Frantz v. Walled

513 F. App'x 815
CourtCourt of Appeals for the Eleventh Circuit
DecidedMarch 18, 2013
DocketNo. 12-12185
StatusPublished
Cited by5 cases

This text of 513 F. App'x 815 (Frantz v. Walled) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Frantz v. Walled, 513 F. App'x 815 (11th Cir. 2013).

Opinion

PER CURIAM:

Plaintiff-Appellant Achille Frantz, pro se, appeals the district court’s dismissal of his amended complaint and the denial of his motion for reconsideration. In the amended complaint, Plaintiff Frantz brings claims under the Racketeering Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. §§ 1961 et seq. and Florida common law against Defendants Rosa Walled, Gregory Delatour, First Coast Service Options, Inc. (“First Coast”), and Suntrust [818]*818Bank (“Suntrust”). After review, we affirm.

I. BACKGROUND

A. The Criminal Case

In this civil appeal, Frantz’s claims involve conduct for which he was prosecuted and convicted along with other defendants. We thus discuss Frantz’s criminal case first.

In 2006, a federal grand jury in the Southern District of Florida indicted Plaintiff Frantz, charging him with one count of conspiracy to commit health care fraud in violation of 18 U.S.C. § 1349 and seven counts of health care fraud and aiding and abetting in violation of 18 U.S.C. §§ 1347 and 2.1 The grand jury alleged that Frantz, a licensed physician, joined a conspiracy with Walled and Delatour, to fraudulently obtain federal Medicare funds. In furtherance of the conspiracy, Walled and Delat-our (not physicians) established two medical clinics in Miami, Florida.2 Walled and Delatour hired Frantz to provide treatment at the clinics. The indictment alleged that Frantz worked at one clinic from January 2005 to April 2005 and at the other clinic from April 2005 to July 2005.

According to the indictment, the conspirators recruited to the clinic Medicare recipients who were not infected with HIV. There, the Medicare recipients provided blood samples, which the conspirators biologically altered so that the samples looked like they came from individuals infected with HIV. Frantz then prescribed unnecessary medications to these Medicare recipients. Thereafter, the medical clinics sought and obtained Medicare reimbursements exceeding two million dollars for these unnecessary treatments.3

In 2006, Frantz was arrested. In 2007, a jury found Frantz guilty of conspiring to commit health care fraud, and guilty as to five of the seven health care fraud counts. The district court sentenced Frantz to a total of 78 months’ imprisonment. This Court affirmed Frantz’s convictions and sentence. See United States v. Achille, 277 Fed.Appx. 875 (11th Cir.2008) (per curiam).

B. The Original Civil Complaint

Subsequently in 2010, Frantz, pro se, filed his original civil complaint in this case against: (1) Walled and Delatour, his criminal co-conspirators described above; (2) First Coast, which processed the Medicare payments; and (3) Suntrust, where the clinic, Walled, and Delatour had bank accounts.4

Each defendant filed a motion to dismiss under Rule 12(b)(6) for failure to state a claim. Before the district court ruled, Frantz moved for leave to file an amended complaint which he attached. The district court agreed with Defendants about the inadequacy of the original complaint and, on July 27, 2011, dismissed it without prejudice. At the same time, however, the [819]*819district court deemed Frantz’s amended complaint filed and ordered Defendants to respond to the amended complaint within 20 days of the order.

C. The Amended Civil Complaint

Plaintiff Frantz’s amended complaint attempted to assert, inter alia, federal civil RICO claims and various state common law claims. Each defendant filed a motion to dismiss the amended complaint on multiple grounds. On February 21, 2012, a magistrate judge’s report recommended granting the motions to dismiss. The magistrate judge concluded that Frantz’s amended complaint, construed liberally, invoked federal subject matter jurisdiction. Nevertheless, the magistrate judge advised that the district court should dismiss the amended complaint because it: (1) failed to comply with pleading requirements in Rule 8(a); and (2) contained claims that were facially time-barred by the applicable statutes of limitations. Because Frantz had already received one opportunity to correct his complaint’s deficiencies, the magistrate judge recommended that the district court dismiss the amended complaint with prejudice.

Frantz objected to the magistrate judge’s report. The district court overruled the objections, adopted the report, and dismissed the amended complaint with prejudice. Frantz then filed a motion for reconsideration which the district court denied. Frantz timely appealed.

II. DISCUSSION

A. Subject Matter Jurisdiction

As the magistrate judge’s report noted, Frantz asserted claims under RICO and invoked federal question jurisdiction under 28 U.S.C. § 13S1.5 Defendant First Coast, however, argues that: (1) it acted as the government’s agent when it took the alleged actions referenced in Frantz’s amended complaint; (2) that as a government agent, First Coast is entitled to sovereign immunity; and (3) thus the district court lacked subject matter jurisdiction over Frantz’s claims against First Coast.6

When the alleged events occurred, First Coast was operating under a contract with the Center for Medicare and Medicaid Services (“CMS”), a division of the United States Department of Health and Human Services. CMS administers the Medicare program, “a federally subsidized, voluntary enrollment health insurance program.” Gulfcoast Med. Supply, Inc. v. Sec’y, Dep’t of Health & Human Servs., 468 F.3d 1347, 1348-49 (11th Cir.2006).

In doing so, CMS enters into agreements with “medicare administrative contractors” (“MACs”) like First Coast. See 42 U.S.C. § 1395u(a). First Coast, as a MAC, performs a variety of functions, including: (1) receiving Medicare funds and disbursing them to health care providers for services rendered to eligible individuals; (2) determining the amounts owed to such health care providers; and (3) audit[820]*820ing claims for Medicare reimbursement. See 42 C.F.R. §§ 421.200, 421.214.

MACs, like First Coast, are typically entitled to sovereign immunity. See Peterson v. Blue Cross/Blue Shield of Tex., 508 F.2d 55, 57-58 (5th Cir.1975).7 This is because, when fulfilling obligations to CMS, a MAC functions as the government’s agent.

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Bluebook (online)
513 F. App'x 815, Counsel Stack Legal Research, https://law.counselstack.com/opinion/frantz-v-walled-ca11-2013.