Recent Developments in eHealth, and Ongoing Litigation Regarding "But-For" Causation Under the False Claims Act
October 28, 2025 | New York Law Journal
In the latest installment of his New York Law Journal column on developments in healthcare enforcement, Morvillo Abramowitz Grand Iason & Anello PC partner and former federal prosecutor Robert M. Radick examines two significant developments shaping False Claims Act litigation.
First, the column revisits United States ex rel. Shea v. eHealth, Inc., where the Department of Justice has alleged that major health insurers and brokers engaged in unlawful kickbacks and discriminatory conduct related to Medicare Advantage enrollments. Radick discusses the defendants’ newly filed motions to dismiss and their arguments challenging DOJ’s theories under the Anti-Kickback Statute and the FCA. He also analyzes two recent district court decisions from the Sixth Circuit that applied the “but-for” causation standard to dismiss FCA claims premised on alleged kickback violations—highlighting the increasingly difficult burden plaintiffs face in linking alleged inducements to government payment decisions.
