JOHN R. BORZILLERI, M.D., Relator, Plaintiff, Appellant, UNITED STATES, ex rel. JOHN R. BORZILLERI, M.D., Plaintiff, Appellee, STATE OF CALIFORNIA, et al., Plaintiffs, v. BAYER HEALTHCARE PHARMACEUTICALS, INC., et al., Defendants, Appellees, CATAMARAN CORPORATION, et al., Defendants.
No. 20-1066
United States Court of Appeals For the First Circuit
January 21, 2022
Before Thompson, Lipez, and Kayatta, Circuit Judges.
APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF RHODE ISLAND [Hon. William E. Smith, U.S. District Judge]
Mary Ann H. Smith for appellant.
Amy R. Romero, Assistant United States Attorney, with whom Aaron L. Weisman, United States Attorney, was on brief, for appellee United States.
Jeffrey S. Bucholtz, Jeremy M. Bylund, King & Spalding LLP, Steven P. Lehotsky, Tara S. Morrissey, and U.S. Chamber Litigation Center on brief for the Chamber of Commerce of the United States of America, amicus curiae.
Applying these conclusions to the facts of this case, we determine that the district court did not err in dismissing the action and affirm.
I.
A. Legal Background
The FCA imposes civil liability on any person who “knowingly presents,” “causes to be presented,” or conspires to present “a false or fraudulent claim for payment or approval” to the United States government.
When a relator brings a qui tam action, he must serve the government with a copy of the complaint and “written disclosure of substantially all material evidence and information” he possesses.
Even if the government initially declines to intervene, the court “may nevertheless permit the [g]overnment to intervene at a later date upon a showing of good cause.”
The qui tam provision is “designed to set up incentives to supplement government enforcement” of the FCA. United States ex rel. Springfield Terminal Ry. Co. v. Quinn, 14 F.3d 645, 649 (D.C. Cir. 1994). The Supreme Court has explained that the “for the person and for the United States [g]overnment” language in the statute “gives the relator himself an interest in the lawsuit, and not merely the right to retain a fee out of the recovery.” Vt. Agency of Nat. Res. v. United States ex rel. Stevens, 529 U.S. 765, 772 (2000). The statute thus “entitles the relator to a hearing before the [g]overnment‘s voluntary dismissal of the suit” when the relator and the government disagree about whether, or when, to pursue the FCA action. Id. (citing
Specifically, the FCA states: “The [g]overnment may dismiss the action notwithstanding the objections of the person initiating the action if the person has been notified by the [g]overnment of the filing of the motion and the court has provided the person with an opportunity for a hearing on the motion.”
Courts have attempted to fill this statutory lacuna, with divergent approaches by the Ninth Circuit and the D.C. Circuit attracting the most discussion.2 The Ninth Circuit has held that the district court at a
By contrast, the D.C. Circuit has held that
B. Facts & Procedural Background
Relator-appellant John R. Borzilleri, a physician and professional healthcare investment fund manager, alleges that several pharmaceutical companies (“Manufacturer Defendants“) and Pharmacy Benefit Managers (“PBM Defendants“) colluded to defraud Medicare Part D, a federal prescription drug program, in violation of the FCA, the common law, and various state-law analogues to the FCA.4 In brief, he contends that the Manufacturer Defendants (which set drug prices) and the PBM Defendants (which administer access to
Borzilleri filed a qui tam complaint under seal in the District of Rhode Island in 2014.6 In 2018, the government declined to intervene (apparently after being granted a number of extensions to make its decision pursuant to
Borzilleri objected to the dismissal and filed a declaration asserting, inter alia, that the government had failed to investigate key aspects of his allegations. The district court subsequently held a hearing, at which it pressed Borzilleri‘s counsel to
come forward with some kind of showing that the government‘s decision [to dismiss the suit] is fraudulent or arbitrary, capricious or illegal in some fashion. Not just that you disagree with it and not just that you think that Dr. Borzilleri‘s argument had merit that the government, for whatever reason, failed to see, but you‘ve got to come up with something pretty powerful that shows me that the government is acting in a fraudulent or illegal manner here.
In response, Borzilleri‘s counsel argued that the government had not performed an adequate investigation of the alleged fraud and had determined that the suit did not allege FCA violations only “because [the government] didn‘t look in the right place.”
In a post-hearing minute order, followed by a written decision, the district court dismissed Borzilleri‘s FCA claims with prejudice as to Borzilleri and without prejudice as to the government.7 The district
the government had provided a rational reason for dismissal -- “the burden this continuing litigation would place on the [g]overnment‘s resources” -- and Borzilleri had not shown that dismissal would be “fraudulent, arbitrary and capricious, or illegal.” Id. at *2-3 (internal quotation marks omitted). The court also denied his request for discovery and an evidentiary hearing. Borzilleri timely appealed.
II.
Although Borzilleri contends that the standard articulated by the Ninth Circuit for a court‘s review of a government motion to dismiss a qui tam suit should apply in this case, he also asserts that the district court‘s decision fails under any of the standards that courts have applied. Given the need to clarify for the district courts their role when an objecting relator invokes the “opportunity for a hearing” provided by
As noted above, although the FCA mandates a hearing at the behest of an objecting relator before a court may grant a government motion to dismiss a qui tam suit, the statute does not specify the nature of the hearing, the government‘s burden, or the factors a court should consider in evaluating the motion. Nevertheless, we agree with Borzilleri‘s premise that the statute plainly anticipates the exercise of some form of judicial discretion. Obtaining an impartial adjudicator‘s decision after parties air their competing views is, after all, the ordinary purpose of a “hearing.” See Hearing, Black‘s Law Dictionary (11th ed. 2019) (defining a “hearing” as a “judicial session . . . held for the purpose of deciding issues of fact or of law“). We are confident that Congress would not mandate an opportunity for a hearing so that the court could only “serve . . . donuts and coffee” while the relator and the government debate the merits of dismissal. CIMZNHCA, 970 F.3d at 850 (internal quotation marks omitted).
Further, the statute by its terms indicates that the hearing requirement is intended, at least in part, to protect the relator‘s interests. The provision focuses on the relator, stating that the government may dismiss the action “if the [qui tam relator] has been notified by the [g]overnment of the filing of the motion and the court has provided the person with an opportunity for a hearing on the motion.”
The nature of that judicial judgment is the more difficult question. Because
The FCA provision that immediately follows
Nor do we consider the Ninth Circuit‘s Sequoia Orange standard to be appropriate. That standard puts the burden on the government to justify its motion to dismiss. See Sequoia Orange, 151 F.3d at 1145 (requiring that the government identify “a rational relation between dismissal and accomplishment of [a valid government] purpose” (internal quotation marks omitted)). But the FCA does not allocate such a burden to the government. We simply see no basis in the statutory language for requiring the government to make a prima facie showing that its motion is rational, reasonable, or otherwise proper.8
dismissal and the defendant has already filed a responsive pleading,
In CIMZNHCA, the Seventh Circuit concluded that, in the qui tam context,
We are unpersuaded by this application of
We thus find limited insight into the role of the court at the
III.
As we have indicated, we reject placing an initial burden on the government to justify its motion because the statutory language does not support the imposition of such a burden. That said, the government is not obligation-free when it moves to dismiss a qui tam suit -- it must provide its reasons for its decision. The need for an explanation is implicit in the statute‘s requirement that, before dismissal is granted, the relator be given an “opportunity” for a hearing on the motion. See
The question then becomes, what is the role of the court at a
It is axiomatic that constitutional limitations attend any exercise of executive authority. See United States v. Armstrong, 517 U.S. 456, 464 (1996). This is the case even for a government decision not to institute an enforcement action -- a decision roughly analogous to the government‘s decision to dismiss a qui tam suit -- where the government is entitled to the greatest discretion. See Heckler v. Chaney, 470 U.S. 821, 838 (1985) (holding that agency decisions not to institute enforcement proceedings are unreviewable under the APA but reserving the question of the reviewability of a claim that an agency decision not to institute proceedings “violated any constitutional rights“); see also CIMZNHCA, 970 F.3d at 851 (“[T]here are always background constraints on executive action, even in the quasi-prosecutorial context of qui tam actions and the decisions to dismiss them.“). For example, we think it beyond debate that the government could not dismiss a qui tam action if its decision to seek dismissal is “based on ‘an unjustifiable standard such as race, religion, or
The limitations on the government‘s right to dismiss a qui tam suit also would include instances in which the dismissal would be “arbitrary in the constitutional sense.” Cnty. of Sacramento v. Lewis, 523 U.S. 833, 846 (1998) (quoting Collins v. City of Harker Heights, 503 U.S. 115, 129 (1992)). Government action is “arbitrary in the constitutional sense” when it “violate[s] a right otherwise protected by the substantive Due Process Clause” and “shock[s] the conscience,” Martinez v. Cui, 608 F.3d 54, 64 (1st Cir. 2010), or when government officials abuse their power and “employ[] it as an instrument of oppression” to the extent that it “shocks the conscience,” Lewis, 523 U.S. at 846 (quoting Collins, 503 U.S. at 126).
The district court should also deny the government‘s motion if the relator can show that, in moving to dismiss the qui tam action, the government is attempting to perpetrate a fraud on the court. See CIMZNHCA, 970 F.3d at 852; Swift, 318 F.3d at 253 (entertaining, but not deciding, that possibility). Courts always “possess[] the inherent power to deny the court‘s processes to one who defiles the judicial system by committing a fraud on the court.” Aoude v. Mobil Oil Corp., 892 F.2d 1115, 1118 (1st Cir. 1989). Generally, “fraud on the court” describes a party‘s “unconscionable scheme calculated to interfere with the judicial system‘s ability impartially to adjudicate a matter by improperly influencing the trier or unfairly hampering the presentation of the opposing party‘s claim or defense.” Id. (finding “fraud on the court” where a party knowingly submitted a fabricated document with its pleadings). Simply put, “fraud on the court” is egregious conduct that is more serious than the mere making of “[i]naccurate assertions in lawsuits.” Torres v. Bella Vista Hosp., Inc., 914 F.3d 15, 19 (1st Cir. 2019).
Borzilleri points to the FCA provision stating that “[t]he Attorney General diligently shall investigate a violation” of the FCA,
First, and most importantly, a “diligence” inquiry is not even hinted at in the text of
We emphasize again that the burden is always on the relator to demonstrate that the government is transgressing constitutional limits or perpetrating a fraud on the court. Moreover, if the relator seeks discovery to establish such improprieties, the court may grant that request only if the relator makes a substantial threshold showing to support his claims. See Swift, 318 F.3d at 254 (describing the standard for demonstrating “entitle[ment] to discovery of information relating to
prosecutorial decisions“); see also United States v. Everglades Coll., Inc., 855 F.3d 1279, 1290 (11th Cir. 2017) (discussing discovery in the context of
In summary, the
IV.
Turning at last to the merits of the appeal, we review de novo Borzilleri‘s contention that the district court erred in dismissing his suit because he raised deficiencies in the government‘s investigation,11 cognizant that we may affirm on any basis apparent in the record. Chiang v. Verizon New Eng., Inc., 595 F.3d 26, 34 (1st Cir. 2010).
Borzilleri details several interactions he had with government officials that he claims reveal a failure by the government to thoroughly investigate his allegations. He further argues that these interactions show “a high likelihood of investigative fraud” by the government, although he offers no details about that potential fraud. Hence, we understand his fraud argument to be a reiteration of his claim of investigative inadequacy and a reflection of his belief that the government should have further pursued, rather than dismissed, what he saw as a promising qui tam action potentially worth billions of dollars. Finally, Borzilleri maintains that the alleged investigative deficiencies reflect arbitrariness in the government‘s decision to dismiss the action. Taken together, these arguments echo Borzilleri‘s overarching theme that the government failed to pursue his FCA claims to the extent or in the manner he would have liked.
The government represented that it conducted a multi-year investigation of Borzilleri‘s allegations, including a review of tens of thousands of documents, interviews with more than thirty witnesses, consultations with regulatory experts within the U.S. Department of Health and Human Services, and the retention of expert consultants.12 In this light, we agree
Affirmed.
