Justia U.S. 11th Circuit Court of Appeals Opinion SummariesArticles Posted in Government Contracts
United States v. Aseracare, Inc.
After three former AseraCare employees alleged that AseraCare had a practice of knowingly submitting unsubstantiated Medicare claims in violation of the False Claims Act, the Government intervened and filed the operative complaint. The Eleventh Circuit held that a clinical judgment of terminal illness warranting hospice benefits under Medicare cannot be deemed false, for purposes of the False Claims Act, when there is only a reasonable disagreement between medical experts as to the accuracy of that conclusion, with no other evidence to prove the falsity of the assessment. However, the court held that the Government should have been allowed to rely on the entire record, not just the trial record, in making its case that disputed issues of fact, beyond just the difference of opinion between experts, existed sufficient to warrant denial of the district court’s post-verdict sua sponte reconsideration of summary judgment on the falsity question. Accordingly, the court affirmed in part and remanded in part. View "United States v. Aseracare, Inc." on Justia Law
Carrel v. AIDS Healthcare Foundation, Inc.
Former employees of the Foundation filed suit under the False Claims Act, alleging that the incentives offered to employees and patients were unlawful kickbacks that rendered false any claims for federal reimbursement. The district court dismissed all but two claims, and later granted summary judgment on the remaining claims. The Eleventh Circuit affirmed and held that the employee exemption to the Anti-Kickback Statute applied to payments that the Foundation made to an employee tasked with referring HIV-positive patients to healthcare services offered by the Foundation. The court also held that the district court correctly dismissed relators' other claims for lack of particularity and that relators waived their argument about amendment. View "Carrel v. AIDS Healthcare Foundation, Inc." on Justia Law
United States v. Cochise Consultancy, Inc.
Relator filed a qui tam action alleging that his employer violated the False Claims Act (FCA), 31 U.S.C. 3729-33, by submitting to the United States false or fraudulent claims for payment. The Eleventh Circuit held, as a matter of first impression, that section 3731(b)(2)'s three year limitations period applies to an FCA claim brought by a relator even when the United States declines to intervene. Because the FCA provides that this period begins to run when the relevant federal government official learns of the facts giving rise to the claim, when the relator learned of the fraud is immaterial for statute of limitations purposes. In this case, it was not apparent from the face of the complaint that relator's claim was untimely where his allegations showed that he filed suit within three years of the date when he disclosed facts material to the right of action to United States officials and within ten years of when the fraud occurred. Therefore, the district court erred in dismissing the complaint, and the court reversed and remanded. View "United States v. Cochise Consultancy, Inc." on Justia Law
Marstettler v. Tilton
Relators filed suit under the False Claims Act (FCA), 31 U.S.C. 3729-30, alleging that MD and others misled the Government by providing material false or incomplete information at two points in the transactional relationship, as well as improprieties between the remaining defendants. The Eleventh Circuit held that the district court must revisit whether the relators alleged facts sufficient to support a theory of implied certification as articulated in Universal Health Services, Inc. v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016). The court also held that the complaint did plead fraud in the inducement, and thus the court remanded so that the district court could reexamine the allegations relating to that theory. View "Marstettler v. Tilton" on Justia Law
Phalp v. Lincare, Inc.
Relators filed a qui tam action under the False Claims Act (FCA), 31 U.S.C. 3729-3733, alleging that defendants submitted claims to Medicare without adequate authorization from the relevant Medicare beneficiaries and claims that were the product of unsolicited telemarketing calls to Medicare beneficiaries. The Eleventh Circuit affirmed the district court's grant of summary judgment to defendants with one modification. The court explained that, although the district court applied an erroneous scienter standard, the evidence proffered by relators as to defendants' state of mind with respect to the assignment of benefits forms was insufficient to survive summary judgment under the proper standard. The district court did not err in granting summary judgment as to relators' claims that defendants violated Medicare's unsolicited telephone contact rules. View "Phalp v. Lincare, Inc." on Justia Law
United States v. Everglades College
Relators filed a qui tam suit against Keiser University under the False Claims Act (FCA), 31 U.S.C. 3729-3733, alleging that the University falsely certified compliance with a federal law banning incentive payments to university admissions counselors. After relators appealed a limited trial victory, the United States stepped in and settled the case with Keiser, securing a larger monetary recovery than relators did at trial. On appeal, relators challenged the district court's ruling as to the United States and the district court's subsequent award of reduced attorneys' fees and costs. The Eleventh Circuit affirmed the judgment, holding that the United States did not need to satisfy the good-cause intervention requirement for qui tam actions under 31 U.S.C. 3730(c)(3) because that subsection applies only when the government intervenes for the purpose of actually proceeding with the litigation—not when it is stepping in only for the purpose of settling and ending the case; the proposed settlement was fair, adequate, and reasonable; the district court did not err in declining to compel discovery in this case; and the district court did not abuse its discretion in awarding fees and costs. View "United States v. Everglades College" on Justia Law
United States ex. rel. Saldivar v. Fresenius Medical Care Holdings, Inc.
Relator filed a qui tam action under the False Claims Act (FCA), 31 U.S.C. 3729-3733, claiming that Fresenius violated the FCA by billing the government for overfill that it received for no cost—allegedly a violation of the statutes governing Centers for Medicare and Medicaid Services (CMS) billing. The district court granted Fresenius's motion for summary judgment. Because the allegations that are the basis of this complaint were publicly disclosed and relator is not an original source, the court lacks jurisdiction to hear this case. The court did not reach the merits of the motion for summary judgment. Accordingly, the court reversed the district court's grant of summary judgment on the merits and remanded for entry of an order dismissing the case for lack of subject matter jurisdiction. View "United States ex. rel. Saldivar v. Fresenius Medical Care Holdings, Inc." on Justia Law
Osheroff v. Humana Inc.
Relator filed a qui tam action under the False Claims Act (FCA), 31 U.S.C. 3729-3733, alleging that healthcare clinics provided, and the Humana defendants either knew of or promoted, a variety of free services for patients and health plan members. Relator alleged that the clinics offered such services without regard for medical purpose or financial need and that the value of the services is more than nominal. The court affirmed the district court's dismissal of the amended complaint with prejudice where, under the prior or amended version of section 3730 of the FCA, relator cannot overcome the public disclosure bar. View "Osheroff v. Humana Inc." on Justia Law
Agility Defense & Gov’t Svcs, et al. v. U.S. Dept. of Defense, et al.
The Federal Acquisition Regulation, 48 C.F.R. 9.407-4(b), governs the acquisition of supplies and services by all federal agencies. At issue was whether a federal agency may suspend two affiliates of an indicted government contractor for the duration of the legal proceedings against the indicted contractor under the Regulation. Because the suspension of an affiliate was included as part of the suspension of the indicted government contractor, the court concluded that legal proceedings initiated against the indicted government contractor tolled the 18-month time limit for the suspension of the affiliates. Accordingly, the court reversed the grant of summary judgment in favor of the affiliates and rendered a judgment in favor of defendants. View "Agility Defense & Gov't Svcs, et al. v. U.S. Dept. of Defense, et al." on Justia Law
Odebrecht Construction, Inc. v. Secretary, FL DOT
In this interlocutory appeal, the Secretary appealed the district court's order granting Odebrecht a preliminary injunction barring the Department's enforcement of a Florida law known as the Cuba Amendment, 2012 Fla. Laws 196, section 2. The Amendment prevented any company that did business in Cuba - or that was in any way related to a company that did business in Cuba - from bidding on state or local public contracts in the State of Florida. The court concluded that Odebrecht has demonstrated a substantial likelihood of success on its claim that the Cuba Amendment violated the Supremacy Clause of the Constitution under principles of conflict preemption; Odebrecht would have suffered irreparable harm absent the injunction; the balance of harms strongly favored the injunction; and the injunction did not disserve the public interest. Accordingly, the court affirmed the judgment. View "Odebrecht Construction, Inc. v. Secretary, FL DOT" on Justia Law
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