Earlier this month, the Tenth Circuit Court of Appeals in United States ex Rel. Conner v. Salina Regional Health Center, Inc., rejected claims by a physician-relator that a hospital violated the False Claims Act (FCA) by not complying with Medicare Conditions of Participations (CoPs). The relator claimed that the hospital violated the FCA by certifying in its cost reports that it had complied with applicable laws and regulations even though the hospital had allegedly violated the CoPs. The Court concluded that "the annual cost report certification does not condition the government's payment on perfect compliance with all underlying statutes and regulations, but rather seeks assurances that the provider continues to comply with the conditions of participation originally agreed upon." The alleged false certification was not a ctionable under the FCA because it was not "material to the government's decision to pay out moneys to the claimant." While the case is limited to CoPs, it could have an impact on hospitals defending FCA lawsuits based on false certification theories of liability.