Lost Without a Cause: The Sixth Circuit’s But-For Standard for False Claims Act Violations Harms Healthcare Fraud Enforcement
Year: 2026
Type: preprint
Abstract: This note examines the growing circuit split over the causation standard governing False Claims Act (FCA) actions predicated on violations of the Anti-Kickback Statute (AKS). Congress’s 2010 amendment to the AKS provides that claims for reimbursement “resulting from” illegal kickbacks constitute false claims under the FCA, but federal courts have disagreed about the meaning of that phrase. Focusing on the Sixth Circuit’s decision in United States ex rel. Martin v. Hathaway, the note analyzes the court’s adoption of a but-for causation requirement and its reliance on textualist principles and the Supreme Court’s decision in Burrage v. United States. The note contrasts that approach with the Third Circuit’s less demanding “link” standard and argues that the Sixth Circuit erred by treating but-for causation as the default and exclusive interpretation of the statutory text. Drawing on principles of statutory interpretation, the whole code rule, legislative history, and Supreme Court decisions interpreting similar causal language, including Paroline v. United States and Pacific Operators Offshore, LLP v. Valladolid, the note contends that courts should consider statutory purpose and context in addition to ordinary meaning. The note further argues that a but-for standard undermines Congress’s objective of strengthening healthcare fraud enforcement by making it substantially more difficult for relators and the government to prove AKS-based FCA violations. Because healthcare fraud often involves complex decision-making processes and multiple contributing factors, the note concludes that the Third Circuit’s causation framework better aligns with the structure and purpose of the AKS and FCA. The note warns that the Sixth Circuit’s approach may weaken fraud deterrence, reduce the effectiveness of whistleblower enforcement, and encourage courts to adopt an overly rigid approach to interpreting causal language across statutory schemes.[This abstract was written by Microsoft Copilot, a generative artificial intelligence.]
Author: Margo Chapin
Language: English
Topic: Legal Cases and Commentary
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Funder: Australian Government
OpenAlex ID: W7002028729
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