Mikes v. Strauss

889 F. Supp. 746, 10 I.E.R. Cas. (BNA) 1348, 1995 U.S. Dist. LEXIS 8627, 1995 WL 373668
CourtDistrict Court, S.D. New York
DecidedJune 20, 1995
Docket92 Civ. 2754 (WCC)
StatusPublished
Cited by62 cases

This text of 889 F. Supp. 746 (Mikes v. Strauss) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mikes v. Strauss, 889 F. Supp. 746, 10 I.E.R. Cas. (BNA) 1348, 1995 U.S. Dist. LEXIS 8627, 1995 WL 373668 (S.D.N.Y. 1995).

Opinion

*749 OPINION AND ORDER

WILLIAM C. CONNER, Senior District Judge.

Patricia Mikes brings this action on behalf of the United States and herself against her former employers under the qui tam provisions of the False Claims Act (“FCA”), 31 U.S.C. § 3730, for alleged improper billing of medical procedures to the United States and for retaliatory discharge, and under New York Labor Law § 191, for unpaid wages for a two-week period of employment after her formal termination. In May, 1994 the Court granted defendants’ motion to dismiss the complaint, in part for failing to state a claim in light of the fraud pleading requirement of Rule 9(b), Fed.R.Civ.Pro., see United States ex rel. Mikes v. Straus, 853 F.Supp. 115 (S.D.N.Y.1994) [hereinafter Mikes I ], but allowed plaintiff to replead her charges to overcome the noted infirmities of the complaint. After plaintiff filed a First Amended Complaint, defendant again moved to dismiss the action under Rules 12(b)(6) and 9(b) or, in the alternative, to compel arbitration. Converting defendants’ motion sua sponte into a motion for summary judgment, the Court reserved decision pending submission by plaintiff of more detailed affidavits to substantiate the allegations of the First Amended Complaint. In accordance with that order, plaintiff has submitted her own affidavit and, in addition, has moved for a continuance under Rule 56(f), Fed.R.Civ.Pro., to allow further discovery prior to our disposition of the court-converted summary judgment motion. Because we find that the First Amended Complaint and plaintiff’s affidavit raise genuine issues of fact for trial on plaintiffs qui tam and retaliatory discharge claims, we see no reason to delay this disposition any longer. Therefore, plaintiffs motion for a continuance and defendants’ converted motion for summary judgment are both denied. Defendants’ motion to compel arbitration is granted in part and denied in part as outlined below. Defendants’ motion for a stay pending arbitration is denied.

I.

In May, 1991 plaintiff entered into an employment agreement (the “Agreement”) with defendants, doing business as Oxford Medical, Oxford Hematology Associates, and Pulmonary and Critical Care Associates (“PCCA”), to provide pulmonary care to individuals in hospitals located in Westchester and Putnam counties in New York. Plaintiff claims that while she was employed by defendants, defendants regularly misused spirome-try and magnetic resonance imaging (“MRI”) 1 tests to overcharge patients, many of which were Medicare recipients, for medical services.

Specifically, plaintiff claims, without citing a specific instance, that over the course of her employment she observed spirometry tests performed incorrectly, performed with uneaiibrated instruments, repeatedly administered to patients when unnecessary, and often administered without subsequent interpretation of the test results. Likewise, plaintiff claims that defendants utilized MRIs to the exclusion of often more probative and less expensive x-ray or CT scans, administered MRIs excessively and unnecessarily, and often obtained MRIs of parts of patients’ bodies unrelated to the diagnosis and treatment of their ailments. Referring to one instance when an x-ray she ordered revealed a patient’s tumor, plaintiff notes that MRIs ordered by defendants, the last as recently as one month prior to her examination, had failed to discover the tumor.

Plaintiff also claims that defendants performed their MRI examinations at facilities operated by Intercounty MRI Imaging of Yonkers (“Intercounty”) and Tri-County Mobil MRI Imaging (“Tri-County”) primarily because Tri-County, a mobile MRI unit founded in part by defendants Straus and Ambinder, paid those defendants a $60,000/ *750 year consulting fee and Intercounty paid defendant Friedman for referring patients to it.

In September, 1991 plaintiff approached defendant Straus and informed him of the misuse of spirometry testing. Around the same time, plaintiff also presented an article to the defendants on the drawbacks of MRI testing of the respiratory system. Plaintiff claims that defendants treated her complaints with indifference and continued their \ improper use of spirometry and MRI tests. Subsequently, on December 16, 1991, plaintiff received written notice of the termination of her employment agreement. Although the notice cited her failure to maintain admitting privileges at Peekskill Hospital as required in the Agreement as the reason for her discharge, plaintiff claims that the discharge was in response to her complaints about defendants’ improper testing and fraudulent billing practices.

In 1992, plaintiff filed suit claiming that defendants are liable under the FCA, 31 U.S.C. § 3729, for submitting claims to the United States through the Medicare program for unwarranted and improperly administered spirometry and MRI tests, under 31 U.S.C. § 3730(h) and New York Labor Law § 740 for retaliatory discharge, and under New York Labor Law § 191 for unpaid wages for work that she performed after defendants terminated the Agreement. Defendants moved to dismiss for, among other things, failing to state a claim on which relief could be granted under Rule 12(b)(6), Fed. R.Civ.Pro., and for failing to meet the heightened pleading requirements for claims based on fraud under Rule 9(b), Fed.R.Civ.Pro. Judge Broderick granted defendants’ motion, but also granted plaintiff leave to amend her complaint to comply with Rule 9(b)’s requirements. Mikes I, 853 F.Supp. at 117.

Plaintiff then filed a First Amended Complaint further detailing the defendants’ fraudulent practices. That complaint, containing five claims for relief, charged defendants with knowingly presenting false claims to the government in violation of 31 U.S.C. § 3729(a)(1), using false records to facilitate payment of a fraudulent claim in violation of 31 U.S.C. § 3729(a)(2), conspiring to defraud the Government in violation of 31 U.S.C. § 3729(a)(3), discharging plaintiff in retaliation for preparing to file this action in violation of 31 U.S.C. § 3730(h), and failing to pay plaintiff wages for the two-week period that she worked after her termination in violation of New York Labor Law § 191(3).

Defendants again moved to dismiss the action under Rules 12(b)(6) and 9(b). In addition, they renewed a previously undis-posed motion to compel arbitration of all of plaintiffs claims pursuant to § 15 of her employment contract and to stay any remaining district court action pending arbitration.

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Bluebook (online)
889 F. Supp. 746, 10 I.E.R. Cas. (BNA) 1348, 1995 U.S. Dist. LEXIS 8627, 1995 WL 373668, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mikes-v-strauss-nysd-1995.