Madelyn B. Barnes, by and on behalf of the United States of America, Relator, and by and on behalf of the State of New York, Relator v. HealthNow New York, Inc., doing business as BlueCross BlueShield of Western New York, doing business as Blueshield of Northeastern New York, now known as Highmark Western and Northeastern New York

District Court, W.D. New York·Decided September 10, 2026·No. 1:16-cv-00088·Unknown

Opinion

TALES SUING CO KS FILED AY UNITED STATES DISTRICT COURT SEP 19 2026 WESTERN DISTRICT OF NEW YORK 4 SBR wR WOREW wy, WELLER. □□ TERN DISTRIC MADELYN B. BARNES, by and on behalf of the United States of America, Relator, and by and on behalf of the State of New York, Relator, 16-CV-88 (JLS) (HKS) Relator, v. HEALTHNOW NEW YORK, INC., doing business as BlueCross BlueShield of Western New York, doing business as Blueshield of Northeastern New York, now known as Highmark Western and Northeastern New York, Defendant.

DECISION AND ORDER Relator Madelyn Barnes brings claims against Defendant HealthNow New York under the federal and New York State False Claims Acts. See Dkt. 94. Currently before this Court is Defendant’s motion for judgment on the pleadings, which challenges the constitutionality of the qui tam provision of the False Claims Act, and for leave to amend its answer.! Dkt. 171. Relator opposed (Dkt. 183; Dkt. 184), and Defendant replied (Dkt. 186). The United States intervened for the

1 Also pending before this Court is Defendant’s motion for reconsideration of this Court’s December 21, 2020 order on Defendant’s motion to dismiss. Dkt. 191. This decision and order does not address that motion. In addition, there is a discovery motion, currently stayed, pending before Judge Schroeder. Dkt. 170; Dkt. 179.

limited purpose of defending the constitutionality of the qui tam provision (Dkt. 182), and opposed Defendant’s motion (Dkt. 1838). United States Magistrate Judge H. Kenneth Schroeder, Jr.,? issued a Report and Recommendation (“R&R”), recommending that this Court (1) deny Defendant judgment on the pleadings, and (2) deny Defendant leave to amend its answer. Dkt. 187. Defendant objected to the R&R. Dkt. 190. Relator and the United States responded to Defendant’s objections. Dkt. 202; Dkt. 203. Defendant replied. Dkt. 206. This Court also allowed the Chamber of Commerce of the United States to file an amicus brief. Dkt. 208; see also Dkt. 197-2. Neither party responded to the amicus brief. In July 2025, the parties attended a status conference with this Court to discuss the status of pending motions and outstanding discovery, a possible interlocutory appeal and associated stay, and the utility of additional mediation. Dkt. 216. Each party filed a letter brief with its position on whether discovery could proceed during any interlocutory appeal. Dkt. 218; Dkt. 219. Thereafter, the Court ordered the parties to participate in mediation. Dkt. 220. The parties engaged in multiple mediation sessions between September 2025 and August 2026. Dkt. 222; Dkt. 224; Dkt. 226; Dkt. 228; Dkt. 229; Dkt. 230; Dkt.

2 The Court referred this case to Judge Schroeder for all proceedings under 28 U.S.C. §§ 636(b)(1)(A), (B), and (C). Dkt. 75.

231; Dkt. 235. At the Court’s request, the parties filed status reports with their views of next steps in the case. Dkt. 234; Dkt. 236; Dkt. 237; Dkt. 238. A district court may accept, reject, or modify the findings or recommendations of a magistrate judge. 28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b)(8). It must conduct a de novo review of those portions of a magistrate judge’s recommendation to which objection is made. 28 U.S.C. § 636(b)(1); Fed. R. Civ. P. 72(b)(8). But neither 28 U.S.C. § 636 nor Federal Rule of Civil Procedure 72 requires a district court to review the recommendation of a magistrate judge to which no objections are raised. See Thomas v. Arn, 474 U.S. 140, 149-50 (1985). This Court carefully reviewed the R&R, the briefing on objections, and the relevant record. Based on its de novo review, the Court accepts Judge Schroeder’s recommendation to deny Defendant’s motion for judgment on the pleadings and for leave to amend its answer. For the reasons stated above and in the R&R (Dkt. 187), which is appended to this decision and order as Exhibit A, the Court DENIES Defendant’s motion for judgment on the pleadings and for leave to amend its answer (Dkt. 171). Given the state of decisional law on the separation-of-powers issue, the status of the issue under Second Circuit caselaw, and the age of various cited decisions that predate more modern pronouncements on the issue, this Court has decided to accept the R&R, deny the motion, and certify that the Court’s order on this issue “involves a controlling question of law as to which there is substantial ground for difference of opinion and that an immediate appeal from the order may materially

advance the ultimate termination of the litigation.” 28 U.S.C. § 1292(b). See 28 U.S.C. § 1292(b). As Justice Thomas has recognized:

There are substantial arguments that the qui tam device is inconsistent with Article I] and that private relators may not represent the interests of the United States in litigation. Because the entire executive Power belongs to the President alone, it can only be exercised by the President and those acting under him. See, e.g., United States ex rel. Polansky v. Exec. Health Res., Inc., 599 U.S. 419, 449 (2023) (Thomas, J., dissenting) (citation modified). A lawsuit “is the ultimate remedy for a breach of the law”; the Supreme Court, therefore, “has held that conducting civil litigation for vindicating public rights of the United States is an executive function that may be discharged only by persons who are ‘Officers of the United States’ under the Appointments Clause.” Id. (citation modified). Because private relator under the FCA... is not appointed as an officer of the United States under Article II,” it “appears to follow that Congress cannot authorize a private relator to wield executive authority to represent the United States’ interests in civil litigation.” Id. at 449-50 (citation modified). As a result, “there is good reason to suspect that Article IJ does not permit private relators to represent the United States’ interests in FCA suits.” Id. at 450. See also id. at 442 (Kavanaugh & Barrett, JJ., concurring) (agreeing with Justice Thomas that “there are substantial arguments that the qui tam device is inconsistent with Article II and that private relators may not represent the

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Madelyn B. Barnes, by and on behalf of the United States of America, Relator, and by and on behalf of the State of New York, Relator v. HealthNow New York, Inc., doing business as BlueCross BlueShield of Western New York, doing business as Blueshield of Northeastern New York, now known as Highmark Western and Northeastern New York, (W.D.N.Y. 2026).

Madelyn B. Barnes, by and on behalf of the United States of America, Relator, and by and on behalf of the State of New York, Relator v. HealthNow New York, Inc., doing business as BlueCross BlueShield of Western New York, doing business as Blueshield of Northeastern New York, now known as Highmark Western and Northeastern New York (Madelyn B. Barnes, by and on behalf of the United States of America, Relator, and by and on behalf of the State of New York, Relator v. HealthNow New York, Inc., doing business as BlueCross BlueShield of Western New York, doing business as Blueshield of Northeastern New York, now known as Highmark Western and Northeastern New York) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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