Sanders, 553 U.S. 662 (2008). Id. . . This docket was last retrieved on December 5, 2022. occurred; (2) said disclosure . (McDonagh, Christina). Arch Flanagan, Martin Flanagan. 3729(b)(2). (Id.). To register for a PACER account, go the Pacer website at # https://pacer.uscourts.gov/register-account.Pro Hac Vice Admission Request Instructions # https://www.mad.uscourts.gov/caseinfo/nextgen-pro-hac-vice.htm.A Notice of Appearance must be entered on the docket by the newly admitted attorney. Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. (Id. The central issue is whether relator can sidestep the requirement to plead false claims with particularity by alleging that every single claim is necessarily false. As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. (Id. 2:22-CV-01807 | 2022-10-21, U.S. District Courts | Personal Injury | Martin Flanagan has been a director and President and Chief Executive Officer of Invesco since 2005. Physicians who wanted to terminate the non-competition agreements were forced to negotiate onerous buyouts. The third, and perhaps most difficult, issue is whether the amended complaint pleads fraud with sufficient particularity to meet the requirements of Fed.R.Civ.P. If relator is correct, that means that the entire government-payor business of FMCNA-which appears to amount to more than $10 billion in revenue per year-is based on fraud. As to Medicaid, the complaint alleges in general terms that state administrators of the program obtain reimbursement from the federal government by submitting a quarterly Form 64 to the Centers for Medicare and Medicaid Services at Department of Health and Human Services. 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. Access this case on the Massachusetts District Court's Electronic Court Filings (ECF) System. ESRD expenditures by Medicare exceed $40 billion annually. D. Pleading Fraud with Particularity under Rule 9(b). 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. WebChutes & LaddersMD Anderson gets new chief quality and value officer as it shifts to value-based care. 1999)). 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. Beneschs healthcare+ attorneys have significant experience representing nephrology group practices and dialysis organization in governmental fraud and abuse investigations. (Entered: 10/05/2021), (#1) ELECTRONIC NOTICE of Case Assignment. (Id. 2007) (citing Rogan v. Menino, 175 F.3d 75, 77 (1st Cir. The qui tam action at issue was United States ex rel. . 14). 308-20). The second issue is whether the public-disclosure bar of the statute precludes all or any of the claims-that is, whether relator is filing suit concerning matters that had been previously disclosed to the public. WebView the profiles of professionals named "Martin Flanagan" on LinkedIn. There is no contention that any dialysis services performed were medically unnecessary or excessive, or that those services were performed in a substandard manner. In many states, Medicaid pays for treatment costs for ESRD patients who do not qualify for Medicare and/or pays for the 20% of treatment costs not covered by Medicare. (Id. As to each, it provides some specifics as to the scheme (such as referral trends and medical-director compensation levels). 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. Family Medicine Call for an (Id. (Id. 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. If the trial Judge issues an Order of Reference of any matter in this case to a Magistrate Judge, the matter will be transmitted to Magistrate Judge Judith G. Dein. In response, relator filed an amended complaint. Here, defendant contends that the allegations were previously disclosed in multiple ways, including a 2005 government investigation and a 2005 Corporate Integrity Agreement (CIA) between FMCNA and the Office of Inspector General of the Department of Health and Human Services (OIG). 2016) (citing Duxbury I, 579 F.3d at 29). 12(b)(6) and for failure to allege fraud with particularity as required by Fed.R.Civ.P. 40). Second, it alleges that FMCNA engaged in improper remuneration relationships with physicians who served as medical directors in its outpatient clinics in five ways: by selecting medical directors based on their expected and historical referrals; by paying them above-market compensation to reward referrals; by making no effort to report or verify their hours; by tracking their referrals to make sure they were not making referrals to competitors; and by requiring them to sign onerous noncompete agreements to lock them into their arrangements with FMCNA. Essentially, that version of the complaint alleged that FMCNA's efforts to incentivize referrals to its clinics violated the Anti-Kickback Statute, 42 U.S.C. 01 Jun 2022. (Woodlock, Douglas) (Entered: 11/02/2021), (#7) NOTICE of Appearance by Abraham R. George on behalf of United States of America (George, Abraham) (Entered: 10/18/2021), (#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), (#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), (#2) Case transferred in from District of Maryland; Case Number 14-cv-00665-GLR. were false.) (emphasis added)). While it is true that CMS data are reports for the purposes of the public disclosure bar, see U.S. ex rel. L. No. WebMartin Flanagan is a Director, National of Acute Dialysis Services at Liberty Dialysis based in Anchorage, Alaska. Again, however, no case, to the Court's knowledge, has ever established such a procedure. Here, the original complaint was 22 pages long and contained 54 numbered paragraphs. CKD Project, LLC v. Fresenius Med. Westmoreland v. Amgen, 707 F.Supp.2d 123, 130 (D. Mass. WebA division of Fresenius Medical Care North America, Azura Vascular Care partners with dedicated, highly skilled physicians and surgeons, providing opportunities for practice Under the circumstances, the Court concludes that it does not. F. DENNIS SAYLOR IV, CHIEF JUDGE, UNITED STATES DISTRICT COURT, MEMORANDUM AND ORDER ON DEFENDANT'S MOTION TO DISMISS. Instead, those services were provided free of charge. plaintiff the benefit of all reasonable inferences therefrom. Ruiz v. Bally Total Fitness Holding Corp., 496 F.3d 1, 5 (1st Cir. Beginning in approximately 2007, FMCNA allegedly realized that the company's organic growth (that is, growth from adding new patients and not through acquisitions) was almost nonexistent. Rule 9(b) may be satisfied where, although some questions remain unanswered, the complaint as a whole is sufficiently particular to pass muster under the FCA. U.S. ex rel. 2019) (quoting U.S. ex rel. 2016). (Id. In substance, the complaint alleged that FMCNA engaged in a scheme to pay kickbacks to physicians with whom it had entered into joint-venture agreements. 40.1(i) and with the approval of the Chief Judge hereby return the case for reassignment by the Clerk through the random draw appropriate for this case, under which all eligible judges -including me - will be eligible for proper assignment according to the luck of the draw. (Id. Make your practice more effective and efficient with Casetexts legal research suite. June 11, 2014). Medical directors are not FMCNA employees, but physicians in private practice. The relator is eligible to collect a portion of any damages awarded in a qui tam action, whether or not the government intervenes. The original complaint referred to joint-venture agreements between FMCNA and physicians, but only in order to contrast such agreements (which it referred to as a product of arms-length negotiations) with the higher compensation paid to medical directors in the absence of such agreements. 353, 357 (Balboa); id. (McManus, Caetlin) (Entered: 11/02/2021), Docket(#10) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #5 Motion for Leave to Appear Pro Hac Vice Added Megan S. Heinz. 3730(e)(4)(B) (2006). 1320a-7b(g); Patient Protection and Affordable Care Act, Pub. Defendant further contends that the original complaint did not contain any allegations concerning medical-director agreements, and that all claims based on such agreements should likewise be dismissed. (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. FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North America, (#20) NOTICE of Appearance by Noah M Rich on behalf of Martin Flanagan (Rich, Noah) (Entered: 11/24/2021), (#19) NOTICE of Appearance by W. Scott Simmer on behalf of Martin Flanagan (Simmer, W.) (Entered: 11/22/2021), Affidavit Certificate of Noah M. Rich in Support of Motion for Appearance Pro Ha, Affidavit Certificate of Jamie Bennett in Support of Motion for Appearance Pro H, Affidavit Certificate of W. Scott Simmer in Support of Motion for Admission Pro, (#12) NOTICE of Appearance by Christopher P. Sullivan on behalf of Martin Flanagan (Sullivan, Christopher) (Entered: 11/18/2021), Affidavit Certification of Megan S. Heinsz, (#4) NOTICE of Appearance by Maria R. Durant on behalf of Fresenius Medical Care Holdings, Inc. (Durant, Maria) (Entered: 10/07/2021), (#3) NOTICE of Appearance by William H. Kettlewell on behalf of Fresenius Medical Care Holdings, Inc. (Kettlewell, William) (Entered: 10/07/2021), Docket(#20) NOTICE of Appearance by Noah M Rich on behalf of Martin Flanagan (Rich, Noah) (Entered: 11/24/2021), Docket(#19) NOTICE of Appearance by W. Scott Simmer on behalf of Martin Flanagan (Simmer, W.) (Entered: 11/22/2021), Docket(#18) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #17 Motion for Leave to Appear Pro Hac Vice Added Noah M. Rich. (Id. The complaint further alleges that FMCNA provided free or below-cost services to physicians to secure referrals. (Id. 181). Another six described a scheme involving improper remuneration relationships with physicians who serve as medical directors at Fresenius clinics. (Id. For the sake of simplicity, the Court will focus first on the Medicare claims. (Id.). It is insufficient to allege a scheme and then to make generalized allegations that the scheme must have, as a matter of logic, resulted in false claims. (McManus, Caetlin) (Entered: 11/02/2021), (#10) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #5 Motion for Leave to Appear Pro Hac Vice Added Megan S. Heinz. Dismissal is appropriate if the complaint fails to set forth factual allegations, either direct or inferential, respecting each material element necessary to sustain recovery under some actionable legal theory. Gagliardi v. Sullivan, 513 F.3d 301, 305 (1st Cir. Relator did comply with that requirement before filing his original complaint, which was 22 pages long and described an illegal scheme with two essential components. by. The complaint alleges that FMCNA engaged in improper remunerative relationships with medical directors in its outpatient clinics to capture their referrals. 154). The remaining six paragraphs describing the alleged scheme consisted of an introductory paragraph (Compl. And the best part of all, documents in their CrowdSourced Library are FREE! . [ ]. Among other things, the complaint uses the passive voice throughout: claims were submitted, rather than FMCNA submitted claims.. A more recent docket listing 30-31). General Description of Medicare and Medicaid Claim Systems. WebView the profiles of people named Martin Flanagan. (Reuters) - A former top legal executive at Germany's Fresenius Medical Care AG & Co KGaA sued the dialysis clinic operator on Tuesday alleging he was Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. 3730(b)(2). 111-148, 124 Stat. Third, it alleges that FMCNA provided physicians free or below-cost practice-management services. 02-11738, 2013 WL 682740, at *5 (D. Mass. Flanagan v. Fresenius Medical Care Holdings, Inc. (#18) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #17 Motion for Leave to Appear Pro Hac Vice Added Noah M. Rich. Martin Flanagan's Phone Number and Email Last Update. 228). 2014), the First Circuit affirmed the denial of a motion to amend the complaint a third time. Relator relies on the Sixth Circuit's holding in United States ex rel. . claims . US$20.14. The description of the alleged scheme consisted of 25 paragraphs. The following is a relevant excerpt from an SEC filing cited by the court in CKD: That excerpt discloses that the joint ventures do not qualify for safe-harbor protection and identifies the penalties that might be imposed should the company be found to be in violation of the relevant statutes. Flanagan v. Fresenius Medical Care Holdings, Inc. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a Fresenius Medical Care North America, CIVIL CASE docketed. The first-to-file bar provides that [w]hen a person brings an action . were false.); id. That is not sufficient, under the case law, to state a false claim with particularity within the meaning of Rule 9(b). 99-345, 1986 U.S.C.C.A.N. This is the same scheme with the same methodology as alleged here. It is sufficient to conclude that judgmental immunity is not applicable where, as here, there is evidence, if believed, that the attorneys fell below the standard of reasonable care in representing their client. 18). 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. According to the complaint, [f]or this reason, claims submitted to the state Medicaid agencies are presented to the federal government within the meaning of the [False Claims Act]. (Id.). Where the defendant allegedly caused a third party to submit a false claim to the government, rather than submitting the false claim itself, a more flexible standard applies, under which Rule 9(b) is satisfied by providing factual or statistical evidence to strengthen the inference of fraud beyond possibility without necessarily providing details as to each false claim submitted. U.S. ex rel. Winkelman v. CVS Caremark Corp., 827 F.3d 201, 208 (1st Cir. (Id. constituted false claims .); id. The CKD complaint alleged that FMCNA used joint-venture agreements as a way to provide remuneration to physicians in exchange for referrals. 44). As to the alleged scheme to provide other services to hospitals, the complaint alleges the following: As to the scheme to provide free or below-cost practice-management services, the complaint alleges the following: As noted, despite its length and detail, the description of the fraudulent scheme set out in the complaint, without more, is insufficient to state a claim under the False Claims Act. Mem. Saldivar v. Fresenius Med. DaVita settled that case in October 2014 by entering into a Corporate Integrity Agreement ("CIA") with the Office of Counsel to the Inspector General of the Department of Health and Human Services. That may, in part, be a result of the fact that relator did not work in any financial or billing capacity, but rather worked as the Director of Acute Market Development for the Fresenius Western Business Unit, and negotiated contracts between FMCNA and hospitals for in-patient dialysis treatment. Defendant also contends that the claims concerning joint-venture agreements are barred by the first-to-file rule.
Cardiff Central Station Webcam,
Functionalist Perspective On Work,
Nora Johnson Billionaire,
Articles M