Blog Browse: What can recent FCA decisions tell us about the Seventh Circuit pleading standard for health care billing fraud claims?

False Claims Act complaints are subject to the heightened pleading requirements of Rule 9(b), but circuits are split on whether that requirement should be relaxed for relators, or whistleblowers, who lack direct access to the alleged fraud. The status of the pleading standard is particularly relevant to health care providers accused of billing fraud under the False Claims Act. Can a whistleblower successfully allege Medicaid/Medicare fraud if the whistleblower lacked direct access to records related to the alleged fraud? How much detail does a whistleblower need to provide in a complaint? 

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