United States of America ex rel SW Challenger v. Evicore Healthcare MSI

Background

This False Claims Act case was brought under the Act’s qui tam provisions. The United States had declined to intervene, and the case was unsealed in June 2020. The defendant had moved to dismiss the relators’ second amended complaint.

One issue raised by the motion was whether the relators adequately alleged the submission of a claim, an element of a False Claims Act claim. The issue concerned how Medicare and Medicaid managed-care plans are structured and what submissions qualify as claims under the statute.

Requests and Ruling

The United States asked to submit a statement of interest under 28 U.S.C. § 517 addressing the definition of a claim and its application in the managed-care context. The defendant asked for additional time to respond to any points raised by the Government.

Judge Victor Marrero granted the request at Docket No. 33. The Government may submit its statement of interest by February 22, 2021, and the defendant’s reply deadline was extended to March 15, 2021. The order did not rule on the pending motion to dismiss or decide the underlying False Claims Act issues.