1:23-cv-00438
W.D.N.Y.Jun 11, 2025Background
- Deborah Conrad, a Physician Assistant, filed a qui tam action under the False Claims Act (FCA) against Rochester Regional Health (RRH) and United Memorial Medical Center, claiming RRH failed to report adverse events to VAERS while seeking federal reimbursement for COVID-19 vaccinations.
- The United States declined to intervene, and following motions to dismiss and amendments, the case proceeded on Conrad's amended complaint.
- RRH allegedly submitted claims for federal payment under a Provider Agreement that required reporting certain adverse events to VAERS; Conrad claims that at least four patients vaccinated at RRH experienced reportable adverse events that RRH failed to report.
- Conrad claims she attempted to address the alleged underreporting internally; after raising these concerns, she was fired by RRH.
- Conrad's amended complaint asserts several FCA causes of action (including fraudulent claims and retaliation) and New York Labor Law retaliation claims; RRH moved to dismiss on several grounds, including pleading sufficiency and statutory interpretation.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| FCA Liability—Provider Agreement obligations | Provider Agreement makes RRH responsible for VAERS reporting | Only individual handlers/locations are liable, not RRH | RRH has organizational responsibility under the Agreement |
| FCA Liability—Statutory obligations under NCVIA/EUA | Statutes create reporting requirements material to payment | COVID shot not covered by NCVIA; no FCA link under EUA | No FCA liability based on NCVIA or EUA alone |
| FCA Fraud Pleading Requirements & Particularity | Alleged sufficient factual examples and specifics (paragraph 91) | Lacks particularity; not all examples tied to RRH vaccines | Adequately pled as to four identified RRH-vaccinated pts |
| FCA Reverse False Claims & Conspiracy Counts | Conduct also supports these theories | No distinct obligation; intra-corporate conspiracy doctrine | Dismissed; underlying facts do not support distinct claims |
| Retaliation (FCA and NY Labor Law) | Fired in retaliation for reporting/confronting fraud | Terminated for refusing COVID vaccine; not protected act | Protected activity plausibly alleged; claims survive |
Key Cases Cited
- Ashcroft v. Iqbal, 556 U.S. 662 (Rule 12(b)(6) pleading standard)
- Universal Health Servs., Inc. v. United States ex rel. Escobar, 579 U.S. 176 (implied false certification theory under the FCA; materiality standard)
- United States ex rel. Chorches v. Am. Med. Response, Inc., 865 F.3d 71 (pleading standards for FCA complaints; Rule 9(b))
- Lynch v. City of New York, 952 F.3d 67 (pleading standards for motions to dismiss)
- United States ex rel. Foreman v. AECOM, 19 F.4th 85 (materiality analysis for FCA claims)