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Higher Education: An Appropriate Realm to Impose False Claims Act Liability Under the Post-Formation Implied False Certification Theory
University of Pittsburgh Law Review ( IF 0.107 ) Pub Date : 2017-03-29 , DOI: 10.5195/lawreview.2016.453
Christopher J. Dellana

Confederate batteries opened up on Fort Sumter in April of 1861, inaugurating the bloodiest conflict in American history. President Abraham Lincoln’s war effort, nursing wounds from defeats at Fredericksburg in 1862 and Chancellorsville in 1863, sorely needed more men and supplies. Propaganda campaigns and conscription efforts filled gaps in the depleted ranks of Lincoln’s army, helping it swell into the largest mobilization of troops in the world. Reliable supplies were, however, harder to come by; while Union soldiers fell to Confederate bullets and bayonets on the battlefield, army commissaries and quartermasters fell victims to fraud. A lack of meaningful government oversight had created an environment rife with profiteering. During the first years of the war, the government unwittingly purchased 1,000 horses so sick with every known equine disease that they were entirely useless; in another instance, the government paid a contractor for 411 horses of which only 76 were found fit for service (with the remainder being either blind, undersized, ringboned, or dead upon arrival). The government also bought artillery shells filled with sawdust rather than gunpowder, flimsy shoes that lasted for only twenty days, “rotten” blankets, “worthless” overcoats, and “muskets not [even] worth shooting.” To stop these abuses, Congress appointed a special committee, called the Select Committee on Government Contracts, to investigate the extent of the fraudulent contracting; the committee solicited testimony from military personnel, experts, and others that highlighted the disturbing magnitude of the problem. In response, the Union government promulgated the False Claims Act (“FCA”) in March of 1863. Following the conclusion of the war, and the rapid decline of government contracting needs, the FCA was left to gather dust in a forgotten corner of federal law until the late twentieth century. In the 1980s, the FCA surged back to prominence to address abuses in the defense contracting industry and, once again, it became the government’s weapon of choice to combat fraud. Since its Civil War origins, the FCA has undergone substantial changes. Congress, in recognition of the FCA’s increasing importance with the growth of the modern regulatory state, expanded the purview of the FCA in both 1986 and 2009, much to the chagrin of government contractors. The 2009 amendment, in particular, was a clear demonstration of congressional intent to expand the scope of the FCA by overriding federal judicial precedent that attempted to limit it. Congress’s goal in amending the FCA, thus, was not just to “enact a broad remedial statute” but rather to “preserve the traditional boundaries of fraud,” as well. The FCA operates as a powerful tool to combat fraud that, otherwise left unchecked, might imperil the federal government’s finances. The FCA allows either the Attorney General or a qui tam whistleblower (known in the FCA context as a relator) to bring an action on behalf of the United States against persons or entities committing certain types of fraud against the government. The FCA, codified at 31 U.S.C. § 3729, holds that any individual who “knowingly” presents or knowingly conspires to “present[], or cause[] to be presented, a false or fraudulent claim for payment or approval” or “makes, uses, or causes to be made or used, a false record or statement material to a false . . . claim” is liable under the FCA, which imposes damages up to $11,000 per violation in addition to treble the amount of the government’s damages. This can result in cases where the damages could total a staggering $2 billion. The FCA, as a tool of fraud deterrence and of compliance enforcement, has had the most significant effect on the healthcare industry. By way of illustration, between 1986 and 2009, two-thirds of the $22 billion recovered by the federal government ($14.3 billion) came from recoveries in the healthcare industry. Since 2009, however, differing interpretations of the Fraud Enforcement and Recovery Act (“FERA”), the passage of the Patient Protection and Affordable Care Act (“ACA”), and the Supreme Court’s unanimous decision in Universal Health Services, Inc. v. United States ex rel. Escobar have all expanded the scope of the FCA, leading new industries to find themselves increasingly in the crosshairs of expanded procedural theories of liability. At an operative level, the FCA posits that both “factually false” and “legally false” claims are actionable; “factually false” claims include goods or services either incorrectly described or not provided at all, and “legally false” claims are false based on statements, promises, or other certifications of compliance. While various circuits have held that the FCA reaches factually false conduct, legal falsity (with the Supreme Court’s recent endorsement) could gain traction as an equally important theory for prosecuting fraud. This expanded theory of liability may continue to evolve as the industries that the FCA regulates continue to evolve, as well. One such industry falling under this broad purview is higher education. This Note will address whether or not educational institutions in the for-profit sector should be held liable under the FCA for entering into a Program Participant Agreement (“PPA”) with the government, in good faith, only to thereafter commit fraud. This Note contends that the modern higher education environment provides an appropriate context in which courts may permissibly disregard any distinction between conditions of participation and conditions of payment for purposes of imposing FCA liability. It further posits that the Supreme Court’s Escobar decision, though an important landmark toward a broader enforcement tool, did not go far enough to deter fraud in higher education. Part I will describe the background of the FCA, the rationale for the development of the “legally false” theory of liability, and the differences between the express and implied types of certification. It will also discuss judicial interpretation of legal falsity, with emphasis on the Supreme Court’s decision in Escobar . Part II will address conditions of participation and conditions of payment and why the difference may remain significant in the fraud context. Part III will explain the structure of for-profit educational institutions, their role as government contractors, and the nature of the circuit split regarding the receipt of Higher Education Act (“HEA”) Title IV funds and FCA liability. Part IV will discuss policy implications of this “implied certification of post-formation performance” theory and why the educational setting is the appropriate venue in which to hold government contractors liable for fraud on an expansive sub-theory of implied false certification.

中文翻译:

高等教育:成立后隐含虚假证明理论下的虚假申报行为责任的适当领域

1861 年 4 月,南方邦联的炮台在萨姆特堡开放,开启了美国历史上最血腥的冲突。亚伯拉罕林肯总统的战争努力,在 1862 年在弗雷德里克斯堡和 1863 年在 Chancellorsville 的失败中护理伤口,迫切需要更多的人员和补给。宣传运动和征兵工作填补了林肯军队精疲力竭的队伍中的空缺,帮助其壮大为世界上最大的军队动员。然而,可靠的供应更难获得。联邦士兵在战场上被邦联的子弹和刺刀击倒,陆军小卖部和军需官则成为欺诈的受害者。缺乏有意义的政府监督造成了暴利泛滥的环境。在战争的头几年,政府不知不觉地购买了 1, 000 匹马患上了各种已知的马病,以至于它们完全没用;在另一个例子中,政府为 411 匹马支付了承包商的费用,其中只有 76 匹适合服役(其余的要么是盲人,要么是身材矮小,要么是马铃薯,要么在抵达时死亡)。政府还购买了装满锯末而不是火药的炮弹、只穿了 20 天的破鞋、“腐烂”的毯子、“毫无价值的”大衣和“[甚至]不值得射击的火枪”。为了制止这些滥用行为,国会任命了一个名为政府合同特别委员会的特别委员会来调查欺诈性合同的程度;委员会征求了军事人员、专家和其他人的证词,以突出问题的严重性。作为回应,联邦政府于 1863 年 3 月颁布了《虚假申报法》(“FCA”)。随着战争的结束和政府合同需求的迅速下降,FCA 在联邦法律的一个被遗忘的角落里尘土飞扬,直到二十世纪末。在 1980 年代,FCA 重新崛起以解决国防承包行业的滥用问题,并再次成为政府打击欺诈的首选武器。自内战起源以来,FCA 发生了重大变化。国会认识到 FCA 随着现代监管国家的发展日益重要,在 1986 年和 2009 年扩大了 FCA 的范围,这让政府承包商非常懊恼。2009 年的修正案,特别是 明确表明国会有意通过推翻试图限制 FCA 的联邦司法先例来扩大 FCA 的范围。因此,国会修改 FCA 的目标不仅仅是“制定广泛的补救法规”,而是“保留欺诈的传统界限”。FCA 是打击欺诈的强大工具,否则可能会危及联邦政府的财政。FCA 允许总检察长或 qui tam 举报人(在 FCA 上下文中称为关联者)代表美国对针对政府实施某些类型欺诈的个人或实体提起诉讼。FCA 编纂在 31 USC § 3729 中,认为任何“故意”呈现或故意共谋“呈现[],或导致[]被呈现,对付款或批准的虚假或欺诈性索赔”或“制作、使用或导致制作或使用虚假记录或陈述材料以伪造 . . . 索赔”是根据 FCA 承担责任的,除了政府赔偿金额的三倍之外,每次违规的赔偿金额最高为 11,000 美元。这可能导致损失总额达到惊人的 20 亿美元。FCA 作为欺诈威慑和合规执法的工具,对医疗保健行业产生了最显着的影响。举例来说,在 1986 年至 2009 年期间,联邦政府收回的 220 亿美元(143 亿美元)中有三分之二来自医疗保健行业的复苏。然而,自 2009 年以来,对欺诈执法和恢复法案(“FERA”)、患者保护和平价医疗法案(“ACA”)的通过有不同的解释,以及最高法院在 Universal Health Services, Inc. v. United States ex rel. 案中的一致裁决。Escobar 都扩大了 FCA 的范围,导致新兴行业发现自己越来越多地处于扩大的程序责任理论的十字准线中。在操作层面上,FCA 认为“事实上虚假”和“合法虚假”的声明都是可以起诉的;“事实上虚假”的声明包括错误描述或根本没有提供的商品或服务,“合法虚假”的声明是基于声明、承诺或其他合规证明的虚假声明。虽然各个巡回法院都认为 FCA 达到了事实上的虚假行为,但法律虚假性(在最高法院最近的认可下)可能会成为起诉欺诈的同样重要的理论。随着 FCA 监管的行业不断发展,这种扩展的责任理论可能会继续发展。属于这一广泛范围的一个这样的行业是高等教育。本说明将讨论营利性部门的教育机构是否应根据 FCA 与政府真诚地签订计划参与者协议 (“PPA”) 并在此后实施欺诈行为承担责任。本说明认为,现代高等教育环境提供了一个适当的背景,在这种背景下,法院可以允许为了施加 FCA 责任而忽略参与条件和支付条件之间的任何区别。它还进一步假定,最高法院的 Escobar 决定虽然是迈向更广泛执法工具的重要里程碑,还不足以阻止高等教育中的欺诈行为。第一部分将描述 FCA 的背景、发展“合法虚假”责任理论的基本原理,以及明示和暗示认证类型之间的差异。它还将讨论法律虚假的司法解释,重点是最高法院在埃斯科瓦尔案的裁决。第二部分将讨论参与条件和付款条件,以及为什么在欺诈情况下差异可能仍然很大。第三部分将解释营利性教育机构的结构、它们作为政府承包商的角色,以及关于接受高等教育法案 (“HEA”) 第四章资金和 FCA 责任的电路拆分的性质。
更新日期:2017-03-29
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