Omni Healthcare Inc. v. North Brevard County Hospital District

CourtDistrict Court, M.D. Florida
DecidedSeptember 19, 2024
Docket6:22-cv-00696
StatusUnknown

This text of Omni Healthcare Inc. v. North Brevard County Hospital District (Omni Healthcare Inc. v. North Brevard County Hospital District) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Omni Healthcare Inc. v. North Brevard County Hospital District, (M.D. Fla. 2024).

Opinion

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA ORLANDO DIVISION

OMNI HEALTHCARE INC. and JOHN DOE,

Plaintiffs,

v. Case No: 6:22-cv-696-JSS-DCI

NORTH BREVARD COUNTY HOSPITAL DISTRICT, HALIFAX HOSPITAL MEDICAL CENTER, GEORGE MIKITARIAN, CHRISTOPHER MCALPINE, ANUAL JACKSON, SR., ERIC PEBURN, and JEFF FEASEL,

Defendants. ___________________________________/ ORDER Defendants move to dismiss the amended complaint as a shotgun pleading and for failure to state a claim. (Dkts. 56 & 57.) Plaintiff Omni Healthcare Inc. opposes the motions. (Dkt. 62.) Upon consideration, for the reasons outlined below, the court grants the motions in part and denies them in part. FACTUAL BACKGROUND1 Given the surplusage of information contained in the amended complaint, (see Dkt. 11), the court reports only the background necessary to explain this order.

1 The court accepts the well-pleaded factual allegations in the amended complaint as true and construes them in the light most favorable to Plaintiffs. See Harry v. Marchant, 291 F.3d 767, 769 (11th Cir. 2002) (en banc). Plaintiff Omni Healthcare Inc. is a corporation based in Brevard County, Florida, that operates as a “multi-specialty physician group.” (Id. ¶ 10.) Plaintiff John Doe, presumably a pseudonym, is an executive at Omni. (Id. ¶ 11.) Non-party Craig

Deligdish is Omni’s principal. (Id. ¶ 132.) Defendant North Brevard County Hospital District does business as Parrish Medical Center and is “an independent special taxing district” in Brevard County that operates a “community hospital, an affiliated medical group[,] and related support services.” (Id. ¶ 12.) From 2017 to 2021, Omni provided

management services to Parrish. (Id. ¶ 115.) Omni’s “duties included evaluating the medical needs of the community, communicating with employees and doctors[,] and recruiting physicians.” (Id.) Defendants George Mikitarian, Christopher McAlpine, and Anual Jackson, Sr. are executives at Parrish. (Id. ¶¶ 14–16.) Mikitarian is Parrish’s President and Chief

Executive Officer, McAlpine is Parrish’s Chief Transformation Officer and a Senior Vice President “responsible for strategic planning, business development[,] and strategy,” and Jackson is Parrish’s Chief Corporate Compliance and Privacy Officer. (Id.) The court refers to Parrish, Mikitarian, McAlpine, and Jackson collectively as the Parrish Defendants. Defendant Halifax Hospital Medical Center is “a

legislatively-chartered taxing healthcare organization governed by a Board of Commissioners appointed by the Governor of Florida.” (Id. ¶ 13.) Defendants Jeff Feasel and Eric Peburn are executives at Halifax. (Id. ¶¶ 17–18.) Feasel is Halifax’s President and Chief Executive Officer, and Peburn is Halifax’s Executive Vice President and Chief Financial Officer. (Id.) The court refers to Halifax, Feasel, and Peburn collectively as the Halifax Defendants. Florida’s Low-Income Pool (LIP) program “is used to pay [healthcare]

providers for the cost of care given to the most vulnerable patients.” (Id. ¶ 1.) See Op. Att’y Gen. Fla. 2009-06 (2009), 2009 Fla. AG LEXIS 7, *4 (“In 2006, the State of Florida established the Low-Income Pool (LIP) program as one of the components of a broad-ranging reform of the Florida Medicaid Program. The program is a joint federal-state program requiring funding from both federal and . . . non-federal

sources.”). The Coronavirus Aid, Relief, and Economic Security (CARES) Act aims to provide federal relief for persons negatively affected by the Covid-19 pandemic and prohibits “physician groups [from] receiv[ing] money from the [g]overnment for services that have already been covered by other C[ovid-19] relief programs.” (Dkt.

11 ¶ 1.) See CARES Act, Pub. L. No. 116-136, 134 Stat. 281 (2020). The Stark Act “makes it illegal for hospitals to compensate referring physicians based on the value and volume of referrals for designated health services.” (Dkt. 11 ¶ 1.) See Stark Act, 42 U.S.C. § 1395nn. Plaintiffs allege that Defendants “colluded to defraud the LIP program and the CARES Act[] and, in doing so, submitted false and/or fraudulent

claims for payment to the United States and the State of Florida.” (Dkt. 11 ¶ 2.) Plaintiffs further allege that Defendants violated the Stark Act by paying physicians “exorbitant salaries” “in exchange for referrals.” (Id. ¶¶ 2, 97.) When describing the violations of the Stark Act, Plaintiffs focus on Parrish’s alleged misconduct to the exclusion of Halifax’s. (See, e.g., id. ¶¶ 97–112.) According to Plaintiffs, Parrish’s “[e]xecutives knew [that] salaries were excessive” and that Parrish “would lose money on certain physician practices” as a result, but Parrish “justified” the salaries “by tracking downstream revenue in the form of physician referrals” and by noting “each

doctor’s contribution . . . to the bottom line.” (Id. ¶ 97.) Florida’s Agency for Health Care Administration (AHCA) handles the LIP program. (See id. ¶ 36.) See Low Income Pool (LIP) Program, Fla. Agency for Health Care Admin. (2024), https://ahca.myflorida.com/medicaid/medicaid-finance-and- analytics/medicaid-program-finance/lip-dsh-gme-operations/low-income-pool-lip-

program (last visited Sept. 17, 2024). “AHCA requires local government contributors to complete a LIP[-program] agreement that spells out their financial commitment, the [LIP-]program rules, the proper use of the aid, audit procedures[,] and record keeping.” (Dkt. 11 ¶ 35.) According to Plaintiffs, “AHCA has been repeatedly

criticized for failing to provide adequate oversight and guidance for the LIP program.” (Id. ¶ 36.) In November 2017, Halifax and Parrish executed an agreement regarding the reallocation of LIP-program funds. (See id. ¶¶ 45–46.) Plaintiffs allege that “[t]he agreement describe[d] the three-step process” that Halifax and Parrish “used to

manipulate the LIP program so Halifax would not have to repay $4 million.” (Id. ¶ 46.) In addition, the agreement allegedly provided that “Halifax w[ould] indemnify [Parrish] for any loss associated with the [reallocation] transaction.” (Id. ¶¶ 53–54.) “AHCA approved the [2017] reallocation.” (Id. ¶ 48.) “Two years later,” in December 2019, Parrish and Halifax executed another agreement, which laid out a similar reallocation and was allegedly “designed to manipulate” the LIP program further. (Id. ¶ 55.) According to Plaintiffs, through these agreements, “Parrish accepted kickbacks in exchange for circumventing” federal regulations even though

“questions [had been] raised internally” about the legality of the transactions. (Id. ¶ 58.) Plaintiffs state that “[c]orrespondence to the media, members of Parrish’s Board of Directors[,] and other community leaders describe[d] the arrangements between Parrish and Halifax” that purportedly “involved manipulation of LIP[-program] funds.” (Id. ¶ 134.)

Concerned that these arrangements violated the Federal False Claims Act, 31 U.S.C. §§ 3729–3733, Plaintiffs shared their concerns with Parrish’s “President, Chief Financial Officer[,] and Chief Compliance Officer” in March 2021, (Dkt. 11 ¶ 130), but “[t]he senior executives ignored [Plaintiffs’] concerns,” (id. ¶ 131). Plaintiffs

undertook “efforts to disclose substantial fraud by the hospital district against government programs,” (id. ¶ 137), and “made voluntary disclosures to the United States” sometime before they filed this lawsuit on February 1, 2022, (id. ¶ 8; see Dkt. 1 at 1).

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