From Kickbacks to False Claims: The Causation Consequences of the 2010 Anti-Kickback Statute Amendment
https://legal-forum.uchicago.edu/print-archive/kickbacks-false-claims-causation-consequences-2010-anti-kickback-statute-amendment
The 2010 amendment to the Anti-Kickback Statute (AKS) sought to strengthen federal healthcare fraud enforcement by clarifying that Medicare and Medicaid claims submitted to the government “resulting from” AKS violations constitute false claims under the False Claims Act (FCA). However, two words, “resulting from,” have created a deep circuit split over the requisite causation standard. Drawing on burden-shifting frameworks from employment discrimination law, antitrust merger challenges, and fiduciary duty cases, this Comment proposes a burden-shifting approach to AKS-predicated FCA claims. This approach addresses the information asymmetry inherent in healthcare fraud cases—where evidence of kickbacks often remains in defendants’ possession—while protecting against prosecutorial overreach. By leveling the evidentiary playing field, a burden-shifting framework offers a practical middle ground that serves both the government’s interest in combating healthcare fraud while not over prosecuting healthcare professionals with good intent.