By Barbara Rowland and Carolyn Kendall (January 3, 2018, 11:51 AM EST) -- On Nov. 16, 2017, the Third Circuit ended a long-fought False Claims Act case of alleged Medicare Part D fraud, holding that a pharmacy benefit manager's (PBM's) limited noncompliance with pharmacy claims processing requirements was not material to Medicare's payment decisions within the meaning of the U.S. Supreme Court's Escobar decision.[1] The Third Circuit's affirmation of the district court's summary judgment dismissal in United States ex rel. Spay v. CVS Caremark Corporation[2] relied heavily on evidence that the government was aware that the alleged noncompliance was an industry practice, even though the government may not have been aware of the specific PBM's alleged noncompliance. For an in-depth discussion of Escobar's materiality requirement, click here....