United States ex rel. Mastej v. Health Management Associates, Inc.
2012 U.S. Dist. LEXIS 19301
M.D. Fla.2012Background
- Relator Mastej files a qui tam action under the False Claims Act alleging Stark Law and Anti-Kickback violations.
- Second Amended Complaint asserts four FCA counts: false claims, false records to cause payment, false records to avoid payment, and conspiracy to commit false claims.
- Defendants move to dismiss for failure to meet Rule 9(b) pleading requirements; Government filed a statement of interest but did not intervene.
- Court analyzes Rule 9(b) specificity, noting requirement to plead time, place, and substance of fraud and the actual submission of false claims.
- Relator alleges three schemes (Article One: neurosurgery call coverage; Article Two: physician inducements including travel and gifts; Article Three: exclusive urology arrangement) under which false claims would be submitted.
- Court grants motion to dismiss the Second Amended Complaint without prejudice, but allows leave to amend.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Count I pleading sufficiency under Rule 9(b)? | Mastej asserts indicia of reliability and time/place details. | Defendants contend lack of specific facts identifying claims/submissions. | Count I dismissed for lack of Rule 9(b) specificity. |
| Count II pleading sufficiency under 9(b) and presentment? | Alleges purpose to obtain false payment and causal link to payments. | No specific claimed payments identified; no direct link shown. | Count II dismissed; no adequate pleading of payment or causation. |
| Count III pleading sufficiency under 9(b) and damages? | Reverse false claim theory alleged; wants penalties for misrepresentations. | General, conclusory allegations with no amounts or specifics. | Count III dismissed. |
| Count IV pleading sufficiency under 9(b) for conspiracy? | Claims of conspiracy to defraud government based on referrals and schemes. | No specific agreement or overt acts described. | Count IV dismissed. |
| Leave to amend after dismissal? | Requests leave to amend to cure pleading deficiencies. | N/A | Leave to amend granted. |
Key Cases Cited
- Hopper v. Solvay Pharm., Inc., 588 F.3d 1318 (11th Cir. 2009) (presentment and causation requirements for FCA § 3729(a)(1)(A))
- Clausen v. Lab. Corp. of Am., Inc., 290 F.3d 1301 (11th Cir. 2002) (Rule 9(b) particularity; actual claim submission required for liability)
- Corsello v. Lincare, Inc., 428 F.3d 1008 (11th Cir. 2005) (Rule 9(b) specificity and pleading requirements in FCA context)
- Atkins v. McInteer, 470 F.3d 1350 (11th Cir. 2006) (requirement to plead time, place, and substance of fraud)
- Walker v. R&F Props. of Lake Cnty., Inc., 433 F.3d 1349 (11th Cir. 2005) (indicia of reliability for FCA pleading)
- Seal v. Lockheed Martin Corp., 429 F.App’x 818 (11th Cir. 2011) (indicia of reliability and particularity in FCA claims)
- Schmidt v. Zimmer, Inc., 386 F.3d 235 (3d Cir. 2004) (requirement to plead actual payment and causation in FCA)