Private persons, known as relators, can file civil qui tam actions on behalf of the United States against persons or entities who violate the act. For the sake of simplicity, the Court will focus first on the Medicare claims. Here, the original complaint was 22 pages long and contained 54 numbered paragraphs. 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). 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. 41 (The fact that medical director compensation is lower where the physician actually shares the cost of his or her compensation through his or her joint venture (ownership) agreement shows that where there are arms-length negotiations between two more or less equal parties, a lower compensation rate results.)). (Id. In any event, as noted, the complaint does not include a single allegation concerning a single specific false claim. (McManus, Caetlin) (Entered: 11/22/2021), Docket(#15) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #13 Motion for Leave to Appear Pro Hac Vice Added W. Scott Simmer. After describing that scheme in some detail, the complaint alleges the following as to the submission of actual false claims: The complaint also provides a somewhat more complete description of the false claims for services allegedly provided to Scripps Health, a large health care system with five hospitals in San Diego, California. (Id. Quick View. 3/17/2023 8:35 PM. Patients who were referred to non-FMCNA clinics were categorized as leakage. (Id. 368-74). UniCourt uses cookies to improve your online experience, for more information please see our Privacy Policy. constituted false claims .); id. Again, however, no case, to the Court's knowledge, has ever established such a procedure. 1:2014cv00665 - Document 72 (D. Md. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. 9(b). According to the complaint, FMCNA also paid physician groups rent above fair market value and provided leases below fair market value in order to secure referrals. Fresenius Medical Care North America, Waltham, MA, USA See all articles by this author. Second, the requirement for direct knowledge was replaced with the requirement that a relator's knowledge must materially add[ ] to the publicly disclosed allegations or transactions. Id. 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. for reimbursement were submitted to the government. The first question, for the purpose of applying the first-to-file bar, is whether the first-filed complaint contained all the essential facts of the fraud later alleged. United States v. Millenium Lab'ys, Inc., 923 F.3d 240, 252 (1st Cir. 14). See Pub. 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. 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. CEO Martin Flanagan still sees a growth opportunity in Chinaand a big risk in Bitcoin. After a review of the claims, the government declined to intervene. Judge Douglas P. Woodlock assigned to case. (Id. Here, the motion to dismiss presents three sets of issues, all arising from the strict requirements for pleading such claims. 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. (Id. The government can intervene in a qui tam action and assume primary responsibility over it. As to Scripps, it alleges the following: The complaint further alleges, at considerable length, a scheme to pay medical directors compensation above fair market value in order to induce referrals. 2013) (quoting Duxbury I, 579 F.3d at 21). Ex. Access this case on the Massachusetts District Court's Electronic Court Filings (ECF) System. And under Rule 9(b), those claims must be described with some level of specificity. 3729 et seq., by a company that provides dialysis services to patients with kidney failure. 334-35). The complaint alleges that certain medical practices, such as Diablo and Balboa, benefited financially from medical-director agreements and joint-venture agreements with FMCNA, that in return they referred patients to FMCNA facilities, and as a result all of their claims for government reimbursement were false. Chronic kidney disease refers to the progressive loss of a person's kidney function, which is normally irreversible. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. 257 (Indiana) (All such claims . 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. (Id. Search Google Scholar for this author (Attachments: #1 Docket Sheet from District of Maryland, #2 Docket Entries 1-30, #3 Docket Entries 31-50, #4 Docket Entries 51-56, #5 Docket Entries 58-74) (Jones, Sherry) Modified on 10/7/2021 to correct docket text. WebFlanagan v. Fresenius Medical Care Holdings, Inc. - Docket Entries . 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. 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. It then alleges, in general terms, that all claims from those facilities were tainted by kickbacks and therefore constitute false claims within the meaning of the False Claims Act. 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. Currently, Sandra Martin works as a Clinical Application Specialist at Fresenius Medical Care North America. United States ex rel. (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. (Finn, Mary) (Entered: 10/05/2021). 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. Defendant further contends that the CIA it had entered into with the OIG relating to conduct of a company FMCNA later acquired (National Medical Care) qualified as a public disclosure. WebFlanagan v. Fresenius Medical Care Holdings, Inc. View recent docket activity Reflects complaints, answers, motions, orders and trial notes entered from Jan. 1, 2011. As to the appellee L. Martin Flanagan, we affirm. 232-35 (Diablo Nephrology in California); id. It further alleges that defendant is required to submit on an annual basis a Form 265 cost report to Medicare that certifies, among other things, that the services identified in the report (that is, the dialysis services) were provided in compliance with federal law, including the Anti-Kickback Statute. If you do not agree with these terms, then do not use our website and/or services. 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. . Fifth, it alleges that FMCNA entered into favorable joint-venture agreements (JVAs) with physician groups to induce them to make referrals. Pilon v. Martin Marietta Corp., 60 F.3d 995, 998-99 (2d Cir. 02-11738, 2013 WL 682740, at *5 (D. Mass. . 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. Finally, the complaint alleges that FMCNA entered into joint-venture agreements with physicians in order to induce referrals to the joint-venture clinic. 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 This is the same scheme with the same methodology as alleged here. As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. There must be particularized allegations of claims for payment arising from that scheme. FMCNA has moved to dismiss the amended complaint on the grounds that (1) the amended complaint is essentially a new complaint and should therefore have been filed under seal as required by 31 U.S.C. Martin Flanagan worked for Fresenius Medical Care North America (FMCNA) for 29 years. 3730(e)(4)(A). . Under the FCA, a relator must comply with the following requirements: Those notification requirements were enacted to allow the Government an adequate opportunity to fully evaluate the private enforcement suit and determine both if that suit involves matters the Government is already investigating and whether it is in the Government's interest to intervene and take over the civil action. United States ex rel. According to the complaint, FMCNA clinics and other providers treating ESRD submit to the government one reimbursement claim bill per month for each patient, including the charges for several dialysis treatments, any separately billable laboratory services, and separately billable drugs. To do so, the complaint must both allege the existence of a scheme to defraud and identify particularized false claims. It alleged that [t]hese problematic physician relationships generally break down into two areas. (Id.). Ge v. Takeda Pharm. WebMichael P. Flanagan, MD. 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. United States v. Takeda Pharm. 30-31). Access the Case Summary and Docket Report to access additional information about this case on the US Court's PACER system. Care Holdings, Inc., 551 F.Supp.3d 27, 43 (E.D.N.Y. Relator Martin Flanagan has brought suit against defendant Fresenius Medical Care Holdings, Inc., d/b/a Fresenius Medical Care North America (FMCNA), alleging that FMCNA improperly provided free or below-cost services to hospitals and physicians, and made various types of improper payments to physicians, in exchange for referrals to its dialysis clinics. The amended complaint describes-in considerable detail-a multi-part scheme to compensate caregivers in return for referrals. Hardback. 176). (Id. 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. Medical directors are not FMCNA employees, but physicians in private practice. 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. Free Services to Hospitals and Patients. The entire basis of the complaint is a theory of tainted referrals; kickbacks paid by FMCNA tainted the physician-referral process, which enabled the company to obtain, unlawfully, a larger share of referrals than it would have otherwise in a properly functioning market. Defendant correctly contends that the initial complaint did not contain any allegations concerning unlawful joint-venture agreements, or the provision of free services to hospitals, physicians, and patients. 29 at 10). 2009) to support the contention that when a first-filed complaint is dismissed on jurisdictional grounds, it cannot bar a later-filed complaint. 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. However, the First Circuit has rejected the holding in Poteet, explaining that earlier-filed complaints must provide only the essential facts to give the government sufficient notice to initiate an investigation into allegedly fraudulent practices and emphasizing that Section 3730(b)(5) contains no exceptions. United States ex rel. To be clear, the dispositive question is not whether FMCNA engaged in an illegal and pervasive scheme to pay kickbacks for referrals. The Marvel Studios Phenomenon. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. carolina east internal medicine, florida counties with no impact fees 2021,

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