Marcia Stein v. Kaiser Foundation Health Plan, Inc.

115 F.4th 1244
Court of Appeals for the Ninth Circuit·Decided September 24, 2024·No. 22-15862·Published·Cited by 5 cases

Opinion

FOR PUBLICATION

UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

MARCIA STEIN; RODOLFO BONE, No. 22-15862 Qui Tam Relators; ex rel. United States of America, D.C. Nos.

Plaintiffs-Appellants, 3:16-cv-05337- EMC and 3:13-cv-03891- UNITED STATES OF AMERICA, EMC

Plaintiff, OPINION v.

KAISER FOUNDATION HEALTH PLAN, INC., a California corporation; KAISER FOUNDATION HOSPITALS, a California corporation; KAISER FOUNDATION HEALTH PLAN OF COLORADO, A Colorado Corporation; KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC., a Georgia corporation; KAISER FOUNDATION HEALTH PLAN OF THE MID- ATLANTIC STATES, INC., a Maryland corporation; KAISER

FOUNDATION HEALTH PLAN OF THE NORTHWEST, an Oregon corporation; KAISER FOUNDATION HEALTH PLAN OF WASHINGTON, a Washington corporation; PERMANENTE MEDICAL GROUP, INC., a California corporation; SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP; COLORADO PERMANENTE MEDICAL GROUP, a Colorado corporation; SOUTHEAST PERMANENTE MEDICAL GROUP; HAWAII PERMANENTE MEDICAL GROUP; MID-ATLANTIC PERMANENTE MEDICAL GROUP; NORTHWEST PERMANENTE, P.C.; GROUP HEALTH PERMANENTE; KAISER PERMANENTE,

Defendants-Appellees.

Appeal from the United States District Court for the Northern District of California Edward M. Chen, District Judge, Presiding

Submitted June 26, 2024* Seattle, Washington

Filed September 24, 2024

* The panel unanimously concludes this case is suitable for decision without oral argument. See Fed. R. App. P. 34(a)(2). STEIN V. KAISER FOUND. HEALTH PLAN, INC. 3

Before: Mary H. Murguia, Chief Judge, and Johnnie B. Rawlinson, Milan D. Smith, Jr., Jacqueline H. Nguyen, Bridget S. Bade, Kenneth K. Lee, Danielle J. Forrest, Patrick J. Bumatay, Gabriel P. Sanchez, Roopali H. Desai and Anthony D. Johnstone, Circuit Judges.

Opinion by Judge Forrest; Concurrence by Judge Forrest

SUMMARY**

False Claims Act

Reversing in part the district court’s dismissal of an action under the False Claims Act for lack of jurisdiction under the Act’s first-to-file rule, the en banc court overruled circuit precedent, held that the first-to-file rule is not jurisdictional, and remanded to the three-judge panel for further proceedings. Plaintiffs sued various Kaiser-related entities alleging Medicare fraud. The district court dismissed the action as barred by the first-to-file rule, 31 U.S.C. § 3730(b)(5), because it related to earlier-filed pending actions against the same defendants or other Kaiser-related entities. The three- judge panel affirmed, applying circuit precedent that the first-to-file rule is jurisdictional.

** This summary constitutes no part of the opinion of the court. It has been prepared by court staff for the convenience of the reader.

Acknowledging a circuit split, the en banc court overruled United States ex rel. Hartpence v. Kinetic Concepts, Inc., 792 F.3d 1121 (9th Cir. 2015) (en banc), and United States ex rel. Hughes Aircraft Co., 243 F.3d 1181 (9th Cir. 2001), and held that the first-to-file rule is not jurisdictional. Applying the Supreme Court’s more recent holding that a statutory bar is jurisdictional only if Congress clearly states that it is, the en banc court held that the first- to-file rule is not jurisdictional because § 3730(b)(5) does not use the term “jurisdiction” or include any other textual clue that points to jurisdiction, unlike other provisions in the False Claims Act that use explicitly jurisdictional language. Concurring, Judge Forrest, joined by Judge Bumatay, wrote that the court should discard its “dicta-is-binding” rule because this rule is burdensome and misguided. Judge Forrest wrote that in Hughes, the court labeled the first-to- file rule as jurisdictional with no explanation. Then, sitting en banc in Hartpence, the court cited Hughes and again summarily proclaimed that the first-to-file rule was jurisdictional. Judge Forrest wrote that the three-judge panel in this case should have been able to analyze the issue without constraint, rather than feeling duty bound to follow Hughes and Hartpence despite their tension with Supreme Court precedent. STEIN V. KAISER FOUND. HEALTH PLAN, INC. 5

COUNSEL

William K. Hanagami (argued), Hanagami Law APC, Incline Village, Nevada; Abram J. Zinberg, The Zinberg Law Firm APC, Huntington Beach, California; for Plaintiffs-Appellants. Shiwon Choe and Benjamin J. Wolinsky, Assistant United States Attorneys, United States Department of Justice, Office of the United States Attorney, San Francisco, California, for Plaintiff United States of America. Dimitri D. Portnoi (argued), David M. Deaton, Stephen M. Sullivan, Caitlin M. Bair, and Kyle M. Grossman, O’Melveny & Myers LLP, San Francisco, California; K. Lee Blalack, II, O’Melveny & Myers LLP, Washington, D.C.; for Defendants-Appellees.

OPINION

FORREST, Circuit Judge:

Plaintiffs Marcia Stein and Rodolfo Bone brought a False Claims Act (FCA) action against various Kaiser- related entities1 alleging Medicare fraud. The district court dismissed plaintiffs’ lawsuit as barred by the FCA’s first-to- file rule because it “related” to earlier-filed, pending FCA actions against the same defendants named in this action or other Kaiser-related entities. See 31 U.S.C. § 3730(b)(5). A three-judge panel of our court affirmed, applying our

1 Kaiser is a trade name referring to a nationwide integrated healthcare provider consisting of Kaiser Health Plans, Permanente Medical Groups, and hospitals.

precedent that the FCA’s first-to-file rule is jurisdictional. Stein v. Kaiser Found. Health Plan, Inc., No. 22-15862, 2024 WL 107099, at *1–2 (9th Cir. Jan. 10, 2024) (citing United States ex rel. Hartpence v. Kinetic Concepts, Inc., 792 F.3d 1121 (9th Cir. 2015) (en banc)). We took this case en banc and now overrule this jurisdictional precedent. The FCA’s first-to-file rule states: “When a person brings an action under this subsection, no person other than the Government may intervene or bring a related action based on the facts underlying the pending action.” 31 U.S.C. § 3730(b)(5). Two decades ago, we labeled this rule “jurisdictional” without any analysis. United States ex rel. Lujan v. Hughes Aircraft Co. (Hughes), 243 F.3d 1181, 1186–87 (9th Cir. 2001). Then, sitting en banc in Hartpence, we cited Hughes and reiterated that we “treat the first-to-file bar as jurisdictional.” 792 F.3d at 1130. But we again neglected to provide any analysis. Simply put, the nature of the first-to-file rule was hardly part of our consideration of these cases. Since Hughes and Hartpence, the Supreme Court has repeatedly cautioned against the “profligate use of the term ‘jurisdiction.’” Sebelius v. Auburn Reg’l Med. Ctr., 568 U.S. 145, 153 (2013). Just last year, the Court again sought “to bring some discipline” to the overly expansive and “sometimes-loose use” of this term. MOAC Mall Holdings LLC v. Transform Holdco LLC, 598 U.S. 288, 298 (2023) (quoting Henderson ex rel. Henderson v. Shinseki, 562 U.S. 428, 435 (2011)). The Court has instructed that a narrow rule governs: A statutory bar is jurisdictional “only if Congress ‘clearly states’ that it is.” Santos-Zacaria v. Garland, 598 U.S. 411, 416 (2023) (quoting Boechler, P.C. v. Comm’r, 596 U.S. 199, 203 (2022)); see also Auburn Reg’l Med. Ctr., 568 U.S. at 153 (emphasizing the need for a “clear STEIN V. KAISER FOUND. HEALTH PLAN, INC. 7

statement” from Congress); Wilkins v. United States, 598 U.S. 152, 156–59 (2023) (same).

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Marcia Stein v. Kaiser Foundation Health Plan, Inc., 115 F.4th 1244 (9th Cir. 2024).

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