City of Warren Police and Fire Retirement System, and Janice Stewart v. Tenet Healthcare Corporation

Court of Appeals of Texas·Decided September 28, 2020·No. 05-19-00260-CV·Published

Opinion

AFFIRMED; Opinion Filed September 28, 2020

In The

Court of Appeals

Fifth District of Texas at Dallas No. 05-19-00260-CV

CITY OF WARREN POLICE AND FIRE RETIREMENT SYSTEM AND JANICE STEWART, Appellants V.

TENET HEALTHCARE CORPORATION, JAMES A. UNRUH, RONALD A. RITTENMEYER, BRENDA J. GAINES, KAREN M. GARRISON, RICHARD R. PETTINGILL, J. ROBERT KERREY, EDWARD A.

KANGAS, FREDA C. LEWIS-HALL, TAMMY ROMO, MATTHEW J.

RIPPERGER, RANDOLPH C. SIMPSON, TREVOR FETTER, DANIEL CANCELMI, R. SCOTT RAMSEY, J. MCDONALD WILLIAMS, JOHN ELLIS BUSH, AND BIGGS C. PORTER, Appellees

On Appeal from the 14th Judicial District Court Dallas County, Texas

Trial Court Cause No. DC-16-15118

MEMORANDUM OPINION

Before Justices Molberg, Carlyle, and Browning1 Opinion by Justice Carlyle

In this shareholder derivative action, appellants—two Tenet Healthcare Corporation shareholders—asserted claims for breach of fiduciary duty, corporate

1 The Honorable David L. Bridges, Justice, participated in the submission of this appeal; however, he did not participate in the issuance of this opinion due to his death on July 25, 2020. Justice Browning has substituted for Justice Bridges and has reviewed the record and the briefs in this cause.

waste, unjust enrichment, and gross mismanagement against appellees, who are current and former Tenet directors and officers.2 Appellees filed special exceptions based on appellants’ alleged failure to adequately plead that a pre-suit litigation demand on Tenet’s board of directors was excused as futile. The trial court granted appellees’ special exceptions and, after appellants declined to replead, dismissed the action with prejudice.

In two issues on appeal, appellants contend they sufficiently pleaded demand futility and the trial court erred by granting appellees’ special exceptions and dismissing the petition. We affirm in this memorandum opinion. See TEX. R. APP. P. 47.4.

Background

Tenet, a Nevada corporation, operates hospitals and outpatient centers throughout the United States. At the time of the complained-of events, Tenet operated about 77 hospitals and 183 outpatient centers nationwide. Its board of directors (the Board) consisted of fourteen members elected annually by its shareholders.

According to appellants’ February 2017 live petition, (1) in June 2006, Tenet “entered into a $900 million settlement with the United States to resolve the Company’s False Claims Act liability for engaging in alleged unlawful Medicare

2 Nominal defendant Tenet Healthcare Corporation is also an appellee.

billing practices”; (2) as part of the 2006 settlement, Tenet “agreed to a Corporate Integrity Agreement (‘CIA’) with the Department of Health and Human Services’ Office of the Inspector General to ensure that all Tenet facilities complied with Medicare and Medicaid program requirements,” including the “federal False Claims Act and Anti-Kickback Statute”; and (3) the CIA required, among other things, that “Tenet strengthen its policies, procedures and controls for contracts with referral sources to ensure compliance with the Anti-Kickback Statute.”

Appellants further alleged that from 2000 “until at least 2013,” four Tenet hospitals in Georgia and South Carolina “systematically paid healthcare kickbacks and bribes to Hispanic Medical Management d/b/a Clinica de la Mama (‘Clinica’) in return for Clinica’s agreement to send patients, mostly undocumented Hispanic women, to Tenet facilities for medical services related to labor and delivery that were paid for by the Medicaid and Medicare programs.” The petition stated that “although undocumented pregnant women are not eligible for regular Medicaid coverage,” Tenet benefitted from those referrals because undocumented patients “can qualify for emergency medical assistance when they deliver their babies” and Tenet hospitals “included the Medicaid-ineligible women when seeking additional Medicaid funds intended to support hospitals that treat a large number of low-income patients.” According to the petition, Tenet “unlawfully obtained more than $145 million in Medicaid and Medicare program funds as a result of [that] patient referral scheme” and, on October 3, 2016, (1) “was forced to pay $513 million to resolve its

federal False Claims Act and Anti-Kickback Statute liability for defrauding the United States and paying bribes to Clinica in exchange for patient referrals” and (2) “entered into an onerous Non-Prosecution Agreement (‘NPA’)” with the U.S. Department of Justice and the U.S. Attorney’s Office for the Northern District of Georgia.3 The petition contended that “[a]s Tenet’s directors and top officers,”4 appellees owed Tenet and its shareholders “a fiduciary duty of loyalty to direct the operations of the Company and its subsidiaries and hospitals in conformity with the laws applicable to its business,” but “breached their fiduciary duties of legal compliance and candor by acting disloyally towards Tenet.” Specifically, “[w]hile under [appellees’] stewardship, Tenet adopted billing and contract review policies, procedures and controls, and/or deployed such policies, procedures and controls, such that multiple Tenet hospitals regularly paid kickbacks to prenatal care clinic

3 Appellants’ petition quoted portions of the NPA’s “Statement of Facts” in support of the petition’s factual allegations.

4 According to the petition, Mr. Unruh “has been a director of Tenet since 2004”; Mr. Rittenmeyer “has been a director of Tenet since 2010”; Ms. Gaines “has been a director of Tenet since March 2005”; Ms. Garrison “has been a director of Tenet since March 2005”; Mr. Pettingill “has been a director of Tenet since March 2004”; Mr. Kerrey “served as a director of Tenet since November 2012 (he previously served as a director from March 2001 to March 2012 as well)”; Mr. Kangas “has been a director of Tenet since April 2003”; Ms. Lewis-Hall “has been a director of Tenet since December 2014”; Ms. Romo “has been a director of Tenet since March 2015”; Mr. Ripperger “has been a director of Tenet since January 2016”; Mr. Simpson “has been a director of Tenet since January 2016”; Mr. Fetter “has been Tenet’s CEO since September 2003” and “has been a director of Tenet since 2003”; Mr. Cancelmi “has been Tenet’s CFO since September 2012”; Mr. Ramsey “has been Tenet’s CAO, Vice President and Controller since September 2012”; Mr. Williams “served as a director of Tenet from March 2005 to May 2010”; Mr. Bush “served as a director of Tenet from April 2007 to December 2014”; and Mr. Porter “served as Tenet’s CFO from June 2006 to March 2012.” The petition also described the required duties of the Board’s Audit Committee and Compliance Committee and alleged that seven of the defendants had served on at least one of those two committees during the relevant time period.

operators in exchange for patient referrals with impunity” and “issued materially false and misleading” financial reports that (1) “misrepresented that Tenet had effective internal controls for legal compliance when, in fact, it did not,” and (2) failed to disclose that Tenet had “obtained millions of dollars in revenues by defrauding the United States and paying bribes and kickback in exchange for patient referrals” and “improperly recorded the unlawful payments as legitimate expenses in Tenet’s consolidated financial statements and financial reports.” The petition stated,

As a result of their access to and review of internal corporate documents, or conversations and connections with other corporate officers, employees, and directors and attendance at management and/or Board meetings, each of the defendants knew, or was reckless in not knowing, the adverse, material, non-public facts about Tenet’s patient referral kickback scheme and/or the false and misleading consolidated financial results and financial statements complained of herein.

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City of Warren Police and Fire Retirement System, and Janice Stewart v. Tenet Healthcare Corporation, (Tex. Ct. App. 2020).

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