ORDER ON DEFENDANTS’ MOTIONS TO DISMISS
This cause is before the Court on Defendants’ Motions to Dismiss Plaintiffs Amended Complaint (Dkts.48, 50), and responses. The Court also has for consideration a Motion for Leave to File Reply (Dkt.62).
STANDARDS
A complaint should not be dismissed for failure to state a claim unless it appears beyond doubt that the Plaintiff can prove no set of facts in support of his claim which would entitle him to relief.
Conley v. Gibson,
FACTS
This action is brought by Dr. Kevin Butler under the “qui tam” provision, 31 U.S.C. 3730, of the False Claims. Act (FCA), 31 U.S.C. §§ 3729-3733 (1994), alleging fraud on the part of the Defendants, Magellan Health Services, Inc., Charter Behavioral Health System of Tampa Bay, Inc., Charter Glades Behavioral Health System, Inc., Ft. Myers, Florida, Charter Springs Health System, Inc., Ocala, Florida, Charter Kissimmee Behavioral Health System, Inc., Orlando Florida, Charter Behavioral System at Manatee Adolescent Treatment Service, Inc., Charter Behavioral Health System of Bradenton, Inc., and Florida Health Facilities, Inc.
Plaintiff was employed as the Medical Director of the Charter Behavioral Health Center System of Tampa Bay, Inc. and as Regional Medical Director for Texas Magellan Health Service, Inc.
Plaintiff alleges that Defendants submitted fraudulent claims to the United States Department of Health and Human Services (HHS) under the Medicare program, and to the Department of Defense (DOD) through the Civilian Health and Medical *1204 Program of the Uniformed Services (CHAMPUS), to obtain benefits and accreditation to which they were not entitled. Plaintiff additionally alleges Defendants fraudulently extended and reduced the duration of patient stays without regard to medical necessity, presenting false certifications to HHS and DOD to augment benefits and obtain selected state accredita-tions. Further, Dr. Butler asserts that the Defendants encouraged unnecessary patient admissions by waiving Medicare deductibles and CHAMPUS co-payments, then submitting false claims derived from the unnecessary admissions. As a result of Plaintiffs refusal to participate in the system, Plaintiff charges that Defendants implemented a business strategy with the intent to divide him from his position, finally resulting in his constructive discharge.
Plaintiff and his company, Behavioral Healthcare Options, Inc. (BHO) filed suit in state court on March 16, 1994, against Charter Medical Corporation and its parent company, Magellan Health Services, on claims of breach of contract, tortious interference with contract, and breach of covenant of good faith and fair dealing.
On March 17, 1994, the following day after filing his state claim, Plaintiff held a press conference announcing the suit, naming one of the Defendants in this qui tam complaint as effectuating a “heads on the beds” (taken to mean provoking inappropriate admissions and demanding physicians not release patients who had insurance benefits regardless if the patient required hospitalization) policy to maximize profits. He also alleged Charter guaranteed some of the Physicians salaries in return for the referral of patients needing inpatient treatment. See Jeff Testerman, Doctor Sues Charter of Tampa Bay, St. Petersburg Times, March 17, 1994 at IB, available in
Plaintiffs filed the Amended Complaint (Dkt.38) on September 15, 1998, alleging that Defendants defrauded the United States by tendering fraudulent claims to the United States Department of Health and Human Services Medicare Program and the Department of Defense Civilian Health and Medical Program of the Uniformed Services to maximize insurance benefits by stretching or reducing the duration of patients’ hospitalization without regard for medical necessity and by encouraging unnecessary patient admissions.
DISCUSSION
I. The False Claims Act
The chronicles and intricate policy goals behind the FCA’s qui tam provision have been recited by numerous courts. See, e.g.,
U.S. ex rel. Findley v. FPC-Boron Employees’ Club,
The statute has since been amended twice in its 136 year history, once in 1943 and mere recently in 1986, in response to alarming court decisions. In
United States ex rel. Marcus v. Hess,
Again Congress responded to a troubling court decision in
United States ex rel. Wisconsin v. Dean,
Trying to find a middle line, the 1986 amendments “sought to resolve the tension between ... encouraging people to come forward with' information and ... preventing parasitic lawsuits.”
Cooper ex rel. United States v. Blue Cross and Blue Shield of Florida, Inc.,
In effect, the 1986 modifications broadened the qui tam provisions, rewarding private individuals who take personal risks in exposing wrongdoings, breaking conspiracies of silence among employees of malfeasors, and to promote whistleblowing. See S.Rep. No. 99-345, at 14 (1986);
United States and Eunice Mathews v. Bank of Farmington,
The current qui tam provisions of the False Claims Act authorize both the United States Attorney General or private persons with personal knowledge of fraud against the government to bring a civil action as a “relator,” acting on behalf of the United States government, and to share in the proceeds for his or her efforts. See 31 U.S.C. 3730(b);
Hughes Aircraft Co. v. U.S. ex rel. Schumer,
Although the Act permits any person to initiate a qui tam action, it precludes actions based upon allegations or transactions disclosed through specifically enumerated means. By allowing certain private parties to sue on behalf of the government, the FCA creates a statutory exception to the general rule regarding standing to sue.
United States ex rel. Weinberger v. Equifax, Inc.,
The FCA, as amended, however, does not confer this standing to sue on all private parties. Parties who fall within the certain exceptions to the FCA may not initiate qui tam actions, for district courts have no jurisdiction over their claims. 31 U.S.C. § 3730(e)(4) provides for a jurisdictional bar in three circumstances where public disclosure occurs:
(4)(A) No court shall have jurisdiction over an action under this section based upon the public disclosure of allegations or transactions in a criminal civil or administrative hearing, in a congressional, administrative, or General Accounting Office report, hearing, audit, or investigation, or from the news media, unless the action is brought by the Attorney General or the person bringing the action is an original source of the information.
(4)(B) For purposes of this paragraph, “original source” means an individual who has direct and independent knowledge of the information on which the allegations are based and has voluntarily provided the information to the Government before filing an action under this section which is based on the information.
31 U.S.C. Section 3730(e)(4)(A) and (B) (1994).
Defendant argues that the allegations upon which Plaintiffs action is based were publicly disclosed, both in the state civil litigation as well as in the news media, and that Defendant’s qui tam action is “based upon” those publicly disclosed allegations. Defendant further contends that Dr. Butler is not an “original source” of the allegations. Defendant also argues that this Court lacks jurisdiction over an action brought by private plaintiffs on behalf of the United States where the United States has declined to intervene and questions the Constitutionality of qui tam provisions.
Defendant’s Alternative Motion to Dismiss Amended Complaint asserts that Plaintiff has failed to plead fraud with particularity as required by the Federal Rules of Civil Procedure, and has therefore failed to state a claim under the False Claims Act.
II. Jurisdiction
The relator bears the burden of proving that a court has jurisdiction over a case. In the Eleventh Circuit, a constructive three part inquiry determines if jurisdiction exists: (1) have the allegations made by the plaintiff been publicly disclosed; (2) if so, is the disclosed information the basis of the plaintiffs suit; (3) if yes, is the plaintiff an “original source” of that information.
Cooper,
A. Public Disclosure
The first inquiry in determining whether the jurisdictional bar of the FCA applies is whether the allegations were publicly disclosed before the initiation of the qui tam action, because if not, there is no jurisdictional bar.
Cooper,
Under the rough language of the statute, a public disclosure can occur (1) in a criminal, civil or administrative hearing; (b) in a congressional, administrative or General Accounting Office report, hearing, audit, or investigation; or (c) from the news media. 31 U.S.C. Section 3730(e)(4)(A).
When ascertaining what constitutes a public disclosure, some courts have interpreted the terms “criminal, civil or administrative hearing” broadly to include criminal indictments, complaints, and discovery materials filed in civil actions. See, e.g.,
Springfield Terminal Ry.,
In analyzing the FCA, the Eleventh Circuit has taken the approach based on the plain language of the statute:
As a preliminary matter, we find that the methods of “public disclosure” set forth in section 3730(e)(4)(A) are exclusive of the types of public disclosure that would defeat jurisdiction under that section. The list of methods of “public disclosure” is specific and is not qualified by words that would indicate that they are only examples of the types of “public disclosure” to which the jurisdictional bar would apply. Congress could easily have used “such as” or “for example” to indicate that its list was not exhaustive. Because it did not, however, we will not give the statute a broader effect than that which appears in its plain language.
Williams,
The plain meaning of the statute supports this determination that the enumerated means are exclusive. Notably, the filing of a lawsuit, civil litigation, or discovery are not methods specifically enumerated in Section 3730(e)(4)(A). United States ex rel.
Stinson, Lyons, Gerlin & Bustamante, P.A. v. Provident Life & Acc. Ins. Co.,
As one commentator has noted, aside from being “exclusive,” with the exception of the news media, all the means involve certain federal government proceedings whereby the Government is a participant. See Gary W. Thompson, A Critical Analysis of Restrictive Interpretations Under the False Claims Act’s Public Disclosure Bar: Reopening the Qui Tam Door, 27 Pub.Cont.L.J. 669, 696 (1998).
In such cases, the Government knows of the information that is disclosed due to its involvement and participation in the disclosure. See id. The Government may never find out about a litigation involving private litigants. Since Congress intended to further the exposure and resolution of fraud, defining civil hearings to include private information passed between parties during a lawsuit flies in the face of encouraging qui tam actions.
Accordingly, courts have usually drawn a distinction when it comes to public disclosure that are actually filed with the court and those that are held in the hands of private parties. Courts normally agree that a disclosure under the term “civil hearing” occurs whenever information is contained in a document actually filed with a court since the information is available to the public, but the public private distinction has led to divergent results.
Springfield Terminal,
In fact, this Circuit has construed narrowly the definition of “Congressional, administrative or General Accounting Office report, hearing, audit or investigation.” See
Cooper,
Nonetheless, every appellate court that has considered the issue of whether discovery material which has been filed with a court has therefore been publicly disclosed has answered in the affirmative. See, e.g.,
United States ex rel. Jones v. Horizon Healthcare Corp.,
As to the disclosures to the media, Dr. Butler has again publicly disclosed the information upon which this suit is based. Dr. Butler himself was responsible for the media revelations and the alleged fraud reaching the public; therefore, this Court is without jurisdiction if the qui tam action is based on those disclosures and relator was not the original source of the allegations. 31 U.S.C. § 3730(e)(4)(A);
U.S. ex rel. Biddle v. Board of Trustees of Leland Stanford, Jr. University,
Dr. Butler initiated his state court action and media disclosures three years prior to submitting his qui tam complaint to the Government. Defendant argues this prior disclosure rendered the qui tam complaint superfluous and instead frustrated the Government’s ability to investigate the allegations due to the Confidentiality Order in the state court action. Whether the issue of frustration is true is largely irrelevant. Nonetheless, the Court finds that Dr. Butler has placed the allegations in the public domain. The Court must therefore turn to the question of whether the allegations are based upon those disclosures. The Court concludes they were.
B. Based Upon
The jurisdictional bar applies only when a qui tam action is “based upon” a public disclosure of allegations or transactions. Plaintiff contends that his FCA complaint is not “based upon” a public disclosure; rather, the complaint is “based upon” his employment and personal knowledge acquired before his termination that forms the basis of his state court action as well as his qui tam action.
Once again, courts are not in agreement as to when a suit is “based upon” publicly disclosed information. Compare, e.g.,
United States ex rel. Findley v. FPC-Boron Employees’ Club,
Other courts have dealt with the term “based upon” in a variety of manners. The Fourth Circuit takes a wholly unique position, focusing on whether the relator actually derived knowledge from the public disclosure. See
United States ex rel. Siller, 21
F.3d 1339 (4th Cir.),
cert.
denied,
In harmony with this Circuit, the Tenth Circuit specifically rejected
Siller’s
“derived from” standard and ruled that “based upon” means “supported by.”
United States ex. rel Fine v. MK-Ferguson Co.,
Moreover, the District of Columbia and the First, Eighth and Eleventh Circuits are more favorable to the relator. For example, the District of Columbia Circuit strictly construes the language, whereby only if a qui tam suit is based upon publicly disclosed allegations or transactions, not just publicly disclosed information, will it fail to meet the jurisdictional bar.
Springfield Terminal,
In
Cooper v. Blue Cross & Blue Shield of Florida,
this Circuit looked at whether the relator actually based his lawsuit on the public disclosure, but also analyzed the issue as whether the relator could qualify as an “original source” of the disclosed information. This Circuit held that “the general definition of ‘based on’ is ‘supported by.’ ”
Cooper,
Obviously, the factual allegations in Plaintiffs state law action are similar to the allegations in the FCA complaint. The only substantial difference between the two is that the FCA complaint does not specifically allege the defendants were submitting false claims to the government and only mentions two of the defendants in this action. Since Plaintiffs state court lawsuit involves only two of the Defendants named in this lawsuit, there is no jurisdictional bar as to the unidentified Defendants.
Cooper,
C. Original Source
If the suit is based upon a “public disclosure,” the Court has no jurisdiction to hear the claim unless Plaintiff shows that he is an “original source” of the information. 31 U.S.C. 3730(e)(4)(B). The original source requirement represents a compromise between advancing private qui tam suits and preventing opportunistic actions. “Original source” is defined as “an individual who has direct and independent knowledge of the information on which the allegations are based and has voluntarily provided the information to the Government before filing an action under this section which is based on the information.” Id.
The standards for the original source inquiry were articulated in
Cooper,
As to disclosure, other circuits have held that the relator “must have directly or indirectly been a source to the entity that publicly disclosed the allegations on which a suit is based.”
United States ex rel. Dick v. Long Island Lighting Co.,
Citing the Sixth Circuit’s opinion in
Jones
and the D.C. Circuit’s opinion in
Findley,
Defendants maintain that in addition to establishing direct and independent knowledge and disclosure to the government prior to the filing of this qui tam action, the “relator also must provide the government with the information upon which the allegations are based prior to any public disclosure.”
Jones,
However, this Circuit has held that in addition to having direct and independent knowledge, the relator need only provide his information to the government before instituting the qui tam action.
Cooper,
As such, Dr. Butler qualifies as an original source. The state court complaint as well as the information to the media was disclosed by his own prerogative. As required, Dr. Butler provided the information to the government before filing this qui tam action. The information obtained by Dr. Butler was obtained “directly and independently,” allegedly through his own eyes. Defendants argue that Dr. Butler did not provide the information prior to making the allegations known to the public. However, in accord with this Circuit’s focus on the plain language of the statute and prior case history, the Court holds that such a requirement imposes reading of the word disclosure which is not present in the statutory language.
III. CONSTITUTIONALITY
A standard defense is an attack on the constitutionality of the FCA. Defendant argues that the qui tam provisions of the FCA violate the (1) separation of powers clause of the Constitution, (2) the appointments clause, and (3) Article III standing. Each of these arguments has been brought repeatedly by defendants in qui tam cases, ■and each has been rejected resoundingly by the District and Circuit courts, but for different reasons.
As to the separation of powers argument, the Justice Department has discretion to intervene and take control of any qui tam case.
Truong,
With respect to the argument that the qui tam provisions violate the appointments clause, the
Truong
court held that relators “enjoy limited powers, have no formal duties, hold no established office, have no prescribed tenure, and receive no federal emoluments. As such, they are more appropriately classified as ‘agents’ for Appointments Clause purposes.”
Truong,
A qui tam plaintiff must satisfy Article Ill’s standing requirement in order to bring a suit in federal court. “The jurisdiction of the federal court is defined and limited by Article III of the Constitution” and is limited to “cases” and “controversies.”
Flast v. Cohen,
The standing argument asserts that in a claim filed under 21 U.S.C. § 3729, the government suffers the injury, not the relator. As such, Dr. Butler would not have suffered the injury; rather, the injury would be to the public fisc. However, this argument has overwhelmingly failed. See, e.g.,
U.S. ex rel. Hall v. Tribal Dev. Corp.,
Four justifications have been given as to why a qui tam plaintiff meets Article III standing with regard to injury. First, courts have found that the real plaintiff in a qui tam suit is the government and that the government’s injury satisfies the injury-in-fact required for Article III standing. Second, courts have concluded that the FCA effectively assigns the government’s claims to qui tam plaintiffs, who then may sue based upon an injury to the federal treasury. See, e.g.,
Kreindler,
For example, in
United States ex rel. Stillwell v. Hughes Helicopters, Inc.,
the court looked
to
case history, but also found that the statutory bounty gave the relator a personal stake and thereby created injury in fact.
United States ex rel. Stillwell v. Hughes Helicopters, Inc.,
The recovery of a qui tam relator is intended to remedy the harm he suffered in several ways: by distancing the relator from the fraud and rewarding him for his involvement in the government’s fight against unlawful activity; by compensating the relator for any harm he suffered with respect to his *1214 employment; and by compensating the relator for substantial time and expense involved in bringing a qui tam action.
Neher,
[A] qui tam relator suffers substantial harm and the qui tam provisions of the FCA are intended to remedy that harm. First, a qui tam relator can suffer severe emotional strain due to the discovery of his unwilling involvement ... the actual or potential ramifications on the relator’s employment can be substantial ... Finally, the relator can suffer substantial financial burdens as a result of the time expense involved in bringing a qui tam action. We thus believe that the FCA’s qui tam provisions are intended to redress wrongs suffered by individual relators ... rather than the general public.
See id. (citations omitted). Other circuits have agreed that a qui tam plaintiff has standing to maintain a qui tam action despite the Government’s election not to join in the suit. See, e.g.,
United States ex rel. Weinberger v. Equifax, Inc., 557
F.2d 456, 460 (5th Cir.1977), cert. denied,
Defendant relies on a recent decision, appeal pending, in
United States ex rel. Riley v. St. Luke’s Episcopal Hosp.,
IV. Particularity
A. Local Rule 3.01
Initially, Plaintiff notes that Defendants’ Alternative Motion to Dismiss violates Local Rule 3.01, which precludes a party from filing supplemental memoranda without leave of court. The Local Rules do not permit the filing of unlimited motions dismiss without leave of the Court. See
Morroni v. Gunderson,
This Court has expressed, with regard to untimeliness under the Local Rules, that the Eleventh Circuit has a vigorous policy of resolving issues on the merits and not on procedural technicalities.
Morroni,
B. Failure to Plead with Particularity
Fed.R.Civ.P. 9(b) states that in “all averments of fraud or mistake, the circumstances constituting fraud or mistake shall be stated with particularity. Malice, intent, knowledge and other condition of mind of a person may be averred generally.” Fed.R.Civ.P. 9(b). A mere eonclusory allegation which asserts fraud without a description of the fraudulent conduct will not fulfill Rule 9(b).
Lincoln Nat’l Bank v. Lampe,
Pleading fraud with particularity is necessary in order to: (1) provide the defendants with sufficient notice of the acts of which the plaintiff complains to enable them to frame a response, (2) prevent fishing expeditions to uncover moral wrongs, and (3) protect defendants from unfounded accusations of immoral and otherwise wrongful conduct.
NCR Credit Corp. v. Reptron Electronics, Inc.,
The “clear intent of Rule 9(b) is to eliminate fraud actions in which all the facts are learned through discovery after the complaint is filed.”
Stinson I,
However, Rule 9(b) must be read in conjunction with Rule 8, Fed.R.Civ.P., regarding “short and plain” notice pleading, to effectuate the purpose of the FCA. See, e.g.,
Durham v. Business Management Associates,
The Eleventh Circuit has held that: “Allegations of date, time or place satisfy the Rule 9(b) requirement that the circumstances of the alleged fraud must be pleaded with particularity, but alternative means are also available to satisfy the rule.”
Durham v. Business Management Associates,
Then again, even in these cases the complaint must still “ ‘adduce specific facts supporting a strong inference of fraud or it will not satisfy even a relaxed pleading standard’ ”.
Stinson I,
The relaxed requirement is applied where “strict application of Rule 9(b) could result in substantial unfairness to private litigants who could not possibly have detailed knowledge of all circumstances surrounding the alleged fraud.”
NCR Credit,
As a whole, the Complaint does provide extensive detail with regard to the process allegedly undertaken by the hospital staff. This, Plaintiff argues, is sufficient to satisfy the relaxed particularity requirements of 9(b). The Court disagrees. The shortcoming of Dr. Butler’s Amended Complaint is that it does not “adduce specific facts supporting a strong inference of fraud.” See
Stinson I,
Markedly, the complaint fails to refer to specific employees who may have been involved in submitting false claims. In
United States ex rel. Robinson v. Northrop,
None of allegations set forth in the amended complaint satisfy Rule 9(b), under the strict or relaxed application. Plaintiff does not provide any specific names of staff involved in the fraud. Moreover, besides naming a hospital Administrator only by title, Plaintiff merely *1217 states “administrative staff,” patients and Charter hospital in the most general of terms. Likewise, the complaint lists the dates as “an unknown date prior to 1989, and continuing until the date of this complaint.”
This Circuit has held that a plaintiff has the right to amend a complaint at least once to eliminate any deficiencies found by the court.
Cooper,
CONCLUSION
For the reasons stated above, the Court concludes that it does have subject matter jurisdiction over this action. Plaintiff, however, has not pleaded its allegations with particularity as required by Rule 9(b). Before the Court will dismiss an action on that ground, it will give the Plaintiff an opportunity to address, the inadequacy. Therefore, the Court denies Defendant’s Motion to Dismiss (Dkt.48) to the extent that it is based on lack of subject matter jurisdiction and constitutionality. The Court grants Defendant’s Alternative Motion to Dismiss (Dkt.50) amended complaint, but allows Plaintiff fifteen calendar days in which to address the deficiencies in the Amended Complaint. The Motion for Leave to File Reply is denied (Dkt.62).
