Whether the implied certification theory of liability under the False Claims Act is viable

QUESTIONS PRESENTED The questions presented for review are: 1. Whether the implied certification theory of liability under the False Claims Act is viable, and if so, whether it requires that the Defendant(s) comply with a specific legal requirement that is material to the government’s payment decision. 2. Whether the First Circuit erred in applying the materiality standard for implied certification claims in this case. 3. Whether the lower court’s interpretation and application of the implied certification theory of False Claims Act (FCA) liability is consistent with the Supreme Court’s decision .in Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016). 4. Whether the lower court’s decision conflicts with other circuit courts’ interpretation and application of the implied certification theory of FCA liability. . 5. Whether the lower court’s decision undermines the materiality standard set forth in Escobar . by allowing FCA claims based on immaterial _ or minor violations. 6. Whether the lower court’s decision improperly ; expands the scope of FCA liability by allowing plaintiffs to bring claims based on implied or unspoken requirements that are not expressly designated as conditions of payment. : | | ; ii 7. Whether the lower court’s decision creates , : uncertainty and unpredictability in FCA litigation by allowing plaintiffs to bring claims based on a broad range of contractual or regulatory violations. 8. Whether the lower court’s decision violates the principles of fair notice and due process by allowing FCA liability based on unclear or ambiguous contractual or regulatory provisions. 9. Whether the lower court’s decision conflicts with the Supreme Courts precedent on . statutory interpretation and the role of agency | guidance in determining FCA lability. | 10. Whether the lower court’s decision improperly shifts the burden of proof in FCA cases by requiring Defendant(s) to disprove materiality rather than requiring plaintiffs to prove it. 11. Whether the lower court’s decision undermines the government’s ability to negotiate and enforce contracts with private parties by : allowing FCA claims based on technical or minor violations. 12.Whether the lower court’s decision conflicts with the policy goals of the FCA and the need to balance the interests of the government and private parties in contract negotiations and performance. 13.Whether multiple diagnostic evaluation and treatment encounter are considered by Horizon’s relator Scott Johnson are Fraud iii : without considering the American Medical _ Association which is the authority of CPT Codes and ICD-9(ICD-10) codes and the billing services which has been verified (AAPC and AMA Reports). . 14.Whether the Americans with Disability Act focus is to prepare the patient with Disabilities ; for Employment and Independent living, as : well as, the New Jersey Mandate for Autism and Other Neurodevelopmental Disabilities emphasis is through frequent evaluative and treatment criteria to prepare the above ; patients with Autism and Other Developmental Disabilities for independent living and self-sufficient employment. | iv