La Frontera Center, Inc. v. United Behavioral Health, Inc.

District Court, D. New Mexico·Decided October 3, 2023·No. 1:15-cv-01164·Unknown

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO

LA FRONTERA CENTER, INC., an Arizona Nonprofit Corporation, RELATOR, United States of America and the State of New Mexico, ex rel.,

Plaintiff, v. 1:15-cv-01164-KWR-JMR

UNITED BEHAVIORAL HEALTH, INC., UNITED HEALTHCARE INSURANCE, INC., OPTUMHEALTH NEW MEXICO, UNITED HEALTHCARE INS. CO., Black and White Corporations, and John and Jane Does 1-X,

Defendants.

ORDER GRANTING IN PART AND DENYING IN PART MOTION TO UNSEAL

THIS MATTER comes before the Court on defendants United Behavioral Health Inc., United Healthcare Insurance, Inc., Optumhealth New Mexico, and United Healthcare Insurance Co.’s Motion to Unseal the Docket and Filings and to Vacate Certain Orders. Doc. 156. Relator La Frontera Center, Inc. filed a response deferring to the position of the United States and New Mexico. Doc. 157. The United States filed a Statement of Interest. Doc. 158. Defendants filed a reply. Doc. 159. New Mexico did not file a Statement of Interest. Having reviewed the submissions and the relevant law, I hereby GRANT IN PART and DENY IN PART defendants’ Motion to Unseal the Docket and Filings and to Vacate Certain Orders (Doc. 156). Documents 2 through 113 are hereby unsealed. I. Background This case is a qui tam reverse false claim action brought on behalf of the United States and the State of New Mexico. Doc. 1. The relator alleges defendants violated the federal False Claims Act (“FCA”), 31 U.S.C. §§ 3729 et seq.; the New Mexico Fraud Against Taxpayers Act (“NMFATA”), N.M. STAT. ANN. §§ 44-9-1 through 44-9-14; the New Mexico Medicaid False Claims Act (“NMMFCA”), N.M. STAT. ANN. §§ 27-14-1 through 27-14-14; and the New Mexico Medicaid Fraud Act (“NMMFA”), N.M. STAT. ANN. §§ 30-44-1 through 30-44-8. Doc. 77.

Pursuant to the FCA, the NMFATA, and the NMMFCA, the relator is required to file the complaint under seal.1 31 U.S.C. § 3730(b)(2); N.M. STAT. ANN. § 44-9-5(B); N.M. STAT ANN. § 27-14-7(C). The seal remains in place for at least 60 days while the government decides whether to intervene in the suit. Id. The complaint was filed on December 23, 2015. Doc. 1. Following an investigation, the United States and the State of New Mexico filed a Joint Notice of Election to Decline Intervention on February 2, 2022. Doc. 114. The Court then lifted the seal for all future filings and ordered service of the complaint on defendants. Doc. 115. Now, defendants request that the Court unseal the entire case—making documents2 2

through 113 public. Doc. 156 at 5. Or, at a minimum, defendants request that an investigatory report from the New Mexico Human Services Department (“HSD”) (Doc. 15) be unsealed. Id. at 7. In response, the relator deferred to the position of the United States and New Mexico. Doc. 157. The United States only opposes the unsealing of select documents. Doc. 158 at 1 (asking that the following remain sealed: Docs. 16, 50, 82, 85, 89, 91, 93, 95, 98, 100, 103, 108, and 110). The United States notes, without taking a position, that the State of New Mexico previously requested that the HSD report be “permanently sealed.” Doc. 158 at 3 (citing Doc. 42

1 The NMMFA does not contain a sealing provision. See N.M. STAT. ANN. §§ 30-44-1 through 30-44-8.

2 All references to document numbers refer to the online CM/ECF docket numbers. at 4). Notably, the HSD breached this Court’s seal by serving a copy of the HSD report (Doc. 15) on defendants—thus, making defendants prematurely aware of this qui tam action. Doc. 43 at 13. The breach was hotly litigated. Docs. 18–24, 26, 28–30, 32–34, 36, 38, 41–49, 52–72, 74– 75. The Court resolved the litigation about the breach. Doc. 75. As a result of this breach, the

sealed docket in this action is significantly longer than most qui tam actions in the same procedural posture. II. Legal Framework A qui tam action is a civil action brought by a private person, known as the “relator,” on behalf of the relator and the United States government. See 31 U.S.C. § 3730(b).3 Successful relators are awarded a percentage of the final settlement award. 31 U.S.C. § 3730(d)(1-2). Qui tam actions brought under the FCA must be filed under seal. 31 U.S.C. § 3730(b)(2). During the seal period the government decides whether it will intervene in the action. Cochise Consultancy, Inc. v. United States ex rel. Hunt, 139 S.Ct. 1507, 1510 (2019). The legislative

history “indicates that the seal provision was meant to allay the Government’s concern that a relator filing a civil complaint would alert defendants to a pending federal criminal investigation.” State Farm Fire and Cas. Co. v. United States ex rel. Rigsby, 580 U.S. 26, 34 (2016) (citing S. Rep. No. 99-345, p. 24 (1986)). In other words, the purpose of the seal is to prevent tipping off the defendants to an investigation against them. Once the government decides whether to intervene, the complaint is unsealed and served on the defendants. 31 U.S.C. § 3730(b)(3).

3 While this case was brought pursuant to four statutes, including three qui tam statutes, the United States is the only entity that opposes this motion. See Doc. 158. It does so based entirely on federal law. Id. As such, the Court limits its discussion to the applicable federal law. Under common law, there is a strong presumption in favor of public access to documents filed with the court. Nixon v. Warner Communications, Inc., 435 U.S. 589, 602 (1978). However, “[a] court can order documents sealed if the party moving for sealing is able to show some significant interest that outweighs the presumption in favor of open access to judicial records.” United States v. Pickard, 733 F.3d 1297, 1300 (10th Cir. 2013) (citation and quotation omitted).

III. Discussion Defendants seek to unseal 112 filed documents. Doc. 156 at 3. These documents fall into three categories: (1) filings which no one opposes unsealing, (2) the HSD report, (3) the United States’ motions for extension of time (Docs. 16, 50, 82, 89, 91, 93, 95, 98, 100, 103, 108).4 The Court finds that all 112 documents should be unsealed. A. The unopposed filings should be unsealed. The relator and the United States take no position on whether the following documents should be unsealed: Docs. 2–14, 17–49, 51–81, 83–88, 90, 92, 94, 96, 97, 99, 101, 102, 104–107, 109–113. Pursuant to Local Rule 7.1(a), failure to oppose a motion “constitutes consent to grant

the motion.” D.N.M.LR-Civ. 7.1(a). The primary purpose of the qui tam seal is to avoid alerting defendants to a federal investigation against them while the United States decides whether to intervene. State Farm Fire

4 The United States also requests that the relator’s Second Ex Parte Motion to Partially Lift Seal (Doc. 110) remain sealed. In that motion, the relator requested that the Court partially lift the seal so that the relator and defendants could engage in arbitration. Doc. 110. The United States’ request appears to be a scrivener’s error. The United States identifies Document 110 as another motion for an extension of time, which it is not. See Doc.

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