High Court Rejects Eli Lilly’s Challenge to $193 Million Award

The US Supreme Court said Monday it won’t review Eli Lilly and Co.'s challenge to a $193 million Medicaid drug fraud judgment in a whistleblower’s False Claims Act suit.

Eli Lilly’s petition seeking the high court’s review argued the award shouldn’t stand because the FCA’s whistleblower provisions violate Article II of the US Constitution.

The company said whistleblowers select themselves to pursue anti-fraud litigation on behalf of the government in a manner that violates the appointments clause in Article II.

Despite this result for Eli Lilly, other FCA disputes over Article II are ongoing, and the high court should expect to consider other petitions in the future. For example, the US Court of Appeals for the Eleventh Circuit is considering whether a whistleblower’s Medicare fraud suit violates the appointments clause. Whoever loses that appeal may seek Supreme Court review.

Eli Lilly also argued that the Seventh Circuit, which upheld the award, improperly concluded that the company acted with the necessary intent under the FCA. The company said the appeals court erred by not adequately considering what the company subjectively believed about its obligations to Medicaid regarding price reporting requirements.

Whistleblower Ronald J. Streck’s April 14 response said the high court should reject the petition because Eli Lilly “remained silent” on the Article II issue for years, and finally raised it in a petition for rehearing en banc. The Seventh Circuit found that the company forfeited, if not waived, the argument.

The high court shouldn’t rescue companies from “their own procedural blunders,” Streck said.

He also said the Supreme Court shouldn’t reweigh evidence with regard to the jury’s conclusion that Eli Lilly acted with intent to defraud.

Streck, who sued in 2014, alleged that Eli Lilly abused Medicaid’s drug rebate program, which deprived the federal health-care program of funds.

A jury in August 2022 found Eli Lilly liable for $61 million for making false claims about pricing under the rebate program, which the US District Court for the Northern District of Illinois automatically trebled, as required by the FCA. The company also owes almost $10 million in civil penalties, the district court said then.

The Seventh Circuit backed the award, stating in September 2025 that Eli Lilly’s decision to exclude price increase values in its average manufacturer price resulted in the company sending Medicaid a lower rebate amount. The higher the drugmaker’s average manufacturer price, the more a drugmaker owes under Medicaid rules, the Seventh Circuit said.

The appeals court rejected Eli Lilly’s argument it should evade liability because it made a good-faith effort to comply with confusing Medicaid rules. The jury reviewed ample evidence allowing it to infer the company was aware of, or disregarded, an “unjustifiable risk of skirting the law,” the Seventh Circuit said.

Clement & Murphy PLLC and Kirkland & Ellis LLP represented Eli Lily. Walden Macht Haran & Williams LLP and Martin Law PC represented Streck.

The case is Eli Lilly and Co. v. United States ex rel. Streck, U.S., No. 25-1126, 5/18/26.