INDIANA PAIN AND SPINE CLINIC, LLC v. CAROLINA LIQUID CHEMISTRIES CORPORATION

CourtDistrict Court, M.D. North Carolina
DecidedMarch 25, 2022
Docket1:21-cv-00543
StatusUnknown

This text of INDIANA PAIN AND SPINE CLINIC, LLC v. CAROLINA LIQUID CHEMISTRIES CORPORATION (INDIANA PAIN AND SPINE CLINIC, LLC v. CAROLINA LIQUID CHEMISTRIES CORPORATION) is published on Counsel Stack Legal Research, covering District Court, M.D. North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
INDIANA PAIN AND SPINE CLINIC, LLC v. CAROLINA LIQUID CHEMISTRIES CORPORATION, (M.D.N.C. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF NORTH CAROLINA

INDIANA PAIN AND SPINE CLINIC, ) LLC, and AMIR KAZI, M.D., ) ) Plaintiffs, ) ) v. ) 1:21CV543 ) CAROLINA LIQUID CHEMISTRIES ) CORPORATION, MR. PHIL SHUGART, ) and MRS. PATRICIA SHUGART, ) ) Defendants. )

MEMORANDUM OPINION AND ORDER

Plaintiff Amir Kazi, M.D. agreed to pay the State of Indiana $424,874.64 in restitution and penalties owed from alleged Medicaid overpayments for urine drug screen confirmation tests. (Compl. ¶¶ 28, 33; Compl. Ex. 6 at 1, 3 (Settlement Agreement) [Doc. #1].) He and his practice Indiana Pain and Spine Clinic, LLC are now suing Defendants for their alleged part in Dr. Kazi’s overpayment liability. The matter is before the Court on Defendants’ Motion to Dismiss [Doc. #13] all claims against them. For the reasons that follow, the motion is granted. I. For purposes of this motion, the facts are construed in the light most favorable to Plaintiffs and all reasonable inferences are drawn in their favor. U.S. ex rel. Oberg v. Pa. Higher Educ. Assistance Agency, 745 F.3d 131, 136 (4th Cir. 2014). Dr. Kazi, a specialist in spine and pain management, resides and practices medicine in Indiana where he owns and operates Indiana Pain and Spine Clinic. (Compl. ¶¶ 6, 7.) Defendants Phil and Patricia Shugart are the president and vice president, respectively, of Defendant Carolina Liquid Chemistries Corporation

(“CLC”), a North Carolina company that manufactures, distributes, resells, and services in-office Urine Drug Testing (“UDT”) machines and reagents. (Id. ¶¶ 8-10, 12.) Dr. Kazi had a UDT system at his office, but it was a “qualitative” system that “only identified the presence of alcohol or drugs but did not test for amounts

or types.” (Id. ¶ 14.) The Shugarts and CLC marketed their UDT machines as being “capable of performing high complexity ‘quantitative’ drug testing, for which Medicare and Medicaid can be billed significant amounts.” (Id. ¶ 13; see also id. ¶ 25.) For example, Dr. Kazi was usually reimbursed approximately $20 per qualitative test, but a quantitative test could be reimbursed at approximately

$467. (Id. ¶ 18.) In addition, quantitative tests “identify which drugs are present in the urine” so Dr. Kazi could “better help his patients with recovery.” (Id. ¶ 20.) In January 2010, to induce physicians to purchase its device and other tools, CLC issued a press release stating that its BioLis 24i UDT device could perform in-office qualitative and quantitative tests. (Id. ¶ 21; Compl. Ex. 2 (Press

Release).) In 2013, CLC published and distributed a brochure on its devices, including the BioLis 24i, showing profitability based on Medicare reimbursement and sample test results identifying the presence of specific drugs. (Compl. ¶¶ 22, 23; Compl. Ex. 3 (Urine Drug Testing 2013 Brochure).) The brochure also included an August 29, 2012 letter by Patricia Shugart advising that the BioLis 24i “is considered a high complexity test system under the Centers for Medicare & Medicaid Services (‘CMS’) regulations . . . .” (Compl. ¶ 24; Compl Ex. 3 at 22.)

In 2013, Joe Pratt, a CLC salesperson, visited Dr. Kazi, “pitch[ed]” that the CLC urinalysis device was approved by the FDA for quantitative analysis, and showed Dr. Kazi a template of revenue he could generate were he to purchase and use a CLC machine. (Id. ¶ 15.) On January 9, 2014, Bob Dupor, another CLC salesperson, sold Dr. Kazi a refurbished BioLis 24i and again told Dr. Kazi that the

system performed quantitative testing that could be charged to Medicare and Medicaid at a much higher rate than his qualitative tests. (Id. ¶¶ 16-19.) Several months later in March, Dupor and another CLC employee, Patti Gaul, connected Dr. Kazi with a billing consultant at Provider Business Partners who “directed Dr. Kazi on the way to bill Medicare and Medicaid for the tests.” (Id. ¶ 26.) Dr. Kazi

performed the tests, billed as instructed, and received payment, having relied on CLC’s marketing and warranty that the BioLis 24i could perform quantitative testing. (Id. ¶ 27.) On October 24, 2017, Dr. Kazi received a notice from the Indiana Attorney General, Medicaid Fraud Unit (“MFU”) alleging that the Indiana Medicaid program

had overpaid him $338,460.83 for drug screening tests between January 1, 2014 and December 31, 2016. (Id. ¶¶ 28, 29.) Dr. Kazi had allegedly up-coded UDT tests by charging for quantitative tests when the UDT equipment was not capable of performing such tests. (Id. ¶ 28; see also id. ¶ 30 (“[T]he Biolis 24i is unable to conduct quantitative testing or multi-assay; it is only capable of single-assay or qualitative testing.”).) Specifically, over two-thirds of the overpayment was for “fee for service traditional Medicaid claims for quantitative, confirmation testing

done with a ‘UDS immunoassay machine manufactured by Carolina Liquid Laboratories in 2015 [that] cannot perform and was never approved by the FDA to perform quantitative, confirmation testing.’” (Id. ¶ 30.) The remainder of the overpayment resulted from inappropriate billing codes. (Id. ¶ 31.) In total, MFU sought $696,411.16 in repayment. (Id.) On September 27, 2018, Dr. Kazi entered

into a settlement with the State of Indiana and agreed to pay $424,874.64 in restitution and penalties over three years in monthly installments. (Id. ¶ 33; Compl. Ex. 6 at 3.) Earlier that year, states and government agencies sued CLC for inducing health care providers to submit false claims. (Compl. ¶ 35.) Dr. Kazi and Indiana Pain and Spine Clinic are suing Defendants for implied-

in-law indemnification (Claim I), false advertising (Claim II), breach of implied warranty of merchantability (Claim III), breach of implied warranty of fitness for a particular purpose (Claim IV), and unfair and deceptive trade practices (Claim V).1 Defendants contend that the statutes of limitations bar all five claims and that Plaintiffs have otherwise failed to state a claim for which relief can be granted.

1 Although Plaintiffs’ tort claims are intentional torts, they allege in one paragraph of the Complaint that Dr. Kazi’s “overpayment liability is clearly the result of the actions [sic] Defendants’ negligent actions”, (Compl. ¶ 34). II. To survive a motion to dismiss made pursuant to Rule 12(b)(6), a complaint “must contain sufficient factual matter, accepted as true, to ‘state a claim to relief

that is plausible on its face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007)). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. (citing Twombly, 550 U.S. at 556); see also McCleary-Evans v. Md. Dep’t of

Transp., State Highway Admin., 780 F.3d 582, 585 (4th Cir. 2015) (noting that a complaint must “contain[] sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face in the sense that the complaint’s factual allegations must allow a court to draw the reasonable inference that the defendant is liable for the misconduct alleged”). However, when a complaint

states facts that are “’merely consistent with’ a defendant’s liability, it ‘stops short of the line between possibility and plausibility of ‘entitlement to relief.’’” Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 557). When evaluating whether the complaint states a claim that is plausible on its face, the facts are construed in the light most favorable to the plaintiff and all

reasonable inferences are drawn in his favor. U.S. ex rel. Oberg, 745 F.3d at 136.

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INDIANA PAIN AND SPINE CLINIC, LLC v. CAROLINA LIQUID CHEMISTRIES CORPORATION, Counsel Stack Legal Research, https://law.counselstack.com/opinion/indiana-pain-and-spine-clinic-llc-v-carolina-liquid-chemistries-ncmd-2022.