DRAFT FOR ATTORNEY REVIEW — NOT FINAL

§ 881

Citation
§ 881
Parent Document
United States v. Southland Management Corp., 326 F.3d 669 (2002)
Effective Date
2002-05-22
Original Source
https://www.courtlistener.com/opinion/27565/united-states-v-southland-managem... ↗

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should have been denied, this court then noted that the parties disputed
whether “the certifications of compliance contained in annual cost reports are
. . . a prerequisite to payment of Medicare claims.” Id. The defendants in
Thompson argued that the certifications were not a prerequisite to payment
because "Medicare claims are submitted for payment shortly after services have
been rendered and well before annual cost reports are filed." Id. The
plaintiff argued "that such certifications are indeed a prerequisite to
payment because the retention of any payment received prior to the submission
of an annual cost report is conditioned on the certification of compliance
contained therein." Id. Because this court was “unable to determine from the
record before us whether, or to what extent, payment for services identified
in defendants' annual cost reports was conditioned on defendants'
certifications of compliance,” this court elected to “deny defendants'
12(b)(6) motions as they relate to this issue and remand to the district court
for further factual development . . . [to] determine whether the government’s
payment of defendants’ Medicare claims was conditioned on defendants’
certifications of compliance in their annual cost reports.” Id. at 902-03
(emphasis added). If the mere certifications had sufficed to establish
liability, this remand would have been unnecessary.
      34
            The Ninth Circuit requires a causal link between the false
certification and the agency’s decision to pay. United States ex rel. Hopper
v. Anton, 91 F.3d 1261, 1266 (9th Cir. 1996).
       35
             See, e.g., United States ex rel. Siewick v. Jamieson Sci. and
Eng’g, 214 F.3d 1372 (D.C. Cir. 2000); United States ex rel. Mikes v. Straus,
274 F.3d 687 (2d Cir. 2001); Harrison v. Westinghouse Savannah River Co., 176
F.3d 776 (4th Cir. 1999); United States ex rel. Hopper v. Anton, 91 F.3d 1261
(9th Cir. 1996).