Morgan v. Azar

District Court, S.D. West Virginia·Decided April 24, 2020·No. 3:19-cv-00406·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA

HUNTINGTON DIVISION

BRETON L. MORGAN, M.D., INC. and BRETON L. MORGAN, M.D.,

Plaintiffs,

v. CIVIL ACTION NO. 3:19-0406

ALEX M. AZAR, Secretary of Department of Health and Human Services,

Defendant.

MEMORANDUM OPINION AND ORDER

Currently pending before the Court is a Motion for an Award of Attorney’s Fees and Costs filed by Plaintiffs Breton L. Morgan, M.D., Inc. and Breton L. Morgan. Mot. for Fees, ECF No. 23. Defendant Alex M. Azar timely filed a Response in Opposition, Resp. in Opp’n, ECF No. 26, and Plaintiffs did the same with their Reply, Reply. Br., ECF No. 30. The issues have been fully briefed and are ripe for resolution. For the reasons set forth below, the Court GRANTS IN PART and DENIES IN PART the Motion. I. RELEVANT BACKGROUND While a fuller picture of the factual setting of this case is available in this Court’s Memorandum Opinion and Order of January 16, 2020, certain essential facts are repeated here where they are relevant. See generally Morgan v. Azar, No. 3:19-0406, 2020 WL 257376 (S.D.W. Va. Jan. 16, 2020). The present motion stems from a years-long series of proceedings seeking the reinstatement of Plaintiffs’ Medicare billing privileges, which in turn stemmed from Dr. Morgan’s own felony conviction and Medicare exclusion in 2006. Id. at *1–3. Dr. Morgan reported the exclusion that stemmed from his felony conviction on the CMS-855I form he used to reapply for Medicare billing privileges, though he did not detail the underlying facts that led to his exclusion. Id. at *3. The regional Medicare Administrative Contractor—Palmetto GBA—approved his application, but reversed its position in 2016 when it apparently discovered his felony conviction. Id. While Palmetto GBA based its initial exclusion on commission of a felony and failing to report

the same, it later changed its position and argued that Morgan had supplied “false or misleading” information in his application. Id. In the wake of Palmetto GBA’s decision, Dr. Morgan proceeded through three layers of appeals. Each administrative decisionmaker ruled against him, reasoning that his failure to exclude explicit reference to his felony conviction constituted “false or misleading” information. Id. Following a final unfavorable agency decision by the Department of Health and Human Services Departmental Appeals Board (“DAB”), Plaintiffs appealed to this Court for review. Id. at *4. The Court determined that the question before it was “quite narrow: whether the ALJ’s conclusion that Morgan’s application was incomplete—and therefore ‘false or misleading’—[was] based on

substantial evidence, or represent[ed] an arbitrary and capricious decision in itself.” Id. at *6. The Court resolved the question in Plaintiffs’ favor, reasoning that “[a] thorough review of Plaintiffs’ application demonstrate[d] Morgan’s repeated disclosure of his exclusion from Medicare, along with his reinstatement letter.” Id. at *7. Consistent with this reasoning, the Court reversed Defendant’s final decision and ordered the immediate reinstatement of Plaintiffs’ Medicare enrollment and billing privileges. Id. The Court also ordered Defendant to “direct CMS to accept all billings for Plaintiffs’ Medicare patients from December 7, 2016 to the present for processing and payment.” Id. As a final matter, the Court held in abeyance “Plaintiffs’ request for costs and attorney’s fees pending submission of an application for those fees and any other expenses.” Id. It is to this open question that the Court now turns. II. LEGAL STANDARDS “In the United States, parties are ordinarily required to bear their own attorney’s fees—the prevailing party is not entitled to collect from the loser.” Buckhannon Bd. and Care Home, Inc. v.

W. Va. Dep’t of Health and Human Res., 532 U.S. 598, 602 (2001). Under this “American Rule,” courts follow a “general practice of not awarding fees to a prevailing party absent explicit statutory authority.” Key Tronic Corp. v. United States, 511 U.S. 809, 819 (1994). The Equal Access to Justice Act (“EAJA”) is represents just such statutory authority, and mandates that courts award attorneys’ fees and expenses to a prevailing party in an action by or against the United States “unless the court finds that the position of the United States was substantially justified or that special circumstances make an award unjust.” 28 U.S.C. § 2412(d)(1)(A). Success on a claim for fees therefore requires: (1) that the claimant be a “prevailing party”; (2) that the Government’s position was not “substantially justified”; (3) that no “special circumstances make an award unjust”; and, (4) pursuant to 28 U.S.C. § 2412(d)(1)(B), that any fee application be submitted to the court within 30 days of final judgment in the action and be supported by an itemized statement.

INS v. Jean, 496 U.S. 154, 158 (1990). “[T]he EAJA [also] authorizes fee awards for litigation before an agency that conducts adversary adjudications.” Pollgreen v. Morris, 911 F.2d 527, 532 (11th Cir.1990) (internal citations omitted). Though fees under the EAJA are capped at $125 per hour, the law also provides that a court may assess liability for attorney’s fees and expenses against the United States “to the same extent that any other party would be liable under the common law.” 28 U.S.C. § 2412(b). “Where the United States has litigated in bad faith, for example, it is subject to a common law attorney fee award based upon prevailing market rates.” Sullivan v. Sullivan, 958 F.2d 574, 577 n.8 (4th Cir. 1992). This “‘bad faith’ exception allows an award where the losing party has willfully disobeyed a court order or has acted in bad faith, vexatiously, wantonly, or for oppressive reasons.” Id. (quoting H.R. Rep. 1418, 96th Cong. 2d Sess. 8 (1980)). This is no easy showing to make, and requires actual “evidence that the government acted in bad faith.” Pet. of Duggan, 734 F. Supp.

705, 707 (D.S.C. 1990). With this statutory framework in mind, the Court now undertakes a review of Plaintiffs’ Motion. III. DISCUSSION Plaintiffs contend that they are entitled to fees and expenses under the common law and the EAJA. Defendant opposes both arguments. The Court will consider Plaintiffs’ contentions separately for the sake of analytical clarity. A. Common Law Fees and Expenses Plaintiffs’ first argument is that “Defendant has acted in a vexatious manner that would justify an award of the full amount of their reasonable attorney fees and costs,” Mot. for Fees, at 4, which they claim totals $122,063.74,1 Reply Br., at 4. As noted supra, the EAJA authorizes courts

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