State ex rel. Balderas v. Bristol-Myers Squibb
This text of 436 P.3d 724 (State ex rel. Balderas v. Bristol-Myers Squibb) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
Opinion
VANZI, Chief Judge.
*726 {1} In this interlocutory appeal, we consider whether a federal district court's dismissal of qui tam claims for failure to state a claim bars the State from pursuing different claims arising from similar facts, where the State had not intervened in the qui tam action. We conclude that it does not and, therefore, affirm the denial of Defendants' motion to dismiss.
BACKGROUND
Qui Tam Actions
{2} In order to situate the facts leading to this appeal, we begin with an overview of qui tam actions generally and the relevant statutes that establish and govern them. "In a 'qui tam action,' a private plaintiff, ... known as a 'relator,' brings suit on behalf of the government to recover a remedy for a harm done to the government." 36 Am. Jur. 2d
Forfeitures and Penalties
§ 83 (2018) (footnotes omitted). "He or she pursues the government's claim against the defendant and asserts the injury in fact suffered by the government, which confers standing on the relator to bring the action as a representative of the [s]tate and as a partial assignee of the government's claim."
Id.
(footnotes omitted). A qui tam action arises only by statute, specifically authorizing a private party to sue on behalf of the government.
Id.
The federal False Claims Act (FCA) and state laws similar to it are typical qui tam statutes.
See
United Seniors Ass'n v. Philip Morris USA
,
The FCA and the New Mexico Medicaid False Claims Act
{3} "The [FCA] prohibits false or fraudulent claims for payment to the United States, and authorizes civil actions to remedy such fraud to be brought by the Attorney General or by private individuals in the government's name." 32 Am. Jur. 2d
False Pretenses
§ 85 (2018) ;
{4} Similarly, the New Mexico Medicaid False Claims Act (MFCA), NMSA 1978, §§ 27-14-1 to -15 (2004), provides for liability where a person presents "a claim for payment under the medicaid program knowing that such claim is false" or otherwise defrauds the state through the state medicaid program. Section 27-14-4. Like the FCA, the MFCA requires the Human Services Department (HSD) to investigate suspected violations and permits HSD to bring a civil action. Section 27-14-7(A). In addition, the MFCA contains a qui tam provision that permits "[a] private civil action [to] be brought by an affected person for a violation of the [MFCA] on behalf of the person bringing suit and for the state." Section 27-14-7(B).
{5} Both the FCA and MFCA require a relator to provide a copy of the complaint and written disclosure of material evidence possessed by the relator to the government so that the government may determine whether there is substantial evidence that a violation has occurred.
{6} The FCA and MFCA differ in that, under the MFCA, the relator may continue the action only "[i]f the department determined that there is substantial evidence that a violation of the [MFCA] has occurred" and that "[i]f the department determines that there is not substantial evidence that a violation has occurred, the complaint shall be dismissed." Section 27-14-7(C), (E)(2).
The First Suit: In re Plavix Marketing, Sales Practice & Products Liability Litigation
{7} The first suit at issue was initiated in March 2011 by relator Elisa Dickson (Relator), who filed a complaint alleging that Bristol-Myers Squibb Company, Sanofi-Aventis U.S., LLC; Sanofi-Aventis U.S., Inc.; and Sanofi-Synthelabo, Inc., (Defendants), manufacturers and marketers of the prescription drug Plavix, promoted Plavix in violation of the FCA and various states' similar fraud statutes, including New Mexico's MFCA. See In re Plavix Mktg., Sales Practice & Prods. Liab. Litig. (No. II) v.
Free access — add to your briefcase to read the full text and ask questions with AI
VANZI, Chief Judge.
*726 {1} In this interlocutory appeal, we consider whether a federal district court's dismissal of qui tam claims for failure to state a claim bars the State from pursuing different claims arising from similar facts, where the State had not intervened in the qui tam action. We conclude that it does not and, therefore, affirm the denial of Defendants' motion to dismiss.
BACKGROUND
Qui Tam Actions
{2} In order to situate the facts leading to this appeal, we begin with an overview of qui tam actions generally and the relevant statutes that establish and govern them. "In a 'qui tam action,' a private plaintiff, ... known as a 'relator,' brings suit on behalf of the government to recover a remedy for a harm done to the government." 36 Am. Jur. 2d
Forfeitures and Penalties
§ 83 (2018) (footnotes omitted). "He or she pursues the government's claim against the defendant and asserts the injury in fact suffered by the government, which confers standing on the relator to bring the action as a representative of the [s]tate and as a partial assignee of the government's claim."
Id.
(footnotes omitted). A qui tam action arises only by statute, specifically authorizing a private party to sue on behalf of the government.
Id.
The federal False Claims Act (FCA) and state laws similar to it are typical qui tam statutes.
See
United Seniors Ass'n v. Philip Morris USA
,
The FCA and the New Mexico Medicaid False Claims Act
{3} "The [FCA] prohibits false or fraudulent claims for payment to the United States, and authorizes civil actions to remedy such fraud to be brought by the Attorney General or by private individuals in the government's name." 32 Am. Jur. 2d
False Pretenses
§ 85 (2018) ;
{4} Similarly, the New Mexico Medicaid False Claims Act (MFCA), NMSA 1978, §§ 27-14-1 to -15 (2004), provides for liability where a person presents "a claim for payment under the medicaid program knowing that such claim is false" or otherwise defrauds the state through the state medicaid program. Section 27-14-4. Like the FCA, the MFCA requires the Human Services Department (HSD) to investigate suspected violations and permits HSD to bring a civil action. Section 27-14-7(A). In addition, the MFCA contains a qui tam provision that permits "[a] private civil action [to] be brought by an affected person for a violation of the [MFCA] on behalf of the person bringing suit and for the state." Section 27-14-7(B).
{5} Both the FCA and MFCA require a relator to provide a copy of the complaint and written disclosure of material evidence possessed by the relator to the government so that the government may determine whether there is substantial evidence that a violation has occurred.
{6} The FCA and MFCA differ in that, under the MFCA, the relator may continue the action only "[i]f the department determined that there is substantial evidence that a violation of the [MFCA] has occurred" and that "[i]f the department determines that there is not substantial evidence that a violation has occurred, the complaint shall be dismissed." Section 27-14-7(C), (E)(2).
The First Suit: In re Plavix Marketing, Sales Practice & Products Liability Litigation
{7} The first suit at issue was initiated in March 2011 by relator Elisa Dickson (Relator), who filed a complaint alleging that Bristol-Myers Squibb Company, Sanofi-Aventis U.S., LLC; Sanofi-Aventis U.S., Inc.; and Sanofi-Synthelabo, Inc., (Defendants), manufacturers and marketers of the prescription drug Plavix, promoted Plavix in violation of the FCA and various states' similar fraud statutes, including New Mexico's MFCA.
See
In re Plavix Mktg., Sales Practice & Prods. Liab. Litig. (No. II) v. Bristol-Myers Squibb Co.
,
{8} Relator filed several amended complaints.
The Second Suit: State of New Mexico ex rel. Hector Balderas, Attorney General v. Bristol-Myers Squibb, et al .
{9} Shortly after Relator filed the fourth amended complaint in In re Plavix Marketing , but before its final dismissal, the New Mexico Attorney General (the State) brought the present action in the First Judicial District Court. The complaint alleges that "Defendants' false, deceptive, and unfair labeling and promotion of their prescription antiplatelet drug Plavix" violated the New Mexico Unfair Practices Act (UPA), NMSA 1978, §§ 57-12-1 to -26 (1967, as amended through 2009); the New Mexico Medicaid Fraud Act (MFA), NMSA 1978, §§ 30-44-1 to - 8 (1989, as amended through 2004); and the New Mexico Fraud Against Taxpayers Act (FATA), NMSA 1978, §§ 44-9-1 to -14 (2007, as amended through 2015), as well as common law and equitable causes of action. The complaint did not allege violations of the MFCA.
{10} Defendants moved to dismiss the State's complaint, arguing that the State had failed to state its claims. They also maintained that the suit should be dismissed without prejudice or stayed pending resolution of the In re Plavix Marketing action and that the State was inappropriately splitting its claims. Without ruling on the substantive arguments in the motion, the state district *728 court stayed the action pending the outcome of Defendants' motion to dismiss in In re Plavix Marketing . Once the federal district court dismissed Relator's fourth amended complaint, the state district court lifted the stay and ordered supplemental briefing on the impact of the dismissal of Relator's claims on the State's complaint and Defendants' motion to dismiss. In supplemental briefing, Defendants argued that the doctrine of claim preclusion bars the State's complaint. They also argued that, even if claim preclusion did not bar the State's claims in their entirety, the claims based on the MFA and FATA should be dismissed for failure to state a claim for the same reasons relied on by the federal district court.
{11} The state district court granted in part and denied in part Defendants' motion to dismiss for failure to state a claim. It found that the State's MFA claim failed as a matter of law and that the economic loss doctrine barred the State's negligence claim. It therefore dismissed those claims with prejudice. It found that the State had inadequately pleaded the UPA and equitable tolling claims but dismissed those claims without prejudice and ordered the State to file an amended complaint if it chose to rectify the deficiencies in the first complaint. The court found the remaining claims adequately pleaded. The State then filed its first amended complaint, which includes claims for violations of the UPA and FATA, as well as common law claims for fraud and unjust enrichment.
{12} In a separate order, the state district court denied Defendants' motion to dismiss the State's complaint on claim preclusion grounds. Although it stated that Relator's claims had been dismissed "with prejudice," it found that "[claim preclusion] does not apply here because the causes of action are not the same in the two suits" and that "[R]elator in [ In re Plavix Marketing ] did not assert any of the claims the State asserts in this case, but rather only a single New Mexico [MFCA] claim." It also stated that "while [R]elator ... stood in the shoes of the State of New Mexico for purposes of the New Mexico [MFCA] claim, [R]elator did not stand in the State's shoes for purposes of the claims asserted by the State here." Finally, the state district court concluded that "in a case such as this, where [R]elator's claims were dismissed based on a failure to comply with the heightened pleading requirements of [Federal Rule of Civil Procedure] 9(b), and not based on the merits of the claim, it would be inappropriate to bar the State's claims."
{13} However, the state district court also found that "[r]egarding the application of [claim preclusion] only," its order "(1) does not practically dispose of the merits of the action, (2) involves a controlling question of law as to which there is substantial ground for difference of opinion, and (3) an immediate appeal from this order or decision may materially advance the ultimate termination of the litigation." See NMSA 1978, § 39-3-4(A), (B) (1999) (providing for interlocutory appeal of district court orders pursuant to this Court's appellate jurisdiction). It therefore certified for interlocutory appeal the portion of the order pertaining to application of claim preclusion. This Court granted Defendants' application for interlocutory appeal. See Rule 12-203 NMRA (governing interlocutory appeals).
DISCUSSION
{14} The issue before the Court is whether the federal court's dismissal of Relator's MFCA claim precludes the State's claims for violations of the UPA and FATA, as well as common law fraud and unjust enrichment. We review such questions of law de novo.
Bank of N.Y. v. Romero
,
*729 General Claim Preclusion Law
{15} "[Claim preclusion] prevents a party or its privies from repeatedly suing another party for the same cause of action when the first suit involving the parties resulted in a final judgment on the merits."
Rosette, Inc. v. U.S. Dep't of the Interior
,
{16} For claim preclusion to apply, the first suit must have ended in a "judgment on the merits."
Rosette, Inc.
,
Defendants' Arguments
{17} Defendants contend that the elements of claim preclusion are met here. Defendants argue that the
In re Plavix Marketing
dismissal was "on the merits" because Relator either failed to plead the requisite materiality under
Universal Health Services, Inc. v. United States ex rel. Escobar
, --- U.S. ----,
Claim Preclusion in the Context of Qui Tam Actions
{18} We first observe that, as a general proposition, "[i]f [the relator] had litigated a qui tam action to the gills and lost, neither another relator nor the [government] could start afresh."
United States ex rel. Lusby v. Rolls-Royce Corp.
,
{19} However, courts have also recognized that, under certain circumstances, the government's role in vindicating public interests militates against preclusion of its claims.
Cf.
Nathan D. Sturycz,
The King and I?: An Examination of the Interest Qui Tam Relators Represent and the Implications for Future False Claims Act Litigation
,
{20} For example, federal courts have relied on the fact that a Rule 12(b)(6) dismissal is based only on the relator's complaint, not the factual bases underlying the allegations, to hold that such a dismissal does not preclude the government's claims when the government has not intervened.
See, e.g.
,
United States ex rel. Williams v. Bell Helicopter Textron, Inc.
,
{21} In
Williams
, the district court dismissed the relator's FCA claims because the relator failed to plead them with sufficient particularity under Rules 12(b)(6) and (9)(b).
Williams
,
{22} The United States Court of Appeals for the Fifth Circuit reversed and modified the dismissal to be without prejudice as to the government.
*731
{23} The
Williams
court then noted that a dismissal with prejudice as to the government would give private parties "perverse incentives" to file poorly drafted or improperly pleaded qui tam actions.
{24} Without deciding the preclusive effect of a Rule 12(b)(6) dismissal on future related actions, but relying on
Williams
, the Eleventh Circuit also modified a district court's dismissal for failure to state a claim to be without prejudice to the government.
Urquilla-Diaz v. Kaplan Univ.
,
{25} Similarly, courts have dismissed a complaint with prejudice to the relator, but without prejudice to the government, where the relator failed to prosecute or acted improperly in litigation.
See, e.g.
,
United States ex. rel. Prince v. Va. Res.Auth.
,
{26} Although distinguishable on its facts,
*732
State ex rel. Peterson v. Aramark Correctional Services, LLC
,
{27} Defendants argue that the
Williams
holding is inapposite for three reasons. Defendants first argue that the United States Supreme Court's decision in
Eisenstein
supersedes
Williams
. Defendants rely on the statement in
Eisenstein
that "the [government] is bound by the judgment in all FCA actions regardless of its participation in the case."
{28} In addition, the statement relied on by Defendants was a statement of the appellant's argument, not a statement of law by the Court.
See
Eisenstein
,
{29} Defendants next argue that the policy considerations in Williams are inapposite because the MFCA "required New Mexico to determine whether there was substantial evidence of a violation ... and to dismiss the claim if none existed." They argue that this "obligation means that no qui tam complaint brought under the [MFCA] should ever receive the State's approval to proceed if, like the [ Williams ] complaint, it is so facially deficient that it lacks substantial evidentiary support." It is true that Section 27-14-7 requires that, when a claim is supported by substantial evidence, the state must either pursue the claim or permit the relator to pursue it. See § 27-14-7(E) (providing that if there is substantial evidence, the state " shall :
*733
(1) proceed with the action, in which case the action shall be conducted by the department; or (2) notify the court and the person who brought the action that it declines to take over the action" (emphasis added) ). However, Defendants' argument conflates a determination of evidence supporting a claim with a determination of the adequacy of the relator's complaint. The state is required to determine only whether "there is substantial evidence that a violation has occurred," not whether the relator's complaint adequately alleges a violation. Section 27-14-7(C);
see
Wallis
,
{30} Finally, Defendants contend that
Williams
is factually distinguishable from the circumstances here. They argue that in
Williams
, the qui tam complaint was dismissed because it was "so deficient [under Rule 9(b) ] that the court never reached the merits of the claim[,]"
Williams
,
{31} We do not read
Williams
as narrowly as Defendants. The
Williams
holding was not limited to the Rule 9(b) pleading standard. Instead, the core of the
Williams
holding is the failure to adequately plead an FCA claim under Rule 12(b)(6), regardless of the standard applied.
See
Williams
,
*734 Dismissal of Relator's Qui Tam Action Does Not Bar the State's Claims
{32} The dismissal order in
In re Plavix Marketing
does not specify whether it is with or without prejudice to Relator or the government.
In re Plavix Mktg.
,
{33} However, for the reasons stated in
Williams
and its progeny, we construe the order as without prejudice to the government.
Cf.
Bralley
,
CONCLUSION
{34} Consistent with federal FCA and claim preclusion law, we construe the In re Plavix Marketing dismissal as without prejudice to the State's claims, and, therefore, hold that the dismissal does not bar the State's present claims under the UPA and FATA, as well as common law claims for fraud and unjust enrichment. Accordingly, we affirm the state district court's denial of Defendants' motion to dismiss.
{35} IT IS SO ORDERED.
WE CONCUR:
J. MILES HANISEE, Judge
JULIE J. VARGAS, Judge
Relator filed the initial complaint in Illinois, but the suit was transferred to the United States District Court for the District of New Jersey to be part of the Plavix Multi-District Litigation.
Id.
at *2,
"Because the language of Rule 1-012 [NMRA ] closely parallels that of its federal counterpart, Rule 12 of the Federal Rules of Civil Procedure, we find federal authority interpreting Rule 12... instructive."
Doe v. Roman Catholic Diocese of Boise, Inc.
,
Notably, although it was unnecessary for the Peterson Court to discuss this fact under the circumstances of that case, "the district court granted [the defendant's] motion for summary judgment, and dismissed, with prejudice, all claims brought on behalf of [the qui tam p]laintiff, stating, however, that its order did not prejudice the [s]tate's ability to bring a related action based on the same facts." Id. ¶ 20.
Related
Cite This Page — Counsel Stack
436 P.3d 724, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-balderas-v-bristol-myers-squibb-nmctapp-2018.