27, 2026) — Applied the public disclosure bar to dismiss claims against a doctor because his status and Medicare billing history were publicly disclosed on the CMS database.

United States ex rel. St. Paul’s Foundation v. Timothy Wipperman 2026 WL 622771 (U.S.D.C., M.D. Tennessee March 5, 2026) — Noted that following the 2010 amendments to the FCA, the public disclosure bar is no longer a jurisdictional hurdle, and must be evaluated under Rule 12(b)(6).

United States ex rel. Relator LLC v. David O’Rourke 2026 WL 799601 (U.S.D.C., E.D. New York March 23, 2026) — Confirmed that data hosted on federal websites regarding PPP loans constitute “federal reports” that trigger the public disclosure bar.

31 U.S.C. § 3730(h) — Relief From Retaliatory Actions

United States ex rel. Quintin J. Schwartz Sr. v. Document Reprocessors 2026 WL 795590 (U.S.D.C., W.D. New York March 23, 2026) — Analyzed the 2009 amendments to the FCA, concluding that the deletion of the word “employer” did not expand retaliation liability to include individual supervisors; liability may only be imposed on the employer entity.

United States ex rel. Sargent v. Collins 2026 WL 171536 (U.S.C.A, First Circuit, January 22, 2026) — Held that the FCA does not contain an express waiver of federal sovereign immunity for retaliation claims, meaning a federal employee cannot sue the United States government for retaliation under this section.

John Libby is an arbitrator, mediator, and settlement counsel with LibbyADR LLC. This summary is provided for general informational purposes and is not legal advice.