SALTER, GARY vs. FRESENIUS MEDICAL CARE HOLDINGS INC, Instituto Mexicano del Seguro Social v. Fresenius Medical Care AG & Co. KGaA. He did not do so, however, before filing his amended complaint, which is 147 pages long and contains a number of substantially new allegations of different components of the scheme. Previo usly, The complaint alleges that FMCNA provided free discharge-planning services to hospitals, free in-service training to staff, free training to patients, and free quality assessment and improvement program data analysis. L. No. In response, relator filed an amended complaint. 111-148, 124 Stat. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. There is no checklist of mandatory requirements that each allegation in a complaint must meet to satisfy Rule 9(b). Hagerty ex rel. Although this financial incentive encourages would-be relators to expose fraud, it also attracts parasitic relators who bring FCA damages claims based on information within the public domain or that the relator did not otherwise discover. United States ex rel. A more recent docket listing Ex. were false.) (emphasis added)). 2005)). Chris Churchill. . (Woodlock, Douglas) (Entered: 11/02/2021), Docket(#7) NOTICE of Appearance by Abraham R. George on behalf of United States of America (George, Abraham) (Entered: 10/18/2021), Docket(#6) MOTION for Leave to Appear Pro Hac Vice for admission of James F. Bennett Filing fee: $ 100, receipt number AMADC-9005666 by Fresenius Medical Care Holdings, Inc.. (Attachments: #1 Affidavit Certification of James F. Bennett)(Durant, Maria) (Entered: 10/13/2021), Docket(#5) MOTION for Leave to Appear Pro Hac Vice for admission of Megan S. Heinsz Filing fee: $ 100, receipt number AMADC-9005610 by Fresenius Medical Care Holdings, Inc.. (Attachments: #1 Affidavit Certification of Megan S. Heinsz)(Durant, Maria) (Entered: 10/13/2021), Docket(#4) NOTICE of Appearance by Maria R. Durant on behalf of Fresenius Medical Care Holdings, Inc. (Durant, Maria) (Entered: 10/07/2021), Docket(#3) NOTICE of Appearance by William H. Kettlewell on behalf of Fresenius Medical Care Holdings, Inc. (Kettlewell, William) (Entered: 10/07/2021), Docket(#2) Case transferred in from District of Maryland; Case Number 14-cv-00665-GLR. Family Medicine Call for an (g), I respectfully disagree with that interpretation. Compl. FMCNA generated reports to track which medical directors and their practice groups referred patients to outside clinics and the reasons why. As to Diablo Nephrology, the complaint alleges the following: As to Balboa Nephrology Medical Group, it alleges the following: As to NANI, the complaint provides a table of Medicare and Medicaid revenue for a period of five years at seventeen dialysis centers in the Chicago area. . were false.); id. Accordingly, the claims concerning joint-venture agreements are barred by the first-to-file rule. Previously, Martin was a Senior Na tional Account Manager at QuickSTAT. United States ex rel. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. The SEC filings at issue state that (1) at most of our clinics, a relatively small number of physicians account for the referral of all or a significant portion of the patient base, (Def. 22-1304 | 2022-04-25, U.S. Courts Of Appeals | Other | The second was that these same doctors are often provided with opportunities to rent office space that they own to Fresenius at above or at the very top of fair market value, with guaranteed long-term leases that are not commercially reasonable. (Id. 1:2014cv00665 - Document 72 (D. Md. (Id. 131). Co., Ltd., 842 F.3d 125, 130 (1st Cir. The qui tam action at issue was United States ex rel. FMCNA decided that one of the keys to capturing new patients for its dialysis clinics was through its relationships with hospitals providing inpatient acute care. Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. Id. The complaint alleges various methods by which FMCNA improperly induced the referral of patients to its dialysis clinics. United States District Court, D. Massachusetts. In summary, the amended complaint fails to state allegations of fraud under the FCA with the particularity required by Rule 9(b). 29 at 10). 2014); cf. While it is true that it did not use the term medical director agreements, its allegations concerning improper remuneration to physicians in the form of compensation above fair-market value and favorable leases are nonetheless substantially similar to those in the amended complaint. 3729(a)(1)(A), (a)(1)(B). The complaint also alleges that Fresenius regularly entered into a variety of problematic arrangements with nephrologists and nephrology group practices intended to secure patient referrals for Fresenius wholly-owned and joint venture outpatient dialysis centers, including: Many of the allegations contained in the Complaint of inappropriate physician arrangements are similar, in many regards, to the allegations contained in whistleblower David Barbettas complaint filed against DaVita in federal district court in 2009. 2019) (cleaned up). Duxbury v. Ortho Biotech Prods., L.P., 579 F.3d 13, 26 (1st Cir. . (McManus, Caetlin) (Entered: 11/02/2021), Docket(#9) ELECTRONIC NOTICE of Case Reassignment. The second question is whether there is an exception to the first-to-file bar that would allow relator's pre-2010 claims to survive. (Id. It then alleges: The complaint does not, however, identify a single specific false claim submitted in connection with any of those dialysis centers. There are 100+ professionals named "Martin Flanagan", who use LinkedIn to exchange information, ideas, and opportunities. A subscription to PACER is required. In addition to Medicare and Medicaid, CHAMPUS/TRICARE, which is administered by the United States Department of Defense, provides ESRD benefits to health-care programs for individuals and dependents affiliated with the armed forces and to covered beneficiaries. Because the complaint does not state allegations of fraud under the FCA with the particularity required by Rule 9(b), the conspiracy claim under the FCA must fail as well. (Id. (Id. 285-91 (practices in Texas); id. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. (Id. . Accordingly, even if relator had complied with the pre-suit requirements of the False Claims Act, the public-disclosure bar would preclude the claims concerning joint-venture agreements. Previo Read More Export Get Full Access to Martin's Info Last Update 12/13/2021 10:41 PM Email @fmcna.com HQ Phone (781) 699-9000 Company Fresenius Medical Care North Appearance form, Docketing Statement, and Transcript Report/Order form due 04/19/2023. (Id. . (Id. By continuing to use this website, you agree to UniCourts General Disclaimer, Terms of Service, (McManus, Caetlin) (Entered: 11/22/2021), (#15) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #13 Motion for Leave to Appear Pro Hac Vice Added W. Scott Simmer. As to the appellee L. Martin Flanagan, we affirm. As to each, it provides some specifics as to the scheme (such as referral trends and medical-director compensation levels). Documents and certified copy of docket sheet and order of transfer received from the Clerk in the transferor district via Email. . Karvelas v. Melrose-Wakefield Hosp., 360 F.3d 220, 233 (1st Cir. 23-7001 | 2023-01-06, U.S. District Courts | Personal Injury | (Attachments: #1 Affidavit Certificate of W. Scott Simmer in Support of Motion for Admission Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#11) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #6 Motion for Leave to Appear Pro Hac Vice Added James F. Bennett. 29 at 10); (2) compensation is negotiated individually [based on] local factors . We believe that the compensation of our medical directors is in line with the market (Id. (Am. were false .); id. In that role, he was responsible for, among other duties, negotiating contracts under which FMCNA provided dialysis treatment to hospital inpatients. Defendant also contends that the claims concerning joint-venture agreements are barred by the first-to-file rule. To the extent that the amended complaint addresses those remuneration relationships, therefore, the claims will not be dismissed. by. 353, 357 (Balboa); id. FMCNA also established the Bridge Program, allegedly to help hospitals save money by streamlining the process for patient discharge from the hospital and admission to a chronic facility for dialysis. (Id. Currently, Sandra Martin works as a Clinical Application Specialist at Fresenius Medical Care North America. 35). 1999)). (McManus, Caetlin) (Entered: 11/22/2021), (#17) MOTION for Leave to Appear Pro Hac Vice for admission of Noah M. Rich Filing fee: $ 100, receipt number AMADC-9065658 by Martin Flanagan. As to some of those medical practices, the complaint provides some amount of additional detail, although again it does not describe any specific false claims. Flanagan v. Fresenius Medical Care Holdings, Inc. 23-1305 | U.S. Court of Appeals, First Circuit | Justia Justia Dockets & Filings First Circuit U.S. Court of Appeals, 97-106). Phone: 1.619.238.4720 Email: inquiries@hoguebelonglaw.com Home Home Gonzales et al. This action is taken to insure the parties receive timely notice of the properly assigned presiding judge and is without prejudice to consideration by the Court as a whole whether Local Rule 40.1 should be amended in some fashion to eliminate any further misunderstanding by the Clerks Office. free or discounted physician practice alignment services, including providing dedicated chronic kidney disease educator services, financial coordination services for patients beginning dialysis, vascular access development services and assistance with physician recruiting through Fresenius online recruiting platform. Id. 270-84 (ENA and other practices in North Carolina); id. 1320a-7b(b), and the resulting claims to Medicare were tainted by illegal kickbacks in violation of the False Claims Act. 3730(b)(2). at 253. (Id. (Id. Again, those claims will be dismissed on other grounds; however, even if those claims survived those challenges, they are duplicative of the allegations in CKD and therefore would be barred by the first-to-file rule. The CKD complaint alleged that FMCNA used joint-venture agreements as a way to provide remuneration to physicians in exchange for referrals. It includes a blank example of such a form as Exhibit A. 167-307). 162). for reimbursement were submitted to the government. 3730(e)(4)(A). See 31 U.S.C. The False Claims Act, 31 U.S.C. . For the foregoing reasons, defendant's motion to dismiss is GRANTED. 2009). United States v. Takeda Pharm. The amended complaint describes-in considerable detail-a multi-part scheme to compensate caregivers in return for referrals. Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. A subscription to PACER is required. (Id. on the assumption that all the allegations in the complaint are true (even if doubtful in fact). Id. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. 2009) (Duxbury I). (Id. (Id. In an FCA case, these may include details concerning the dates of the claims, the content of the forms or bills submitted, their identification numbers, the amount of money charged to the government, the particular goods or services for which the government was billed, the individuals involved in the billing, and the length of time between the alleged fraudulent practices and the submission of claims based on those practices. U.S. ex rel. 38). The matter was unsealed, and therefore publicly disclosed, in 2018. 40). 247-48). FMCNA has moved to dismiss the complaint for failure to state a claim upon which relief can be granted pursuant to Fed.R.Civ.P. It also contracts with hospitals to provide dialysis services on an outpatient basis. See United States ex rel. See Id. WebMichael D. Flanagan, MD, specializes in Obstetrics / Gynecology and Maternity Care, Geriatrics and sees patients in Bryn Mawr. FMCNA tracked the referrals recorded as part of the Bridge Program. By contrast, here the statements in defendant's securities filings concerning medical-director agreements do not even convey the possibility that those agreements might violate the law. FMCNA is America's largest dialysis-services provider. And the best part of all, documents in their CrowdSourced Library are FREE! Stevens v. Vermont Agency of Nat. (Id. Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. Because the False Claims Act is a statute directed at fraudulent conduct, Rule 9(b) requires both that the circumstances of the alleged fraud and the claims themselves be alleged with particularity. Lawton ex rel. 3729(a)(1)(A) (Count 1); making or using false records material to a false or fraudulent claim in violation of the False Claims Act, 31 U.S.C. 13). The complaint further alleges a scheme to provide favorable leases to physician groups in order to induce referrals. At most, relator merely adds detail or color to previously disclosed elements of an alleged scheme [which] is not materially adding to the public disclosures. United States ex rel. 91, 93). (Id. The Medicare ESRD program is administered through the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS). June 11, 2014). . Winkelman v. CVS Caremark Corp., 827 F.3d 201, 213 (1st Cir. Documents and certified copy of docket sheet and order of transfer received from the Clerk in the transferor district via Email. 3730(b)(5); (4) the complaint has not pleaded fraud with particularity as required by Rule 9(b); and (5) the complaint fails to state a claim for FCA conspiracy. at *3 (collecting cases). Notice of appeal (doc. et al, County of Lycoming v. Purdue Pharma, L.P. et al, Lazy S Ranch Properties v. Valero Terminaling and Distribution, et al, Lester E. Cox Medical Centers d/b/a Cox Medical Centers et al v. Amneal Pharmaceuticals, LLC et al. 2016). (Id. Under Rule 9(b), the standard for allegations of fraud is higher than the normal pleading standard. 217). 3729-33, provides for civil liability for anyone who knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval or knowingly makes, uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim. 31 U.S.C. The settlement required DaVita to repay a total of $400 million to the federal government and various states, and the CIA that it entered into with the government impacted various aspects of DaVitas business operations. 2016). 249 (NANI) (All . The complaint alleges that the Bridge Program was actually designed to capture all of a hospital's referrals, as about half of the company's patients came into [FMCNA] clinics via [the discharge planning process]. (Id. (Id. 23). Fresenius Medical Care North America, Waltham, MA, USA See all articles by this author. (Id. First, defendant contends that the salaries paid to all of its medical directors is a matter of public record and is available on the website of the Center for Medicare and Medicaid Services (CMS). 332-36). Furthermore, they do not directly disclose the existence of any of the alleged schemes, or any other form of fraud, nor do they describe facts from which the existence of a fraudulent scheme might be inferred. See Wilson, 2011 WL 2462469, at *7. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. Compl. The Marvel Studios Phenomenon. Another six described a scheme involving improper remuneration relationships with physicians who serve as medical directors at Fresenius clinics. (Id. Feb. 25, 2013), the mere publication of compensation information, without an allegation of fraud or misrepresentation, is not sufficient to trigger the bar.
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