9th Circuit Affirms, Finds Materiality Absent In FCA Prior Authorization Suit

Mealey's ( January 20, 2023, 2:13 PM EST) -- SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals affirmed a district court order dismissing a relator’s qui tam action alleging that pharmacies participated in fraudulent conduct that violated the False Claims Act (FCA) to obtain prior authorizations for prescriptions from government and private insurers, finding that the claims “fail to plead a government payor” and do not “adequately allege materiality.”...