A former employee filed an amended whistleblower complaint against Fresenius Medical Care North America, alleging the dialysis company had unlawful The amended complaint describes-in considerable detail-a multi-part scheme to compensate caregivers in return for referrals. The second issue is whether the public-disclosure bar of the statute precludes all or any of the claims-that is, whether relator is filing suit concerning matters that had been previously disclosed to the public. at 253. . Dismissal is appropriate if the complaint fails to set forth factual allegations, either direct or inferential, respecting each material element necessary to sustain recovery under some actionable legal theory. Gagliardi v. Sullivan, 513 F.3d 301, 305 (1st Cir. At most, the filings describe a set of circumstances that might be vulnerable to manipulation. 90). Previously, Martin was a Senior Na tional Account Manager at QuickSTAT. . Flanagan v. Fresenius Medical Care Holdings, Inc. - Law360 . 15). 4:05-cv-985 (E.D. In 2014, a qui tam action was filed in the Eastern District of New York alleging that on FMCNA acquired controlling interests in dialysis clinics and paid physician owners above market value for their clinics and that this excess constituted payment to induce the doctors to refer patients back to these clinics. U.S. ex rel. v. Fresenius Medical Care [$6,000,000.00] Gonzales et al. Previo usly, Submission of claims to Medicaid that were ineligible for payment because of violation of the AKS are actionable under the FCA because the payments of those claims were made with federal funds. Co., 827 F.3d 5, 13 (1st Cir. Search Google Scholar for this author 176). Third, defendant contends that relevant public disclosures occurred in multiple SEC filings by FMCNA. Parties for Flanagan v. Fresenius Medical Care Holdings, Inc., 119 (2010). (McManus, Caetlin) (Entered: 11/22/2021), Docket(#14) MOTION for Leave to Appear Pro Hac Vice for admission of Jamie Bennett Filing fee: $ 100, receipt number AMADC-9065597 by Martin Flanagan. FMCNA is headquartered in Waltham, Massachusetts. The first question, for the purpose of applying the first-to-file bar, is whether the first-filed complaint contained all the essential facts of the fraud later alleged. United States v. Millenium Lab'ys, Inc., 923 F.3d 240, 252 (1st Cir. Michael D. Flanagan, MD | Main Line Health Make your practice more effective and efficient with Casetexts legal research suite. (Finn, Mary) (Entered: 10/05/2021). Instead, it alleges that FMCNA paid kickbacks for referrals on a widespread basis, and that therefore all claims for payment that it submitted to the government were false. 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 Court takes judicial notice of the proffered SEC filings as undisputed documents provided by the parties in connection with a Rule 12(b)(6) motion based on the public-disclosure bar. It employs more than 40,000 employees and treats nearly 190,000 patients at approximately 2,400 outpatient clinics in the United States, including 39 in Massachusetts. To strike a balance between encouraging whistle-blowing and discouraging opportunistic behavior, the FCA contains a public-disclosure bar. Id. Family Medicine Call for an (Id.). joins whistleblower suit vs. Fresenius 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 . Under the circumstances, the Court concludes that it does not. Flanagan v. Fresenius Medical Care Holdings, Inc., No. 18). (Id. At most, relator merely adds detail or color to previously disclosed elements of an alleged scheme [which] is not materially adding to the public disclosures. United States ex rel. any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program shall be guilty of a felony. Lutz v. United States, 853 F.3d 131, 135 (4th Cir. 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. 3730(c)(3). Previously, Martin was a Direct or, Acute Maket Development There is no contention that any dialysis services performed were medically unnecessary or excessive, or that those services were performed in a substandard manner. Access this case on the Massachusetts District Court's Electronic Court Filings (ECF) System. 2013). 172, 206-13). Read More . 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. 40. 154). It alleges that Flanagan and colleagues were directed by their superiors to pursue contracts even when they resulted in losses. US$20.14. The first-to-file bar provides that [w]hen a person brings an action . 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. United States v. Takeda Pharm. (Id. Care Holdings, Inc., 906 F.Supp.2d 1264, 1274 (N.D.Ga. 361 (Dallas Nephrology Associates)). (Id.). Employed by Penn State Health. There must be particularized allegations of claims for payment arising from that scheme. 9(b). 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. 2009) (Duxbury I). WebMichael D. Flanagan, MD, specializes in Obstetrics / Gynecology and Maternity Care, Geriatrics and sees patients in Bryn Mawr. 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. they [therefore] violated the FCA's filing and service requirements. Wilson, 750 F.3d at 120. . 3730(e)(4)(A). . Private persons, known as relators, can file civil qui tam actions on behalf of the United States against persons or entities who violate the act. Martin Flanagan United States v. Cyberonics, Inc., 844 F.3d 26, 31 (1st Cir. Flanagan v. Fresenius Medical Care Holdings, Inc. :: Justia Dockets & Filings Notice of appeal (doc. For example, in United States ex rel. US$184.67 US$190.00. Martin Flanagan is a journalist and author who writes on sport, Australian culture and the relationship between indigenous and non-indigenous Australia. Add to The question here is whether the complaint has met that standard. #57) filed by Appellant Martin Flanagan. Because the complaint does not state allegations of fraud under the FCA with the particularity required by Rule 9(b), the conspiracy claim under the FCA must fail as well. 01 Oct 2018. 332). 23). 29 at 10); (2) compensation is negotiated individually [based on] local factors . We believe that the compensation of our medical directors is in line with the market (Id. In many states, Medicaid pays for treatment costs for ESRD patients who do not qualify for Medicare and/or pays for the 20% of treatment costs not covered by Medicare. (Id.). It includes a blank example of such a form as Exhibit A. It also provides a very limited amount of statistical evidence to attempt to bolster those allegations. (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. In 2010, Congress amended the AKS to clarify that any Medicare claim that includes items or services resulting from a violation of [the AKS] constitutes a false or fraudulent claim for the purposes of [the FCA]. 42 U.S.C. (McDonagh, Christina). #57) filed by Appellant Martin Flanagan. Relator here has not attempted to do so. The original complaint referred to joint-venture agreements between FMCNA and physicians, but only in order to contrast such agreements (which it referred to as a product of arms-length negotiations) with the higher compensation paid to medical directors in the absence of such agreements. Scott Downing at 312.624.6326 or sdowning@beneschlaw.com, Mark Silberman at 312.212.4952 or msilberman@beneschlaw.com, Juan Morado Jr. at 312.212.4967 or jmorado@beneschlaw.com, Whistleblower Lawsuit Against Fresenius Alleges Unlawful Arrangements with Hospitals and Nephrologists Intended to Induce Dialysis Referrals. (Id. for money or property presented to an officer, employee, or agent of the United States. The complaint alleges various methods by which FMCNA improperly induced the referral of patients to its dialysis clinics. Accordingly, [f]ailure to comply with these mandatory threshold requirements warrants dismissal of the qui tam complaint with prejudice. United States ex rel. (Id. . It further alleges that defendant is required to submit on an annual basis a Form 265 cost report to Medicare that certifies, among other things, that the services identified in the report (that is, the dialysis services) were provided in compliance with federal law, including the Anti-Kickback Statute. 1999)). Vascular Access Care - Fresenius Medical Care According to ZoomInfo records, Sandra Martins professional experience began in 1986. 40. 93). b. The allegations in CKD described a scheme whereby FMCNA allegedly paid kickbacks to doctors with whom it had entered into joint-venture agreements. . Fresenius fired lawyer for reporting embezzlement, misconduct 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. 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.). 9(b). L. No. Martin Flanagan hasnt hidden himself from view in The Short Long Book but he says he wouldnt trust any journalist who did. Previo Read More Export Get Full Access to Martin's Info Last Update 12/13/2021 10:41 PM Email @fmcna.com HQ Phone (781) 699-9000 Company Fresenius Medical Care North CEO Martin Flanagan still sees a growth opportunity in Chinaand a big risk in Bitcoin. v. Balfour Beatty Infrastructure, Inc., 2014 WL 2611312, at *2 (N.D. Cal. Add to basket. Ex. Chief Judge F. Dennis Saylor, IV assigned to case. Wilson v. Bristol-Myers Squibb, Inc., 2011 WL 2462469, at *6-7 (D. Mass. To survive a motion to dismiss, a complaint alleging fraud must state with particularity the circumstances constituting fraud. Fed.R.Civ.P. (Danieli, Chris) (Entered: 11/02/2021), Docket(#8) Judge Douglas P. Woodlock: ELECTRONIC ORDER FOR TRANSFER entered. 3/17/2023 8:35 PM. Martin On a motion to dismiss, the court must assume the truth of all well-plead[ed] facts and give . The public-disclosure bar seeks to prevent parasitic qui tam actions in which relators, rather than bringing to light independently discovered information of fraud, simply feed off of previous disclosures of public fraud. United States ex rel. . . Evidence of an actual false claim is the sine qua non of a False Claims Act violation. Karvelas, 360 F.3d at 225. Among other things, the complaint uses the passive voice throughout: claims were submitted, rather than FMCNA submitted claims.. Compl. United States ex rel. 22). The Marvel Studios Phenomenon. 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. As is often the case with qui tam actions, the issue is not whether the complaint alleges an unlawful scheme-it does, in considerable detail-but whether it actually pleads a violation of the False Claims Act. WebBrigid M. Flanagan, RN, MS, Sean Philpott, PhD, MS, and Martin A. Strosberg, MA, MPH, PhD. (Attachments: #1 Affidavit Certificate of Jamie Bennett in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#13) MOTION for Leave to Appear Pro Hac Vice for admission of W Scott Simmer Filing fee: $ 100, receipt number AMADC-9065559 by Martin Flanagan. 84). 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. As noted, there are no allegations at all concerning the payments of claims under the CHAMPUS/TRICARE or CHAMPVA programs. 35). 44). Id. 256-69 (IMN and other practices in Indiana); id. 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. Martin Flanagan is a resident of Texas. 97-106). L. No. The complaint further alleges that FMCNA provided free or below-cost services to physicians to secure referrals. In affirming that decision, the First Circuit stated that the new paragraphs in the [p]roposed [complaint] were attributable to the new relator and . free or discounted physician practice alignment services, including providing dedicated chronic kidney disease educator services, financial coordination services for patients beginning dialysis, vascular access development services and assistance with physician recruiting through Fresenius online recruiting platform. Complicating matters further is the nature of the alleged false claims. Conrad v. Abbott Lab'ys, Inc., No. 25) and five paragraphs addressing how the scheme resulted in false claims (Id. (Id. The complaint alleges that FMCNA violated the Anti-Kickback Statute (AKS) and caused the submission of false claims for payment to Medicare, Medicaid, and other government health-care payors. As set forth above, the complaint alleges that FMCNA provided dialysis services to hospitals at prices well below cost in order to capture referrals of discharged patients to its dialysis clinics. Res., 162 F.3d 195, 200 (2d Cir. He is also a trustee and vice-Chair of the Inv Martin Flanagan's Phone Number and Email Last Update 4/3/2023 2:19 PM Contact Number (***) ***-**** Engage via Phone Mobile Number (***) ***-**** Engage via Mobile Test Drive Martin Flanagan and United States of America: Defendant: FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North 42 U.S.C. 3730(e)(4)(B) (2006). martin flanagan fresenius Save US$2.12. Poteet v. Medtronic, Inc., 552 F.3d 503, 516-17 (6th Cir. Where the defendant allegedly caused a third party to submit a false claim to the government, rather than submitting the false claim itself, a more flexible standard applies, under which Rule 9(b) is satisfied by providing factual or statistical evidence to strengthen the inference of fraud beyond possibility without necessarily providing details as to each false claim submitted. U.S. ex rel. 28). 02 Jun 2016. Third, it alleges that FMCNA provided physicians free or below-cost practice-management services. 14). If the trial Judge issues an Order of Reference of any matter in this case to a Magistrate Judge, the matter will be transmitted to Magistrate Judge Judith G. Dein. 13). Compl. 111-148, 10104(j)(2), 124 Stat. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. The qui tam action at issue was United States ex rel. The complaint goes on to identify four specific sets of joint-venture arrangements (Balboa, NANI, ENA, and Dallas Nephrology Associates) and again alleges that all claims submitted in connection with patients treated by those physicians or facilities were tainted by kickbacks and therefore false. The portions of the claims based on those allegations will therefore be dismissed for failing to comply with the FCA's pre-suit requirements. The 2005 complaint alleged improper conduct dating from a decade before the conduct alleged here. A medical director's productivity was tracked, and contracts with medical directors who generated a large number of patients were renewed. Second, defendant contends that a complaint alleging medical-director fraud filed in Missouri in 2005 against two different companies-both of which were later acquired by FMCNA-qualified as a public disclosure barring the current allegations. (Attachments: #1 Affidavit Certificate of W. Scott Simmer in Support of Motion for Admission Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), Docket(#12) NOTICE of Appearance by Christopher P. Sullivan on behalf of Martin Flanagan (Sullivan, Christopher) (Entered: 11/18/2021), Docket(#11) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #6 Motion for Leave to Appear Pro Hac Vice Added James F. Bennett. Accordingly, the claims concerning joint-venture agreements are barred by the first-to-file rule. Our Leadership Team - Fresenius Medical Care 3730(b)(2), (b)(4), (c)(1). Duxbury v. Ortho Biotech Prods., L.P., 719 F.3d 31, 33 (1st Cir. Martin Flanagan 25). Martin Flanagan Here, despite its length, the amended complaint does not describe a single particular false claim. (McManus, Caetlin) (Entered: 11/22/2021), (#14) MOTION for Leave to Appear Pro Hac Vice for admission of Jamie Bennett Filing fee: $ 100, receipt number AMADC-9065597 by Martin Flanagan. While it is true that it did not use the term medical director agreements, its allegations concerning improper remuneration to physicians in the form of compensation above fair-market value and favorable leases are nonetheless substantially similar to those in the amended complaint. The Crusader Takes a Closer Look: The Dialysis Hustle Part 2 Flanagan v. Fresenius Medical Care Holdings, Inc. Martin Flanagan is a Senior National Account Manager at Quick International Courier based in Jamaica, New York. Defendant also contends that the claims concerning joint-venture agreements are barred by the first-to-file rule. The objective of the essential facts test is to determine whether the statutorily required threshold for notifying the government of the fraud alleged in the later-filed suit has been met. (Id. Protecting Participants of Clinical Trials Conducted in the 38). . The CKD complaint therefore contained the essential facts alleged here, thus barring the allegations contained in the amended complaint. Martin Flanagan - Flower Mound, Texas, United States He was employed by Fresenius for 29 years. Gonzales et al. 3730(b)(5); (4) the complaint has not pleaded fraud with particularity as required by Rule 9(b); and (5) the complaint fails to state a claim for FCA conspiracy. 3729(a)(1)(B) (Count 2); and conspiring to present false claims and making or using false records material to a false or fraudulent claim in violation of the False Claims Act, 31 U.S.C. Mo. 3729(a)(1)(C) (Count 3). Martin Flanagan. (Id. The complaint provides a detailed account of Fresenius acute care dialysis management business and alleges that it systematically used acute care dialysis management contracts with hospitals as loss leaders to secure patient referrals for Fresenius outpatient dialysis centers in violation of the FCA and AKS. 2009). 308-20). (Id. Medicare is a federally-funded health-insurance program that primarily provides benefits to the elderly, but also provides coverage to patients with ESRD, regardless of age. First, the complaint alleges in general terms that all claims for reimbursement made to Medicare require the submission of a Form UB-40 (or a substantially similar form) that contains various data, including the patient's identifying information and line items for each claim sought to be reimbursed. (Am. And, presumably, it has other weapons in its arsenal for dealing with fraudulent conduct. Defendant correctly contends that the initial complaint did not contain any allegations concerning unlawful joint-venture agreements, or the provision of free services to hospitals, physicians, and patients. If the government declines to intervene and the qui tam case is unsealed, further proceedings are governed by 31 U.S.C. Compl. Under the circumstances, the Court concludes that the bar does not apply. Id. were false .); id. 2013) (Duxbury II) (internal quotation marks and citations omitted). (Am. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. 3730(e)(4)(B). Stevens v. Vermont Agency of Nat. 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. Notice of appeal (doc. Public Records Policy. at *3 (collecting cases). 181). occurred in the manner which is specified in the FCA; and (3) the relator's suit [is] based upon' those publicly disclosed allegations or transactions. U.S. ex rel.
