Fresenius In affirming that decision, the First Circuit stated that the new paragraphs in the [p]roposed [complaint] were attributable to the new relator and . (Id.). The Medicare ESRD program is administered through the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS). FMCNA decided that one of the keys to capturing new patients for its dialysis clinics was through its relationships with hospitals providing inpatient acute care. 1). And it means that relator stands to reap a reward of 15%-30% of any recovery-an amount that might well be measured in tens of billions of dollars. By law, all outpatient dialysis clinics must have a qualified medical director to be responsible for the delivery of patient care and outcomes in the facility. 42 C.F.R. United States ex rel. . But whatever the merits of that argument may be, the law requires more. The False Claims Act permits relators to reap substantial awards for reporting false claims to the government-in this case, the relator could conceivably recover billions of dollars if his allegations are proved. Flanagan According to the complaint, FMCNA clinics and other providers treating ESRD submit to the government one reimbursement claim bill per month for each patient, including the charges for several dialysis treatments, any separately billable laboratory services, and separately billable drugs. 3730(d). Accordingly, the public-disclosure bar does not preclude the claims concerning unlawful medical-director agreements. Chief Judge F. Dennis Saylor, IV assigned to case. Martin Flanagan is a resident of Texas. See Pub. 19). One problem lies in the phrase results in-that is, the requirement of causation. WebView the profiles of professionals named "Martin Flanagan" on LinkedIn. (Id.). 14-cv-6646 (E.D.N.Y. (Id. Family Medicine Call for an (Attachments: #1 Docket Sheet from District of Maryland, #2 Docket Entries 1-30, #3 Docket Entries 31-50, #4 Docket Entries 51-56, #5 Docket Entries 58-74) (Jones, Sherry) Modified on 10/7/2021 to correct docket text. As to some of those medical practices, the complaint provides some amount of additional detail, although again it does not describe any specific false claims. 38). Now, a relator may also qualify as an original source if prior to a public disclosure under subsection (e)(4)(a), [he] voluntarily disclosed to the Government the information on which allegations or transactions in a claim are based. Id. Flanagan v. Fresenius Medical Care Holdings, Inc. :: Justia Dockets & Filings Notice of appeal (doc. The Marvel Studios Phenomenon. claims . To the extent that the amended complaint addresses those remuneration relationships, therefore, the claims will not be dismissed. 39). A claim is any request or demand . 176). The district court had found that the relators had violated the filing and service requirements of the FCA because the new allegations were not substantially similar to those in the original complaint. (Id. According to the complaint, [f]or this reason, claims submitted to the state Medicaid agencies are presented to the federal government within the meaning of the [False Claims Act]. (Id.). (Id. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. 6:22-CV-03192 | 2022-07-28. (Id.). The matter was unsealed, and therefore publicly disclosed, in 2018. The complaint further alleges that FMCNA paid its medical directors far above fair market value. (McManus, Caetlin) (Entered: 11/02/2021), Docket(#9) ELECTRONIC NOTICE of Case Reassignment. (McManus, Caetlin) (Entered: 11/02/2021), (#9) ELECTRONIC NOTICE of Case Reassignment. For the foregoing reasons, defendant's motion to dismiss is GRANTED. (Attachments: #1 Docket Sheet from District of Maryland, #2 Docket Entries 1-30, #3 Docket Entries 31-50, #4 Docket Entries 51-56, #5 Docket Entries 58-74) (Jones, Sherry) Modified on 10/7/2021 to correct docket text. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. Dr. Michael D. Flanagan, MD | Bryn Mawr, PA - US News Health . These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. See Id. Feb. 25, 2013), the mere publication of compensation information, without an allegation of fraud or misrepresentation, is not sufficient to trigger the bar. 1320a-7b, states that whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person . At most, the filings describe a set of circumstances that might be vulnerable to manipulation. It alleges that Flanagan and colleagues were directed by their superiors to pursue contracts even when they resulted in losses. Cases involving fraud against the government, False Claims Act (FCA) - 31 USC 3729-3733. FMCNA also inserted non-competition clauses into their JVAs in order to lock partners into referring patients to its facility. Here, despite its length, the amended complaint does not describe a single particular false claim. Gonzales et al. FMCNA is America's largest dialysis-services provider. 3730(e)(4); (3) the claims concerning joint-venture agreements are barred by the FCA's first-to-file bar, 31 U.S.C. Defendant also contends that the claims concerning joint-venture agreements are barred by the first-to-file rule. The first issue is whether relator complied with the requirements of the False Claims Act to notify the government of his claims prior to filing suit. Rule 9(b) requires that a relator plausibly allege that specific payments concerning specific patients were caused by the AKS violation-that is, that they were part of the 25% of the claims that resulted from a violation, not the 75% that were not. The qui tam provisions of the FCA permit relators, in some instances, to reap huge financial windfalls. The following is a relevant excerpt from an SEC filing cited by the court in CKD: That excerpt discloses that the joint ventures do not qualify for safe-harbor protection and identifies the penalties that might be imposed should the company be found to be in violation of the relevant statutes. But this is not enough to satisfy Rule 9(b).). 11). Previo usly, UniCourt uses cookies to improve your online experience, for more information please see our Privacy Policy. (McManus, Caetlin) (Entered: 11/22/2021), Docket(#17) MOTION for Leave to Appear Pro Hac Vice for admission of Noah M. Rich Filing fee: $ 100, receipt number AMADC-9065658 by Martin Flanagan. Mo. Id. Compl. [23-1305] (JAW) [Entered: 04/05/2023 09:24 PM]. Nov. 12, 2014) (ECF No. 2013) (quoting Duxbury I, 579 F.3d at 21). Again, the complaint does not identify a single specific false claim-by Form UB-40, by patient name, by date, by location, by dollar amount, by billing code, by type of service, or otherwise. As to Diablo Nephrology, the complaint alleges the following: As to Balboa Nephrology Medical Group, it alleges the following: As to NANI, the complaint provides a table of Medicare and Medicaid revenue for a period of five years at seventeen dialysis centers in the Chicago area. 228). . Rule 9(b) may be satisfied where, although some questions remain unanswered, the complaint as a whole is sufficiently particular to pass muster under the FCA. U.S. ex rel. On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended complaint (Complaint) against Fresenius alleging that the company had entered into arrangements with hospitals and physicians in order to secure dialysis patient referrals for Fresenius outpatient dialysis clinics, and that such arrangements violated the Federal False Claims Act (FCA) and the Federal Anti-Kickback Statute (AKS). Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. The question here is whether the complaint has met that standard. CEO Martin Flanagan still sees a growth opportunity in Chinaand a big risk in Bitcoin. To begin, it appears-although the complaint is ambiguous at times-that the Medicare claims at issue were submitted to the federal government by FMCNA itself, and that the Medicaid claims were submitted by various state government agencies based on claims that FMCNA submitted to those agencies.As to the Medicare claims, therefore, the complaint must be evaluated according to the ordinary standard applicable in False Claims Act cases, not the more flexible standard applicable where the defendant allegedly caused a third party to submit false claims. FMCNA generated reports to track which medical directors and their practice groups referred patients to outside clinics and the reasons why. This action is taken to insure the parties receive timely notice of the properly assigned presiding judge and is without prejudice to consideration by the Court as a whole whether Local Rule 40.1 should be amended in some fashion to eliminate any further misunderstanding by the Clerks Office. 2023-03-23, Brevard County Courts | Personal Injury | 22-1304 | 2022-04-25, U.S. Courts Of Appeals | Other | Compl. Here, the motion to dismiss presents three sets of issues, all arising from the strict requirements for pleading such claims. Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. 1320a-7b(b)(2). Because he did not present those new claims to the government, that portion of the amended complaint alleging false claims based on that conduct will be dismissed. . (Id. . Flanagan filed the original complaint on March 6, 2014, alleging presentation of false claims in violation of the False Claims Act, 31 U.S.C. That is not sufficient, under the case law, to state a false claim with particularity within the meaning of Rule 9(b). Furthermore, they do not directly disclose the existence of any of the alleged schemes, or any other form of fraud, nor do they describe facts from which the existence of a fraudulent scheme might be inferred. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. In response, relator filed an amended complaint. Based on the allegations of the complaint, it appears that all of the patients in question would have received treatment at a facility operated by FMCNA or a competitor, and all of those treatments would have been paid by Medicare regardless. WebView the profiles of people named Martin Flanagan. (g), I respectfully disagree with that interpretation. Care Holdings, Inc., 906 F.Supp.2d 1264, 1274 (N.D.Ga. Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. Relator responds that (1) the complaints do not allege the same essential facts and (2) the CKD complaint was later dismissed on jurisdictional grounds, which makes the first-to-file bar inapplicable. Relator did comply with that requirement before filing his original complaint, which was 22 pages long and described an illegal scheme with two essential components. . (Id. WebDr. The statute has a variety of strict requirements, however, that serve both to ensure that the government has a fair opportunity to control the litigation and to screen out claims that are incomplete, redundant, or parasitic. As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. Martin Flanagan is a Senior National Account Manager at Quick International Courier based in Jamaica, New York. However, the First Circuit has rejected the holding in Poteet, explaining that earlier-filed complaints must provide only the essential facts to give the government sufficient notice to initiate an investigation into allegedly fraudulent practices and emphasizing that Section 3730(b)(5) contains no exceptions. United States ex rel. If the government declines to intervene and the qui tam case is unsealed, further proceedings are governed by 31 U.S.C. The Crusader Takes a Closer Look: The Dialysis Hustle Part 2 (McDonagh, Christina). Here, the complaint describes in general terms how claims are submitted to Medicare and Medicaid; it describes the various ways in which FMCNA allegedly paid kickbacks for referrals; and as to each such aspect of the scheme, it alleges that every claim or all claims were fraudulent. Stevens v. Vermont Agency of Nat. Ex. (Id. (Id. To register for a PACER account, go the Pacer website at # https://pacer.uscourts.gov/register-account.Pro Hac Vice Admission Request Instructions # https://www.mad.uscourts.gov/caseinfo/nextgen-pro-hac-vice.htm.A Notice of Appearance must be entered on the docket by the newly admitted attorney. v. Fresenius Medical Care [$6,000,000.00] Gonzales et al. As to joint-venture agreements, the complaint again alleges in general terms that all claims submitted by facilities with joint-venture partners are false claims. MEMORANDUM AND ORDER: This case was erroneously assigned to my docket as a result of a failure by docketing personnel in the Clerks Office to recognize that it is not related to the MDL proceeding assigned to me. 172, 206-13). Plaintiff-Relator Martin Flanagan (Relator) worked for Fresenius for twenty-nine years, most recently as Director of Acute Market Development for the
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