Evidence as to where, how, and to whom allegedly false representations were made can state a claim under the statute for fraudulent claims against the government.
Evidence as to the who, what, where, when, and how can state a claim for fraudulent inducement in contractual negotiations; a relator who is not a party to the negotiations might be unable to provide details of the negotiations.
Implied false certification is a species of fraud, and therefore subject to heightened pleading.
Continuing to bill the set capitation after ending the subcontracting that provided enhanced services states a claim for implied false certification under the Act, since the services were a material term of the deal.
DISSENT (CJ)
Mere request for payment from the government while not materially complying with a contractual term is insufficient to state a claim under the Act, given the Act's extreme remedies, including treble damages.
Contract was a contract to provide beneficiaries with access to needed services, not needed services themselves.
These circumstances wouldn't state a claim, even absent heightened pleading. There was no express factual falsity; the omission was an implied falsity. Precedent requires that a request for payment also make specific representations in order to be actionable. Suggesting that noncompliance is material means that any noncompliance is material.