Pack v. Hickey

CourtCourt of Appeals for the Tenth Circuit
DecidedJune 11, 2019
Docket18-8035
StatusUnpublished

This text of Pack v. Hickey (Pack v. Hickey) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Pack v. Hickey, (10th Cir. 2019).

Opinion

FILED United States Court of Appeals UNITED STATES COURT OF APPEALS Tenth Circuit

FOR THE TENTH CIRCUIT June 11, 2019 _________________________________ Elisabeth A. Shumaker Clerk of Court ROY PACK,

Plaintiff - Appellant,

v. No. 18-8035 (D.C. No. 1:15-CV-00185-NDF) MAUREEN HICKEY; CLOUDPEAK (D. Wyo.) INITIATIVES, INC.,

Defendants - Appellees. _________________________________

ORDER AND JUDGMENT* _________________________________

Before BRISCOE, BALDOCK, and BACHARACH, Circuit Judges. _________________________________

Plaintiff Roy Pack appeals the district court’s grant of summary judgment and

related orders in favor of Defendants Maureen Hickey and Cloud Peak Initiatives,

Inc. on Pack’s claims under the False Claims Act (FCA), 31 U.S.C. §§ 3729-3733.

Exercising jurisdiction under 28 U.S.C. § 1291,1 we affirm.

* After examining the briefs and appellate record, this panel has determined unanimously to honor the parties’ request for a decision on the briefs without oral argument. See Fed. R. App. P. 34(f); 10th Cir. R. 34.1(G). The case is therefore submitted without oral argument. This order and judgment is not binding precedent, except under the doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1. 1 We initially questioned whether we had appellate jurisdiction. Specifically, after dismissing one of Defendants’ counterclaims with prejudice and granting summary judgment in favor of Defendants, the district court, following a stipulation by the parties, dismissed Defendants’ remaining counterclaims without prejudice. As I. Background

In 2002, Pack founded Cloud Peak, a private mental health services facility in

Sheridan, Wyoming. Pack and Hickey, who were in a romantic relationship,

incorporated Cloud Peak in 2005, and for the next eight years, Hickey served as

Cloud Peak’s President, owner, and sole shareholder and Pack as its CEO. In

February 2013, Hickey terminated Pack’s employment as well as their romantic

relationship and assumed control over property that Pack asserted was either his

personal property or joint property. In response, Pack remotely seized control of

Cloud Peak’s electronic records system, prompting Cloud Peak to seek and obtain an

injunction against Pack.

While Pack and Hickey traded volleys in state court, including in a child

custody action, Pack contacted Wyoming state regulatory authorities and alleged

Hickey and Cloud Peak engaged in Medicaid fraud. After investigating the

allegation, the Medicaid Fraud Control Unit of the Wyoming Attorney General’s

Office elected not to pursue criminal charges but referred the matter to Wyoming

Medicaid for possible administration action. Wyoming Medicaid initially penalized

such, when Pack filed his notice of appeal following the denial of his motion for reconsideration and the granting of Defendants’ motion for attorneys’ fees, there was not a final judgment. See Heimann v. Snead, 133 F.3d 767, 769 (10th Cir. 1998). In response to this court’s jurisdictional inquiry, Pack filed a motion in the district court seeking certification of a partial final judgment. See Fed. R. App. P. 54(b). The district court granted the motion, and accordingly, we have jurisdiction. See Lewis v. B.F. Goodrich Co., 850 F.2d 641, 645 (10th Cir. 1988) (“[I]f the appellant obtains a 54(b) certification after the notice of appeal was filed, we will deem the notice of appeal to ripen as of the date of certification and will accept the jurisdiction[.]”). 2 Cloud Peak $349,893.11 for lack of adequate documentation and failing to respond to

records requests. After Cloud Peak produced additional records, Wyoming Medicaid

reduced the penalty to $71,705.97, and Cloud Peak paid the penalty.

Thereafter, in October 2015, Pack initiated this FCA qui tam action2 against

Defendants. Pack alleged that Hickey was the sole person responsible for reviewing

and submitting bills to Medicaid and that she committed Medicaid fraud based upon

three types of false billing.

First, Pack alleged Defendants billed a skills group as a therapy group.

Specifically, Pack alleged that after David Peterson, a licensed therapist who

supervised a therapy group, left Cloud Peak in September 2011, Hickey instructed

Cloud Peak staff to continue that same group with Ryan Legler as its leader, even

though Legler was not a licensed therapist. Pack alleged this treatment was billed as

if Galin McGowan, a licensed therapist and clinical director for Cloud Peak, was

supervising the group. Pack alleged Legler drafted the treatment notes and emailed

them to McGowan, with McGowan then entering the notes into the electronic records

system as though he wrote them. Pack further alleged McGowan never attended the

sessions, including those held on Fridays, which all treating staff had off from work.

2 “Qui tam is short for ‘qui tam pro domino rege quam pro se ipso in hac parte sequitur,’ which means ‘who pursues this action on our Lord the King’s behalf as well as his own.’” Rockwell Int’l Corp. v. United States, 549 U.S. 457, 463 n.2 (2007). Under the FCA, either the government may initiate the action itself or, as in this case, a private party, known as a relator, may bring a qui tam suit in the government’s name. United States ex rel. Barrick v. Parker-Migliorini Int’l, LLC, 878 F.3d 1224, 1226 (10th Cir. 2017), cert. denied, 139 S. Ct. 78 (2018). Relators may receive 25 to 30 percent of a recovery. See 31 U.S.C. § 3730(d). 3 Pack, thus, alleged Legler effectively led a skills group, although Hickey billed it as a

therapy group, thereby commanding a higher reimbursement rate.

Next, Pack alleged Defendants improperly billed group therapy sessions as

individual therapy sessions. Specifically, Pack alleged that Hickey billed a group

session conducted by therapist Roderick Foley as though Foley was conducting

individual sessions for each of the group participants, thereby inflating the Medicaid

reimbursement amount.

Finally, Pack alleged Defendants improperly billed for direct targeted case

management services without documentation of medical necessity, insisting Hickey

often would be seen leaving clients’ residences at the same time the assigned case

manager was arriving to provide those services.

II. Discussion

On appeal, Pack contends the district court erred by: (1) refusing to grant his

discovery request to copy Cloud Peak’s electronic records; (2) striking portions of his

affidavit; (3) granting summary judgment for Defendants; (4) denying his motion for

reconsideration; and (5) awarding attorneys’ fees to Defendants.

A. Discovery Order

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