Barnes v. HealthNow New York, Inc.

District Court, W.D. New York·Decided August 14, 2024·No. 1:16-cv-00088·Unknown

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NEW YORK

MADELYN B. BARNES By and on Behalf of the United States of America, and By and on Behalf of the State of New York, Relator, -V- 16-CV-88-JLS-HKS HEALTHNOW NEW YORK INC., D/B/A BLUECROSS BLUESHIELD OF WESTERN NEW YORK, AND D/B/A BLUESHIELD OF NORTHEASTERN NEW YORK, NOW KNOWN AS HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC., Defendant.

DECISION AND ORDER This case was referred to the undersigned by the Hon. John L. Sinatra, in accordance with 28 U.S.C. § 636(b), for all pretrial matters and to hear and report upon dispositive motions. Dkt. #75.

Relator Madelyn B. Barnes (“Barnes” or “Relator’) is the relator in this qui tam action on behalf of the United States of America and New York State under the False Claims Act, 31 U.S.C. § 3729 et seq. (“FCA”), and the New York State False Claims Act, N.Y. State Fin. Law § 187 et seq. (“NYSFCA”). Dkt. #94. Barnes alleges that defendant HealthNow New York Inc., d/b/a BlueCross BlueShield of Western New York, and d/b/a BlueShield of Northeastern New York, now known as Highmark Western and Northeastern New York Inc. (“HealthNow’) improperly overpaid healthcare claims at the

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expense of the United States, New York State, and “local governments/municipalities” by submitting false statements to these entities. Id.

Currently before this Court are the parties’ motions to compel. Dkt. ##127,

133, 138.

BACKGROUND The factual background of this matter was set forth in a prior Report, Recommendation and Order, Dkt. #113, and a Decision and Order, Dkt. #123, and it is incorporated here. A brief review of the case’s procedural history, however, will be helpful.

Plaintiff filed this case on March 2, 2016, but the United States did not elect to decline intervention until July 10, 2019. Dkt. #27. Following amendments to the complaint, initial motion practice, and mediation, the Court entered a case management order on March 25, 2021. Dkt. #79.

On May 25, 2021—prior to the completion of discovery—HealthNow filed a motion for summary judgment. Dkt. #86. On October 28, 2021, the Court stayed the case pending resolution of that motion. Dkt. #107.

On March 21, 2023, the undersigned issued a Report, Recommendation, and Order addressing HealthNow’s motion for summary judgment. Dkt. #113. On July 26, 2023, the Court issued a Decision and Order granting in part and denying in part the motion for summary judgment. Dkt. #123. This decision allowed Relator’s claims under the federal False Claims Act and New York False Claims Act—except those based on damages to local government entities—to proceed. Dkt. #123, pp. 4-5.

As to the claims concerning local governments, the Court adopted the undersigned’s recommendation that the claims failed because those entities—who were the real parties in interest under the relevant statutes—had not been made parties to the action. Dkt. #113, p. 20; Dkt. #123, p. 4. Nonetheless, the Court noted that Relator “is still free to seek leave to add any local government entities revealed through discovery at a later date, subject to the relevant standard for adding parties after the deadline.” Dkt. #113, p. 20.

The Court then set a status conference for August 9, 2023. Dkt. #124. Following that conference, the Court entered an Amended Scheduling Order setting new

discovery and dispositive motion deadlines, including a new discovery deadline of March 22, 2024. Dkt. #126. That deadline and all other pre-trial deadlines—other than that for dispositive motions—have now passed.

On September 21, 2023, HealthNow filed a motion to compel, Dkt. #127, and on February 27, 2024, Relator filed a motion to compel. Dkt. #133. On March 18, 2024, the Court again stayed discovery. Dkt. #136. Finally, HealthNow filed another motion to compel on April 5, 2024. Dkt. #138. These three motions to compel are now ripe for resolution.

DISCUSSION AND ANALYSIS Legal Standards

Pursuant to Fed. R. Civ. P. 26, parties “may obtain discovery regarding any nonprivileged matter that is relevant to any party’s claim or defense and proportional to the needs of the case.” Fed. R. Civ. P. 26(b)(1).

“Information is relevant if: (a) it has any tendency to make a fact more or less probable than it would be without the evidence; and (b) the fact is of consequence in determining the action.” Duhaney v. TransUnion, LLC, 23-CV-04066 (NJC) (JMW), 2024 WL 85074, at *1 (E.D.N.Y. Jan. 8, 2024) (citation and internal quotation marks omitted). Relevance, “for purposes of discovery, is an extremely broad concept.” Carlyle Aviation Mgmt. Ltd. v. Frontier Airlines, Inc., 23 Civ. 4774 (PAE), 2023 WL 8472725, at *1

(S.D.N.Y. Dec. 7, 2023) (citation and internal quotation marks omitted).

“Once any possibility of relevance sufficient to warrant discovery is shown, the burden shifts to the party opposing discovery to show the discovery is improper.” Rhodes v. Phoenix Arms, 1:20-CV-267 (GTS/CFH), 2022 WL 2079088, at *2 (June 9, 2022) (citation and internal quotation marks omitted). “Generally, discovery is only limited when sought in bad faith, to harass or oppress the party subject to it, [or] when it is irrelevant or privileged.” Id. Defendant’s Motion to Compel Initial Disclosures Rule 26 of the Federal Rules of Civil Procedure requires that a party must provide in its initial disclosures “a computation of each category of damages claimed by the disclosing party” and must “make available for inspection and copying as under Rule

34 the documents or other evidentiary material . . . on which each computation is based.” Fed. R. Civ. P. 26(a)(1)(iii).

This rule further states: A party must make its initial disclosures based on the information then reasonably available to it. A party is not excused from making its disclosures because it has not fully investigated the case or because it challenges the sufficiency of another party’s disclosures or because another party has not made its disclosures.

Fed. R. Civ. P. 26(a)(1)(E).

“As a leading treatise explains, ‘[a] party claiming damages must, of course, have some evidence that an injury occurred and some basis for calculating the damages the party suffered as the result of that injury before filing suit.’” Fed. Trade Comm’n v. Chase Nissan, LLC, Civil No. 3:24-cv-00012 (JCH), 2024 WL 3566205, at *9 (D. Conn. July 29, 2024) (quoting 6 James Wm. Moore et al., Moore’s Federal Practice § 26.22[4][c] (3d ed. 2023)). “The party making such a claim, therefore, has the obligation, when it makes its initial disclosures, to disclose to the other part[y] the best information then available to it concerning that claim, however limited and potentially challenging it may be.” Id. “Of course, the party is entitled to amend or supplement its calculation and supporting document production as it learns more in discovery.” Id. (citation and internal quotation marks omitted). “But it cannot avoid its initial disclosure obligation by claiming

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