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Page Number: 19.0

16  UNITED STATES EX REL. SCHUTTE v. SUPERVALU INC. 

Opinion of the Court 

P. 2d  471,  474  (1959).  That  is  because  such  a  statement 
says something about both the correct meaning of building 
codes  and  the  facts  about  the  home’s  construction.  Ibid.; 
see also Hoyt Properties, Inc. v. Production Resource Group, 
L. L. C.,  736  N. W.  2d 313,  319  (Minn.  2007).    And  home-
owners might justifiably rely on that latter representation 
about the facts, which thus could be actionable as fraud. 

Respondents’ disclosures here sound more like our hypo-
thetical  plumber,  not  our  hypothetical  legal  advisor.    Ra-
ther  than  saying,  “this  is  what  ‛usual  and  customary’ 
means,”  respondents  essentially  said,  “this  is  what  our 
‛usual and customary’ prices are.”  In doing so, they plainly 
implied facts about their prices that were not known to the
plan sponsors, pharmacy benefit managers, and state Med-
icaid agencies that received their claims. Petitioners’ cases
thus make out a valid fraud theory even under respondents’ 
common-law rule. 

* 

* 

* 

Under  the  FCA,  petitioners  may  establish  scienter  by 
showing that respondents (1) actually knew that their re-
ported prices were not their “usual and customary” prices
when they reported those prices, (2) were aware of a sub-
stantial risk that their higher, retail prices were not their 
“usual  and  customary”  prices  and  intentionally  avoided 
learning  whether  their  reports  were  accurate,  or  (3)  were 
aware of such a substantial and unjustifiable risk but sub-
mitted  the  claims  anyway.  §3729(b)(1)(A).  If  petitioners
can  make  that  showing,  then  it  does  not  matter  whether
some other, objectively reasonable interpretation of “usual 
and customary” would point to respondents’ higher prices. 
For scienter, it is enough if respondents believed that their 
claims were not accurate. 

We need not address any of the other factual or legal dis-
putes involved in these cases, including whether petitioners
have  made  a  showing  sufficient  under  the  correct  legal