United States ex rel. Roycroft v. Geo Group, Inc., 17-3521

Background

Roycroft was a clinical supervisor at Geo Group’s residential drug/alcohol treatment center in Shelby, Ohio from May 2008 to March 2009; she reviewed and approved counselors’ progress notes before billing.
Roycroft alleges Geo Group submitted Medicaid claims for bundled three‑hour daily group counseling units while some group sessions (evening, closure) were infrequently provided, partially provided, or not provided at all; group time was sometimes used for noncounseling activities.
She also alleges implied false certifications by using billing codes that conveyed compliance while Geo Group allegedly failed to provide required 20 hours/week of services, improperly documented groups, and used unqualified personnel.
The complaint identified seven representative claims (by provider, client, date/claim number); invoices for six of those seven were billed to Medicaid and were considered on appeal.
The government declined to intervene; the district court dismissed Roycroft’s amended complaint with prejudice for failing to plead the presentment of at least one representative false claim with the particularity required by Fed. R. Civ. P. 9(b).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Roycroft pleaded a §3729(a)(1)(A) presentment claim with Rule 9(b) particularity	Roycroft alleged a scheme and identified seven representative claims; she argued closure‑group nonprovision was the main express falsehood making the claims false	Geo Group argued the complaint failed to specify what was false in each representative claim and so lacked particularity	Court: Dismissed presentment claim — representative claims did not specify which element of the multifaceted scheme made each claim false, failing Rule 9(b)
Whether Roycroft pleaded a §3729(a)(1)(G) failure‑to‑reimburse claim	Argued Geo Group retained overpayments stemming from false claims	Geo Group defended on same grounds as to presentment claim	Court: Dismissed §3729(a)(1)(G) claim because it depended on the deficient presentment claim
Whether district court abused discretion by dismissing with prejudice and denying leave to amend	Roycroft requested leave to amend but did not present proposed amended allegations	Geo Group argued plaintiff never sought leave or identified proposed amendment substance	Court: No abuse — plaintiff never moved to amend or furnished proposed amendment, so denial of leave was appropriate
Whether invoices and later‑learned facts could supply particularity for claims dated earlier	Roycroft pointed to later discovery and invoice context	Geo Group argued invoices did not show falsity and later facts post‑date the billed claims	Court: Invoices and later allegations did not show which alleged violation applied to the specific billed claims; temporal gaps undermined inference of falsity

Key Cases Cited

United States ex rel. Bledsoe v. Cmty. Health Sys., Inc., 501 F.3d 493 (6th Cir.) (explaining need to plead representative false claims with particularity under Rule 9(b))
Sanderson v. HCA-The Healthcare Co., 447 F.3d 873 (6th Cir.) (Rule 9(b) requires who, what, when, where, how)
SNAPP, Inc. v. Ford Motor Co., 532 F.3d 496 (6th Cir.) (de novo review and construing complaint in plaintiff’s favor)
Marlar v. BWXT Y-12, L.L.C., 525 F.3d 439 (6th Cir.) (presentment element requires proof claim was presented to the government)
Prather v. Brookdale Senior Living Cmtys., Inc., 838 F.3d 750 (6th Cir.) (limited circumstances where pleading of presentment may be relaxed)
Ibanez v. Bristol-Myers Squibb Co., 874 F.3d 905 (6th Cir.) (§3729(a)(1)(G) requires allegation that defendant received overpayments and failed to refund)
Newberry v. Silverman, 789 F.3d 636 (6th Cir.) (leave to amend analysis where proposed amendment was effectively before the court)
CNH Am. LLC v. Int’l Union, UAW, 645 F.3d 785 (6th Cir.) (district court not required to sua sponte grant leave to amend when plaintiff never sought leave)
Louisiana Sch. Employees’ Ret. Sys. v. Ernst & Young, LLP, 622 F.3d 471 (6th Cir.) (a bare request to amend in opposition to a motion to dismiss is not a motion to amend)
Beydoun v. Sessions, 871 F.3d 459 (6th Cir.) (district court needs proposed amendment substance to decide whether leave should be granted)
Islamic Ctr. of Nashville v. Tennessee, 872 F.3d 377 (6th Cir.) (same principle: failure to seek leave to amend forecloses reversal for denial of leave)