Larry M. Gentilello M.D. v. University of Texas Southwestern Health Systems

Court of Appeals of Texas·Decided March 24, 2014·No. 05-13-00149-CV·Published

Opinion

AFFIRM; and Opinion Filed March 24, 2014.

S In The

Court of Appeals

Fifth District of Texas at Dallas No. 05-13-00149-CV

LARRY M. GENTILELLO, M.D., Appellant V.

THE UNIVERSITY OF TEXAS SOUTHWESTERN HEALTH SYSTEMS A/K/A UT SOUTHWESTERN HEALTH SYSTEMS, THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER MEDICAL SERVICE, RESEARCH AND DEVELOPMENT PLAN, AND THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS, Appellees

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

Trial Court Cause No. 07-6167

MEMORANDUM OPINION

Before Justices Moseley, Lang, and Brown Opinion by Justice Brown

Larry M. Gentilello, M.D. appeals the trial court’s order granting a plea to the jurisdiction

filed by the University of Texas Southwestern Health Systems a/k/a UT Southwestern Health Systems, the University of Texas Southwestern Medical Center Medical Service, Research and Development Plan, and the University of Texas Southwestern Medical Center at Dallas (collectively “UT Southwestern”), in which UT Southwestern asserted it was entitled to sovereign immunity. In four issues, Gentilello contends the trial court erred in granting the plea to the jurisdiction because UT Southwestern waived sovereign immunity under the terms of a settlement agreement and also by its conduct. We affirm the trial court’s order.

Factual and Procedural Background In 2003, Dr. Gentilello was employed by UT Southwestern Medical Center as the Chair of the Division of Burn, Trauma and Critical Care. At UT Southwestern, he was also a tenured professor of surgery and held the position of Distinguished C. James Carrico, M.D. Chair in Trauma. During his employment, Gentilello came to believe that UT Southwestern failed to properly supervise its residents, which resulted in certain practices Gentilello believed were contrary to Medicaid requirements and procedures. According to Gentilello, UT Southwestern knowingly and repeatedly violated the Texas Medicaid Fraud Prevention Act (TMFPA) by billing Medicaid for an attending physician’s direct supervision of certain complex and/or dangerous procedures when in fact no such physician was present or a physician was only minimally involved. UT Southwestern’s Billing Compliance Plan provided that, “Employees who report, in good faith, possible compliance problems shall be protected from retaliation or harassment, as established by law.” Gentilello brought his concerns to Dr. Robert Rege, who was responsible for UT Southwestern’s policies regarding the presence of teaching attending physicians and who oversaw internal compliance with Medicaid requirements.

Effective March 5, 2007, Gentilello was stripped of his position as the Chair of the Division of Burn, Trauma and Critical Care and of his position as the Distinguished C. James Carrico, M.D. Chair in Trauma. He also contends UT Southwestern removed him from trauma call, gave him an unsatisfactory review, docked his pay for participating in professional service activities, evicted him from his Distinguished Chair office space, and did not allow him adequate time to recover from back surgery. Gentilello maintains these adverse personnel actions were taken in retaliation for his good faith report about activities that violated Medicaid patient care requirements.

In his original petition in this case filed in 2007, Gentilello brought a qui tam action on behalf of the State of Texas against UT Southwestern and the Dallas County Hospital District d/b/a Parkland Health and Hospital System (“Parkland”), the primary teaching hospital for UT Southwestern, alleging violations of section 36.002 of the TMFPA. Gentilello later amended his petition to allege that after he reported UT Southwestern’s Medicaid fraud, UT Southwestern retaliated against him in violation of section 36.115 of the TMFPA. 1 See TEX. HUM. RES. CODE ANN. §§ 36.002, 36.115 (West Supp. 2013).

Gentilello also filed a parallel lawsuit in federal court. There he brought a qui tam action on behalf of the United States government, alleging UT Southwestern and Parkland violated the False Claims Act (FCA) by filing fraudulent Medicaid claims. Gentilello also brought an individual cause of action for retaliation under the FCA. The federal court later ruled that Gentilello’s retaliation claim under the FCA was barred by sovereign immunity under the Eleventh Amendment. Gentilello v. Univ. of Tex. Sw. Health Sys., No. 3:07-CV-1172-K, 2012 WL 3638676, at *4 (N.D. Tex. Aug. 24, 2012).

In 2011, Gentilello, the United States, and the State of Texas settled the state and federal qui tam claims with UT Southwestern and Parkland. Under the terms of the settlement agreement, UT Southwestern denied the allegations against it, but agreed to pay the United States and Texas $1,400,000. The settlement agreement reserved Gentilello’s right to maintain his retaliation claim under the TMFPA.

In 2012, UT Southwestern filed a plea to the jurisdiction in this case, asserting that because it is a state entity, Gentilello’s remaining retaliation claim was barred by sovereign

1 In addition, Gentilello filed a separate lawsuit against UT Southwestern for violations of the Texas Whistleblower Act. That act expressly waives sovereign immunity if a public employee has properly alleged a violation of the act. State v. Lueck, 290 S.W.3d 876, 881 (Tex. 2009). The Texas Supreme Court ultimately dismissed Gentilello’s whistleblower case for lack of jurisdiction because Gentilello could not have formed an objectively reasonable belief that the person to whom he reported the violations, Dr. Rege, possessed law enforcement powers as required by the act. Univ. of Tex. Sw. Med. Ctr. v. Gentilello, 398 S.W.3d 680, 689 (Tex. 2013).

immunity. Gentilello countered that UT Southwestern had waived sovereign immunity by the terms of the settlement agreement regarding the qui tam claims and also by its egregious conduct. The trial court held two hearings on UT Southwestern’s plea to the jurisdiction. At the end of the first hearing, the trial court reserved its ruling to allow Gentilello to take the deposition of a UT Southwestern representative and thereby explore the meaning of certain language in the Billing Compliance Plan. The day before the second hearing, Gentilello amended his pleadings to include a breach of contract claim, apparently based on the Billing Compliance Plan. At the second hearing, UT Southwestern urged that the analysis in its plea to the jurisdiction regarding the retaliation claim also applied to a breach of contract claim. 2 The trial court granted UT Southwestern’s plea to the jurisdiction on the basis of sovereign immunity and dismissed Gentilello’s lawsuit with prejudice. 3 This appeal followed.

Sovereign Immunity

Sovereign immunity protects the State from lawsuits for money damages. Tex. Natural Res. Conservation Comm’n v. IT-Davy, 74 S.W.3d 849, 853 (Tex. 2002). Sovereign immunity encompasses two principles: immunity from suit and immunity from liability. Id. Immunity from suit bars a suit against the State unless the Legislature expressly consents to the suit. Id. It is the Legislature’s sole province to waive or abrogate sovereign immunity. Id. at 857. Legislative consent for suit or any other sovereign immunity waiver must be by clear and unambiguous language. Fed. Sign v. Tex. S. Univ., 951 S.W.2d 401, 405 (Tex. 1997). Sovereign immunity from suit defeats a trial court’s subject matter jurisdiction and thus is properly asserted

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Larry M. Gentilello M.D. v. University of Texas Southwestern Health Systems, (Tex. Ct. App. 2014).

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