United States ex rel. LaCorte v. SmithKline Beecham Clinical Laboratories, Inc.United States ex rel. LaCorte v. SmithKline Beecham Clinical Laboratories, Inc.
OPINION OF THE COURT
This appeal requires us to interpret for the first time 31 .U.S.C. § 3730(b)(5), a provision of the False Claims Act intended to prevent duplicative lawsuits. Jeffrey Clausen, William LaCorte and Donald Miller appeal from an order dismissing their False Claims Act suits under section 3730(b)(5) and denying them a share of the proceeds from a settlement based on similar claims alleged in pre-existent lawsuits. We will affirm.
I.
The False Claims Act prescribes civil penalties for knowingly submitting fraudulent claims to the federal government. Under the Act, the United States may bring a civil suit to recover funds lost through such fraudulent transactions.
This appeal involves six suits under the qui tam provisions of the False Claims Act. Appellee Robert J. Merena filed the first of these qui tam actions against SmithKline on November 12, 1993 in the Eastern District of Pennsylvania. Appellee Glenn Grossenbacher, .later joined by Charles Robinson, Jr., (“the Grossenbacher parties”) filed suit in the Western District of Texas on December 15,
All three complaints alleged that Smith-Kline, which operates a nationwide system of clinical laboratories, adopted myriad complicated procedures for the purpose of defrauding state and federal healthcare programs, in particular Medicare and Medicaid. Most of these fraudulent schemes permitted Smith-Kline to bill the federal government for unauthorized and medically unnecessary laboratory tests. The original relators also alleged that SmithKline used various methods to evade Medicare and Medicaid requirements dictating the maximum level of reimbursement for certain services.
Based on its investigation of claims in the original lawsuits, the United States negotiated a $325,000,000 settlement releasing Smith-Kline for certain false claims made between January 1, 1989 and September 16, 1996. After the government and SmithKline reached this proposed settlement, but before final execution of the settlement agreement, Jeffrey Clausen, Donald Miller and William LaCorte each filed a separate qui tarn, action (the “later” lawsuits) against SmithKline. Like the original relators, Clausen, LaCorte and Miller alleged that SmithKline intentionally overcharged several government health benefit plans, including the Medicare. and Medicaid programs. Although these later cases originated in different parts of the country, they were transferred to the Eastern District of Pennsylvania and reviewed together with the original lawsuits. The later actions were never consolidated with the original suits, however.
Under the False Claims Act, the government may settle a qui tam relator’s claim over the relator’s objections only “if the [trial] court determines, after a hearing, that the proposed settlement is fair, adequate, and reasonable under all the circumstances.”
After reviewing the parties’ submissions, the district court ruled that the settlement agreement included all but one of the later claims, i.e., an allegation in LaCorte’s complaint alleging fraudulent billing for urinalysis tests. It also held that this urinalysis claim was the only allegation in the later complaints not barred by
II.
The district court had jurisdiction under
The original relators challenge appellate jurisdiction over Clausen’s claims because Clausen filed a notice of appeal only from the district court’s July 23,1997 order dismissing his suit. They contend that this dismissal was not a reviewable final order, and that Clausen instead should have appealed from a later order certifying his claims for appellate review under
Unlike the cases of the three original relators, Clausen’s suit was never consolidated with any of the other qui tam actions. Thus when the district court dismissed Clau-sen’s appeal with prejudice on July 23, 1997, it did not retain jurisdiction over any part of his case. Therefore the dismissal of Clau-sen’s complaint with prejudice was an appeal-able final judgment, and we have jurisdiction over Clausen’s appeal from that decision. See In re Westinghouse Securities Litig.,
III.
Before addressing Clausen, La-Corte and Miller’s contentions that the trial judge misapplied
Clausen, Miller and LaCorte urge us to hold that
To support their argument that
Subsection (b)(5) ofsection 3730 further clarifies that only the Government may intervene in a qui tam action. While there are few known instances of multiple parties intervening in past qui tam eases, United States v. Baker-Lockwood Manufacturing Co.,138 F.2d 48 (8th Cir.1943), the Committee wishes to clarify in the statute that private enforcement under the civil False Claims Act is not meant to produce class actions or multiple separate suits based on identical facts and circumstances.
S.Rep. No. 99-345, at 25 (1986), reprinted in 1986 U.S.C.C.A.N. 5266, 5290. Clausen, LaCorte and Miller maintain that Congress’ reference to “identical facts” requires us to interpret
This argument is unpersuasive for several reasons. First, we may examine a statute’s legislative history to determine its meaning only if the text of the statute is ambiguous. See Carteret Sav. Bank, F.A. v. Office of Thrift Supervision,
Furthermore, even if we found the statutory language ambiguous and therefore considered the Senate’s report, the language quoted above would not compel a different interpretation. Although it is possible to read this passage as supporting Clausen, La-Corte and Miller’s perspective, other constructions are equally plausible. Nothing suggests that the legislative references to class actions and suits “based on identical facts and circumstances” constitute an exhaustive list of all claims subject to the statutory bar. It is just as likely that these are merely two examples among several types of suits prohibited by the statute.
Moreover, we note that interpreting
Following a decline in qui tam litigation after the 1943 amendment, the legislature again amended the Act in 1986. The primary purpose of this change was to “shift the advantage back to the government” in the
Defining “facts underlying the pending action” as identical facts would upset that balance by unnecessarily handicapping future government efforts to recover fraudulently obtained funds. Under the later plaintiffs’ overly narrow interpretation, dozens of rela-tors could expect to share a recovery for the same conduct, decreasing their incentive to bring a qui tam action in the first place. By contrast, interpreting
Further, if the statute barred only claims identical to prior allegations, early filing rela-tors might resist government efforts to keep a suit under .seal beyond the sixty-day statutory period out of fear that other plaintiffs might have time to bring additional suits and thereby reduce each relator’s share of the qui tam award. This could pose significant problems in cases involving complicated or extensive transactions, where prolonged investigations likely will be necessary.
In a final effort to defend their construction of the statute, Clausen, LaCorte and Miller argue that unless
IV.
Having determined the proper interpretation of
A.
1.
LaCorte argues that four allegations in his original complaint (“Claims 1, 2, 3 and 4”) survive
2.
LaCorte’s Claim 2 also repeats allegations in the original complaints. Claim 2 alleges that SmithKline substituted its more expensive tradename blood profiles when doctors ordered certain standard blood chemistry panels (known as “SMAC,” for Simultaneous Multiple Analyzer Computerized and “SMA” for Sequential Multi-analy-sis).
We disagree. Merena and the Grossen-bacher parties pleaded that SmithKline fraudulently billed and marketed blood chemistry profiles. These allegations clearly encompass Claim 2. For instance, Merena alleged that
[by] expanding and manipulating its test profiles, performing tests that are not medically necessary, and improperly billing for tests that should have been part of an automated test profile, [SmithKline] has knowingly presented numerous false and fraudulent claims for payment by the government.
App. at 188.
Additionally, the Grossenbacher parties alleged that SmithKline intentionally struc
In sum, Claim 2 only differs from the Merena and Grossenbaeher allegations in that it specifically lists the names of the tests SmithKline improperly added to the SMA and SMAC orders, while the original relators alleged more generally that Smith-Kline “began separately billing for a whole series of tests,” App. at 189, and billed for “several tests not ordinarily included in a standard SMAC profile.” App. at 133. This difference is immaterial. Merena and the Grossenbaeher parties stated that Smith-Kline deliberately performed and billed the government for numerous unordered blood chemistry profiles. Thus they have alleged every essential element of Claim 2, and that claim is barred by
3.
In Claim 3, LaCorte alleged that during phony “screening programs” Smith-Kline employees drew blood and urine specimens from nursing home patients without informing the patients’ physicians. The company then performed unauthorized CBC, hematology, urinalysis and blood chemistry tests on these samples, charging the government for those services. App. at 238-39, 244. SmithKline also sent the United States a bill for drawing and transporting the specimens. App. at 238-40.
4.
Finally, LaCorte’s Claim 4 also repeats allegations raised by the original lawsuits. That claim alleges that while pretending to perform audits to verify orders, SmithKline employees surreptitiously gathered data regarding patients’ screening tests and blood chemistry panels from their medical charts. App. at 240-43. SmithKline allegedly used this data (1) to generate fraudulent requisition forms appearing to authorize the company’s performance of unrequested testing and (2) to design new requisition forms that would mislead medical staff into ordering unneeded tests.
The Grossenbaeher parties alleged the essential elements of Claim 4 by stating that SmithKline “design[ed] and implemented] its standard chemistry profiles, its clinical laboratory requisition forms, and its related practices and procedures in a manner calculated to promote unnecessary chemical testing .... ” App. at 140. Moreover, the Spear parties’ claim that SmithKline performed and billed for blood tests that were neither ordered nor medically necessary also covers Claim 4’s material facts.
We turn next to Clausen’s contention that
Clausen’s attempt to distinguish his claims is misguided. First, as noted above, Merena and the Grossenbacher parties alleged that SmithKline used a separate billing scheme for a wide variety of blood chemistry tests. App. at 135-36, 189. We see no meaningful distinction between Clausen’s allegation that SmithKline secretly added tests to its profiles to confuse doctors about what they ordered, on the one hand, and Merena’s allegations that the company “improperly bill[ed] for tests that should have been part of an automated test profile,” on the other. App. at 189. We therefore hold that these earlier allegations encompass Clausen’s first claim. Accordingly, that claim is barred by
Second, the original complaints’ failure specifically to mention GGT as one of the blood tests for which SmithKline fraudulently billed the government is of no significance. Again, Merena pleaded that SmithKline improperly billed Medicare, Medicaid and CHAMPUS separately for a “whole series of tests” that should have been included in the price for an automated test. Thus Merena’s claim states the essential facts of Clausen’s allegations regarding GGT. Furthermore, Merena’s claim clearly sufficed to give the government notice of SmithKline’s false claims for GGT, because the United States sought compensation for that fraud over a year before Clausen filed his suit. App. at 1047, 1051-52.
Clausen also argues that it is inconsistent to dismiss his claims but not those of the Grossenbacher and Spear parties, which also overlap with the allegations in the Mere-na complaint. Clausen is correct that Mere-na filed his complaint before any of the other consolidated relators, and that
C.
We turn next to Miller’s allegations. As an initial matter, we must determine whether Miller abandoned his appeal when he sought to adopt the arguments in Clausen’s brief rather than filing his own. The original rela-tors contend that although
We decline to apply that rule to this appeal. The cases in which courts have reached this conclusion involved attempts to incorporate by reference a co-defendant’s arguments regarding such necessarily fact-specific issue as sufficiency of the evidence. See, e.g., Harris,
Having rejected that statutory interpretation, however, we conclude that
V.
In light of our decision that
VI.
For the foregoing reasons, we hereby affirm the district court’s judgment dismissing Clausen, LaCorte and Miller’s claims under
Notes
. “Qui tam " is part of the longer Latin phrase “qui tam pro domino rege quam pro se ipso in hac parte sequitur," which means "who brings the action for the king as well as for himself.” See United States ex rel. Stinson v. Prudential Ins.,
. Section 3730(e) also creates certain jurisdictional bars to qui tam actions, none of which is at issue in this appeal. See, e.g., Stinson,
.
. Fearing that vital evidence will be destroyed before the appellate process is complete, LaCorte recently asked this Court to issue a writ of mandamus ordering the district court to lift the stay. For several reasons, we decline to address that petition here. First, because the district court order indicated that the stay would last only until such time as we reached a decision in this appeal, discussion of that order is now unnecessary. Second, that petition is before another panel of the court. Finally, because SmithKline and the government concede that the urinalysis claim is neither barred nor settled, that claim is
. Indeed, this case exemplifies the importance of extending an investigation under such circumstances. The original complaints revealed a scheme of nationwide fraud spanning ‘ several years. Consequently, the United States sought to keep the original complaints under seal beyond the statutorily required sixty days, and the district court granted the additional time without objection from any of the original relators. Based on its investigation, the government was able to negotiate a settlement in a relatively short period of time, thereby avoiding the cost and delay of litigation. Had they anticipated that the gui tam award would be reduced if other plaintiffs stepped forward with similar claims, however, the original relators might well have opposed the government’s request for additional time.
. . Because we may decide whether the later complaints allege the same material elements as claims in the original lawsuits simply by comparing the original and later complaints, further factual development is unnecessary. We therefore reject LaCorte’s suggestion that we remand his claims to the district court for discovery
. We express no opinion as to LaCorte’s urinalysis claim, which the district court determined was neither settled nor barred by section 3730(b)(5). As previously explained, supra n. 4, that claim is not at issue in this appeal because neither SmithKline nor the United States contests the trial court's decision regarding La-Corte’s urinalysis allegations.
. In their appellate brief, the original relators state that the acronym "SMAC” indicates "serial multichannel automated chemistry.” Br. of Ap-pellees Merena, Robinson, Grossenbacher & Spear et al. at 21. Because no party contends
.In his brief to this Court, LaCorte argued that only the 19-profile test and the ionized calcium test were not included in the settlement. However, the portion of his brief dedicated to his argument under section 3730(b)(5) did not specify any particular tests, but referred to his earlier contentions regarding the 19-profile test and the ionized calcium test. Thus LaCorte effectively conceded that the other tests included in Claim 2 are barred by