Schmuckley v. Rite Aid Corporation

District Court, E.D. California·Decided January 15, 2020·No. 2:12-cv-01699·Unknown

Opinion

UNITED STATES OF AMERICA, and the No. 2:12-cv-1699-KJM-EFB STATE OF CALIFORNIA, et al., ex rel Plaintiffs, v. Defendant. In this qui tam action, Relator Lloyd F. Schmuckley, Jr. and the State of California (“plaintiffs”) move to strike defendant’s affirmative defenses under Federal Rule of Civil Procedure 12(f). Defendant opposes. For the below reasons, plaintiffs’ motion is GRANTED in part and DENIED in part. Under the False Claims Act (FCA), a private individual can bring an action known as a qui tam action on behalf of the United States government against any individual or company who has knowingly presented a false or fraudulent claim to the government. United States ex rel. Anderson v. Northern Telecom, 52 F.3d 810, 812–13 (9th Cir. 1995). Here, relator Loyd F. Schmuckley alleges Rite Aid has submitted false claims for reimbursement in prescribing “Code 1” drugs, which may not be reimbursed unless certain requirements are met. First Am. Compl. (FAC) ¶¶ 3, 21, ECF No. 79. Specifically, these Code 1 drugs have restrictions based on patient age or diagnosis that must be met before the appropriate government entity, here Medi-Cal, will reimburse for prescriptions for that medication. Id. ¶ 23. According to Schmuckley, “California regulations explicitly state that the pharmacist must have documentation of the patient’s diagnosis, in order for Medi-Cal to reimburse the prescription.” Id. ¶ 24. California intervened in this case on claims under the California FCA (CFCA) and filed its Complaint-In-Intervention, alleging Rite Aid failed to comply with “Code 1 restrictions.” Complaint-In-Intervention (CII) ¶ 4, ECF No. 75. More specifically, California alleges that “[f]rom 2007 to 2014, [Rite Aid] knowingly submitted false pharmacy claims to Medi-Cal and expressly and impliedly made false certifications through the Medi-Cal electronic claims submission and reimbursement process.” Id. ¶ 6. Defendant filed a First Amended Answer to Relator’s First Amended Complaint (“Relator Answer”), ECF No. 146, and a First Amended Answer to California’s Complaint-In- Intervention (“State Answer”), ECF No. 147. Plaintiffs jointly moved to strike all affirmative defenses under Rule 12(f). Mot., ECF No. 158. Defendant opposed, ECF No. 173, and plaintiffs replied, ECF No. 186. The court heard oral argument on the motion on January 25, 2019, and issued a bench order granting plaintiffs’ motion to strike the following affirmative defenses (numbered according to defendant’s Answer to Relator’s Complaint): 5th (good faith), 7th (no treble damages), 8th (no attorney’s fees), 10th (denial of actual injury), 13th (compliance with industry standards), and 14th (not willful or knowledgeable). See ECF No. 187. In a joint statement submitted after hearing, the parties asked the court to allow them until July 15, 2019 to meet and confer and prepare a stipulation regarding the 11th affirmative defense in defendant’s Answer to Relator’s Complaint. ECF No. 188. The court later extended this deadline to February 28, 2020. ECF No. 260. Because the parties are still attempting to agree on this issue, the court declines to resolve it in this order, but instead resolves the remainder of the issues raised in plaintiffs’ motion and not addressed at hearing, below. //// The court may strike “from a pleading an insufficient defense or any redundant, immaterial, impertinent or scandalous matter.” Fed. R. Civ. P. 12(f). “A defense may be insufficient as a matter of pleading or as a matter of law.” Cal. Brewing Co. v. 3 Daughters Brewing LLC, No. 2:15-cv-02278-KJM-CMK, 2016 WL 4001133, at *1 (E.D. Cal. Jul. 26, 2016) (citation omitted). A. Affirmative Defenses Generally “[A]n affirmative defense, under the meaning of Federal Rule of Civil Procedure 8(c), is a defense that does not negate the elements of the plaintiff’s claim, but instead precludes liability even if all of the elements of the plaintiff’s claim are proven.” Barnes v. AT & T Pension Ben. Plan–Nonbargained Program, 718 F. Supp. 2d 1167, 1173 (N.D. Cal. 2010) (citation omitted). “It is a defense on which the defendant has the burden of proof.” Id. at 1174. On the other hand, “[a] defense which demonstrates that plaintiff has not met its burden of proof is not an affirmative defense,” but a negative defense. Zivkovic v. S. California Edison Co., 302 F.3d 1080, 1088 (9th Cir. 2002) (citation omitted). While courts rarely grant Rule 12(f) motions to strike affirmative defenses, if an affirmative defense is, in actuality, a negative defense and should instead be included as a denial in the answer, the motion to strike will be granted. See Barnes, 718 F. Supp. 2d at 1173–1174.1 B. Insufficiency as a Matter of Pleading Consistent with the nomenclature, a party must affirmatively state its affirmative defenses. Fed. R. Civ. P. 8(c)(1). Generally, the pleading standard is met if the affirmative defense provides “fair notice.” Wyshak v. City Nat’l Bank, 607 F.2d 824, 827 (9th Cir. 1979)

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