JESSE POLANSKY, M.D., M.P.H.; THE STATE OF CALIFORNIA, THE STATE OF COLORADO, THE STATE OF CONNECTICUT, THE STATE OF DELAWARE, THE DISTRICT OF COLUMBIA, THE STATE OF FLORIDA, THE STATE OF GEORGIA, THE STATE OF HAWAII, THE STATE OF ILLINOIS, THE STATE OF INDIANA, THE STATE OF IOWA, THE STATE OF LOUISIANA, THE STATE OF MARYLAND, THE COMMONWEALTH OF MASSACHUSETTS, THE STATE OF MICHIGAN, THE STATE OF MINNESOTA, THE STATE OF MONTANA, THE STATE OF NEVADA, THE STATE OF NEW JERSEY, THE STATE OF NEW MEXICO, THE STATE OF NEW YORK, THE STATE OF NORTH CAROLINA, THE STATE OF OKLAHOMA, THE STATE OF RHODE ISLAND, THE STATE OF TENNESSEE, THE STATE OF TEXAS, THE COMMONWEALTH OF VIRGINIA, THE STATE OF WASHINGTON, and THE STATE OF WISCONSIN v. EXECUTIVE HEALTH RESOURCES INC; UNITEDHEALTH GROUP INC; UNITED HEALTHCARE SERVICES INC; OPTUM INC; OPTUMINSIGHT INC; OPTUMINSIGHT HOLDINGS LLC; COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA; YALE NEW HAVEN HOSPITAL
No. 19-3810
UNITED STATES COURT OF APPEALS
October 28, 2021
KRAUSE, Circuit Judge
PRECEDENTIAL. On Appeal from the United States District Court for the Eastern District of Pennsylvania (D.C. No. 2-12-cv-04239). Honorable Michael M. Baylson, U.S. District Judge. Argued November 18, 2020. Before: JORDAN, KRAUSE, and RESTREPO, Circuit Judges.
PRECEDENTIAL
UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT
No. 19-3810
JESSE POLANSKY, M.D., M.P.H.; THE STATE OF CALIFORNIA, THE STATE OF COLORADO, THE STATE OF CONNECTICUT, THE STATE OF DELAWARE, THE DISTRICT OF COLUMBIA, THE STATE OF FLORIDA, THE STATE OF GEORGIA, THE STATE OF HAWAII, THE STATE OF ILLINOIS, THE STATE OF INDIANA, THE STATE OF IOWA, THE STATE OF LOUISIANA, THE STATE OF MARYLAND, THE COMMONWEALTH OF MASSACHUSETTS, THE STATE OF MICHIGAN, THE STATE OF MINNESOTA, THE STATE OF MONTANA, THE STATE OF NEVADA, THE STATE OF NEW JERSEY, THE STATE OF NEW MEXICO, THE STATE OF NEW YORK, THE STATE OF NORTH CAROLINA, THE STATE OF OKLAHOMA, THE STATE OF RHODE ISLAND, THE STATE OF TENNESSEE, THE STATE OF TEXAS, THE COMMONWEALTH OF VIRGINIA, THE STATE OF WASHINGTON, and THE STATE OF WISCONSIN
v.
EXECUTIVE HEALTH RESOURCES INC; UNITEDHEALTH GROUP INC; UNITED HEALTHCARE SERVICES INC; OPTUM INC; OPTUMINSIGHT INC; OPTUMINSIGHT HOLDINGS LLC; COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA; YALE NEW HAVEN HOSPITAL
UNITED STATES OF AMERICA
Jesse Polansky, M.D., M.P.H., Appellant.
On Appeal from the United States District Court for the Eastern District of Pennsylvania (D.C. No. 2-12-cv-04239) Honorable Michael M. Baylson, U.S. District Judge
Argued November 18, 2020
Before: JORDAN, KRAUSE, and RESTREPO, Circuit Judges
(Filed: October 28, 2021)
Nicholas C. Carullo
Stephen L. Shackelford, Jr.
Susman Godfrey
1301 Avenue of the Americas - 32nd Fl.
New York, NY 10019
Daniel L. Geyser [ARGUED]
Haynes & Boone
2323 Victory Avenue - Ste. 700
Dallas, TX 75219
William T. Jacks
Fish & Richardson
111 Congress Avenue - Ste. 810
Austin, TX 78701
Counsel for Appellant
Tejinder Singh
Goldstein & Russell
7475 Wisconsin Avenue - Ste. 850
Bethesda, MD 20814
Counsel for Amicus Appellant Taxpayers Against Fraud Education Fund
Ned I. Miltenberg
National Legal Scholars Law Firm
5410 Mohican Road - Ste. 200
Bethesda, MD 20816
Counsel for Amicus Appellants Erwin Chemerinsky, National Whistleblowers Center, and Project on Government Oversight
Ethan M. Posner [ARGUED]
Christopher M. Denig
Matthew F. Dunn
Michael M. Maya
Krysten R. Moller
Covington & Burling
850 10th Street, NW
One City Center
Washington, DC 20001
Abigail A. Hazlett
Tracy Rhodes
Robin P. Sumner
Troutman Pepper Hamilton Sanders
3000 Two Logan Square - Ste. 1250
18th and Arch Streets
Philadelphia, PA 19103
Counsel for Appellee Executive Health Resources Inc.
Jeffrey B. Clark [ARGUED]
United States Department of Justice
Environment & Natural Resources Division
950 Pennsylvania Avenue, NW
Washington, DC 20530
Stephanie R. Marcus
United States Department of Justice
Civil Division
950 Pennsylvania Avenue, NW - Rm. 7642
Washington, DC 20530
Charles W. Scarborough
United States Department of Justice
Appellate Section
950 Pennsylvania Avenue, NW - Rm. 7244
Counsel for Appellee United States of America
Jeffrey S. Bucholtz
Jeremy M. Bylund
King & Spalding
1700 Pennsylvania Avenue, NW - Ste. 200
Washington, DC 20006
Counsel for Amicus Appellee Chamber of Commerce of the United States of America
OPINION OF THE COURT
KRAUSE, Circuit Judge.
The False Claims Act (FCA),
To answer, we must resolve two key questions that have divided our sister circuits: (1) whether the Government in that situation can move for dismissal without first intervening, and (2) if the Government properly moves for dismissal, what, if any, standard must it meet for its motion to be granted? For the reasons that follow, we conclude that the Government is required to intervene before moving to dismiss and that its motion must meet the standard of
I. BACKGROUND
A. Factual Background
The False Claims Act has its roots in the Civil War, when “a series of sensational congressional investigations” uncovered widespread fraud by wartime contractors that had bilked the federal government by charging for “nonexistent or worthless goods.” United States v. McNinch, 356 U.S. 595, 599 (1958). In response, Congress not only prohibited the making of false claims to the Government,
This case involves such a qui tam action. Relator-Appellant Dr. Jesse Polansky was an official at the Centers for Medicare and Medicaid Services (CMS) before consulting for Defendant-Appellee EHR, a “physician advisor” company that provides review and billing certification services to hospitals
B. Procedural History
In 2012, on the basis of those allegations, Polansky filed this FCA action. His complaint remained in camera and under seal for the next two years while the Government conducted its own investigation and ultimately determined it would not participate in the case. Under the FCA, “[i]f the Government elects not to proceed with the action, the person who initiated the action shall have the right to conduct the action.”
Over the next several years, the parties and the District Court invested considerable time and resources in the case. Once EHR‘s motion to dismiss was denied,3 the District Court divided the case into two segments for case-management purposes: “Phase I” claims, covering EHR‘s certifications from 2009 to October 1, 2013, and “Phase II” claims, covering its certifications after October 1, 2013, the date that CMS‘s formal regulation went into effect. Because the complaint implicated hundreds of thousands of allegedly false claims, the District Court also decided to select a small number for a bellwether trial where “the jury would answer interrogatories,” and the Court would then “enter judgment on all other claims encompassed by the jury verdict.” Polansky v. Exec. Health Res., Inc., 422 F. Supp. 3d 916, 919 (E.D. Pa. 2019). In anticipation of that trial, the Court designed a procedure for selecting the bellwether claims and appointed a special master, and the parties commenced discovery, focused on Phase I claims.
In February 2019, however, the case took an unexpected turn: The Government notified the parties that it intended to dismiss the entire action pursuant to
intervened, it pointed to
The Court stayed the proceedings while the parties negotiated with the Government. Initially, the Government acceded to Polansky‘s request not to dismiss his case in exchange for his filing of an amended complaint that substantially narrowed the scope of his Phase I claims. But the Government also reserved the right to reconsider, and a few months later, in August 2019, it invoked that right, and filed a motion to dismiss pursuant to
II. JURISDICTION AND STANDARD OF REVIEW
The District Court had jurisdiction pursuant to
III. DISCUSSION
Polansky challenges the District Court‘s dismissal on the ground that the Government lacked statutory authority to move to dismiss in the first place. He also contends that, if the Government did have that authority, its motion should have been denied on the merits under the applicable standard.
We address these arguments in three parts. We consider, first, whether the FCA requires the Government to intervene in order to seek dismissal pursuant to
A. The Government‘s Authority to Seek Dismissal under the FCA
We begin with the first of the questions in this area that have divided the Courts of Appeals: whether, and in what circumstances, the Government retains statutory authority to move to dismiss an FCA action, pursuant to
answer turns on the interrelationship among the subsections of
Section 3730(c) sets forth the rights and relationship of the Government and relator through the life of an FCA action. Because our analysis turns on the language and structure of the statute, we excerpt its relevant provisions below:
(1) If the Government proceeds with the action . . . [the relator] shall have the right to continue as a party to the action, subject to the limitations set forth in paragraph (2).
(2)(A) The Government may dismiss the action notwithstanding the objections of the [relator] if the [relator] has . . . [notice and] an opportunity for a hearing[.]
(B) The Government may settle the action with the defendant notwithstanding the objections of the [relator] if the court determines . . . the proposed settlement is fair, adequate, and reasonable . . . .
(C) Upon a showing by the Government that [the relator‘s] unrestricted participation . . . would interfere with or unduly
delay the Government‘s prosecution of the case . . . the court may, in its discretion, impose limitations on the [relator‘s] participation . . . .
Whether the FCA permits the Government to dismiss a relator‘s action that it previously declined is a pure question of statutory interpretation; the district courts would benefit from guidance on a question that has divided the Courts of Appeals, see infra n.8; and resolving this question is logically antecedent to the question before us: the standard that applies when the Government seeks dismissal. We therefore exercise our discretion to excuse Polansky‘s forfeiture.
(D) Upon a showing by the defendant that [the relator‘s] unrestricted participation . . . would cause the defendant undue burden or unnecessary expense, the court may limit the [relator‘s] participation . . . .
(3) If the Government elects not to proceed with the action, the [relator] shall have the right to conduct the action. . . . When [the relator] proceeds with the action, the court, without limiting the status and rights of the [relator], may nevertheless permit the Government to intervene at a later date upon a showing of good cause.
(4) Whether or not the Government proceeds with the action, [it may seek a stay of the relator‘s discovery that] would interfere with [a Government investigation] . . . .
The scope of the Government‘s dismissal authority in this context has engendered significant debate. The parties’ positions track a split among our sister circuits.8 The
Government and EHR (collectively, “Appellees“) ask us to follow the D.C., Ninth, and Tenth Circuits in reading this provision as a standalone grant of dismissal authority that empowers the Government to move for dismissal of the relator‘s action at any point in the litigation and regardless of whether it has intervened.9 Polansky, on the other hand, presses the view of the Sixth and Seventh Circuits that Congress authorized the Government to move for dismissal under
“[B]ear[ing] in mind the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme,” Mejia-Castanon v. Att‘y Gen., 931 F.3d 224, 233-34
(3d Cir. 2019) (quoting King v. Burwell, 576 U.S. 473, 492 (2015)), we conclude Congress intended the reading adopted by the Sixth and Seventh Circuits, i.e., under
To this, Appellees object that those limitations are not nestled under paragraph (c)(1), as one might expect if they were contingent on “the Government proceed[ing] with the action.”
subparagraphs in
That
Though we reject Appellee‘s interpretation as failing to read the paragraphs of
Both of Polansky‘s premises are flawed. First, nothing in Stevens compels such a reading. The Court used “exclusive” to mean that only the relator, as opposed to any other private individual, could proceed with an FCA action after the Government declines it, which the statute explicitly states in another section.11 See
at 769. It nowhere suggests that the relator‘s right to control the action is exclusive vis-a-vis the Government. Second, had Congress intended so draconian a consequence as to strip the Government of all ability to terminate a case brought in its name, it would not have obscured it in a clause preserving the “status and rights of the [relator].”
Indeed, if anything the language of paragraph (c)(3) cuts the other way, for the statutory rights that the relator retains upon the Government‘s intervention can be no more or less than those originally vested by the FCA: “the right to continue as a party to the action, subject to the limitations set forth in paragraph (2),”
In opposition to that reading, Appellees invoke one last canon of construction: constitutional avoidance. They argue that interpreting the statute to make intervention a prerequisite to moving to dismiss would compromise the Government‘s ability to control litigation brought in its name and thereby “place the FCA on constitutionally unsteady ground.” Ridenour v. Kaiser-Hill Co., 397 F.3d 925, 934 (10th Cir. 2005). Specifically, they contend, it risks violating the separation of
powers embodied in the Take Care Clause, which entrusts the Executive Branch with the duty to “take Care that the Laws be faithfully executed.”
We recognize that the Tenth Circuit found this argument persuasive, see Ridenour, 397 F.3d at 934-35, but we do not see genuine constitutional doubts to avoid. As the Seventh Circuit also concluded, showing “good cause” is neither a burdensome nor unfamiliar obligation. See CIMZNHCA, 970 F.3d at 848-49. It is a “uniquely flexible and capacious concept,” meaning simply a “legally sufficient reason,” id. at 846 (quoting Good Cause, s.v. Cause, Black‘s Law Dictionary 101 (4th pocket ed. 2011)), and it is a standard the Government routinely satisfies to extend its time to investigate the relator‘s case under
in both England and at the time of the founding); Marvin v. Trout, 199 U.S. 212, 225 (1905) (noting that qui tam statutes were “in existence for hundreds of years in England, and in this country ever since the foundation of our government“); Adams v. Woods, 6 U.S. (2 Cranch) 336, 341 (1805) (Marshall, C.J.) (“Almost every fine or forfeiture under a penal statute, may be recovered by an action of debt [qui tam].“); 3 William Blackstone, Commentaries *160 (relating that forfeitures created by penal statutes “more usually are given at large, to any common informer; or . . . to the people in general . . . . [I]f any one hath begun a qui tam, or popular, action, no other person can pursue it; and the verdict passed upon the defendant . . . is . . . conclusive even to the king himself.“). These deep historical roots suggest that, even if the “good cause” standard reduces the Government‘s degree of control over a relator‘s suit, such a lack of direct control was not considered an unconstitutional flaw at the founding.
B. The Applicable Standard
We next consider the standard applicable to the Government‘s motion. Is the Government automatically entitled to dismissal, or does that decision lie in the District Court‘s discretion? Or in practical terms, is the “opportunity for a hearing on the motion” in
case,” as the Government argues, Gov‘t Br. 28, or is it an adversarial hearing to inform the District Court‘s ruling on the Government‘s motion?
This issue, too, has divided the Courts of Appeals, see Chang v. Children‘s Advocacy Center of Delaware, 938 F.3d 384, 387 (3d Cir. 2019), which have taken three paths.13 While the D.C. Circuit agrees with the Government that it has an “unfettered right” to dismiss, see Swift v. United States, 318 F.3d 250, 252 (D.C. Cir. 2003), and the Ninth and Tenth Circuits hold it to a “rational relation” standard drawn from substantive due process jurisprudence, see United States ex rel. Sequoia Orange Co. v. Baird-Neece Packing Corp., 151 F.3d 1139, 1145-46 (9th Cir. 1998); Ridenour v. Kaiser-Hill Co., 397 F.3d 925, 936 (10th Cir. 2005), the Seventh Circuit simply applies the Federal Rules of Civil Procedure as it would to any party, see CIMZNHCA, 970 F.3d at 849-50. Today we wade into the fray, again siding with the Seventh Circuit.
Below, we discuss the standard we adopt, and then explain why we decline to
1. The Standard We Adopt
The standard applicable to the Government‘s motion to dismiss follows logically from the FCA‘s request that the Government intervene before seeking dismissal. Having intervened, the Government becomes a party, and like any party, it is subject to the Federal Rules of Civil Procedure, including the rule governing Voluntary Dismissal.
That is
Of course, the FCA does add certain wrinkles. For example, while
In practice, then, when the Government moves to dismiss a relator‘s case pursuant to
heard,16
As an important caveat, we note that, even in a typical case between private parties, dismissal at this later stage “should be allowed unless defendant will suffer some prejudice other than the mere prospect of a second lawsuit,” Estate of Ware v. Hosp. of the Univ. of Pa., 871 F.3d 273, 285 (3d Cir. 2017) (quoting In re Paoli R.R. Yard PCB Litig., 916 F.2d 829, 863 (3d Cir. 1990)), and that rule carries particular force, with constitutional implications in an FCA case, where it is the Government seeking to dismiss a matter brought in its name.18 See
(explaining that the standards set out in
2. The Alternative Approaches Among the Courts of Appeals
While we respect and have carefully weighed the considered views of other courts, we are satisfied that we have chosen the best path forward.
The D.C. Circuit has interpreted
Appellees (alongside amicus United States Chamber of Commerce, Commerce Br. 9-10) have pressed these points with us as well, but we are unconvinced. For one, the analogy to prosecutorial discretion is too loose a fit because qui tam actions involve not just the Government but also the relator in the role of “prosecutors,” each with its own interest in the action. And as Congress recognized in assuring the relator a hearing on the Government‘s motion, those interests can be different.
In addition, reading
incongruous with other provisions of the FCA. For example,
Polansky asks us to go the other way and adopt the rational relation test promulgated by the Ninth Circuit and followed by the Tenth, which is drawn from the former‘s substantive due process jurisprudence. See Sequoia, 151 F.3d at 1145; Ridenour, 397 F.3d at 936. Under this test, the court requires “(1) identification of a valid government purpose; and (2) a rational relation between dismissal and accomplishment of the
purpose.” Sequoia, 151 F.3d at 1145. If the Government satisfies that two-prong test, “the burden switches to the relator to demonstrate that dismissal is fraudulent, arbitrary and capricious, or illegal.” Id. (internal quotation marks omitted).
But neither does that slipper fit. The right against arbitrary government action may provide a constitutional floor, but the Federal Rules of Civil Procedure are built above it, and the Ninth Circuit‘s approach omits that structure entirely. And
In sum, our review of the alternate approaches confirms the one on which we have settled: When the Government declines to adopt a relator‘s FCA action, and the relator elects to proceed on his or her own, the Government must intervene pursuant to
C. Whether the District Court‘s Grant of Dismissal was a Reasonable Exercise of Discretion
Having clarified the operation of
We start with the requirement that the Government intervene under
to dismiss as including a motion to intervene because “intervention was in substance what the government sought and in form what the False Claims Act requires.” CIMZNHCA, 970 F.3d at 849 (treating a government motion to dismiss as a motion to intervene as well); see also Swift, 318 F.3d at 252 (assuming that, if intervention “were . . . a requirement, we could construe the government‘s motion to dismiss as including a motion to intervene“). And, by thoroughly examining the Government‘s stated reasons for moving to dismiss and granting the motion, the District Court necessarily found the Government had shown the “legally sufficient
Moving on to the District Court‘s grant of dismissal, we perceive no abuse of discretion. The Court exhaustively examined the interests of the parties, their conduct over the course of the litigation, and the Government‘s reasons for terminating the action. It discussed, for instance, the litigation costs that Polansky‘s suit imposed on the Government, including “internal staff obligations,” “anticipated . . . document production,” and the need to expend attorney time preparing and defending depositions of CMS personnel. Polansky, 422 F. Supp. 3d at 928. It also noted three events that took place in the run-up to the Government‘s motion that justified its interest in discontinuing the action: (1) the Government and Polansky apparently disagreed on the extent to which Polansky had actually narrowed his case pursuant to their agreement; (2) EHR deposed Polansky; and (3) a mere five days before the Government sought to dismiss the case, the District Court overruled the Government‘s objections to the Special Master‘s rejection of its deliberative process privilege and ordered it to begin producing documents.
The District Court also adequately considered the prejudice to the non-governmental parties, concluding that, even though the litigation was at an advanced stage and significant resources had been expended on it by both the parties and the Court, there was little risk of prejudice to EHR because it supported the Government‘s motion. As for Polansky, the District
Court considered his argument that, by dismissing the case, the Government was “leaving billions of dollars of potential recovery on the table,” but concluded that there were “genuine concerns” that “the potential benefits he highlights will be realized,” both because Polansky maintained he had significantly narrowed his claims and because the prospect of success was doubtful. Id. at 927. The Court also noted that Polansky had engaged in potentially sanctionable conduct during the course of discovery, and that this “behavior was material and plays a role in the final disposition of this case.” Id. at 920.
In light of this thorough examination and weighing of the interests of all the parties, and
KRAUSE
UNITED STATES CIRCUIT JUDGE
