Stewart v. Golden Victory Medical LLC

CourtDistrict Court, D. Minnesota
DecidedMarch 26, 2024
Docket0:22-cv-02145
StatusUnknown

This text of Stewart v. Golden Victory Medical LLC (Stewart v. Golden Victory Medical LLC) is published on Counsel Stack Legal Research, covering District Court, D. Minnesota primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stewart v. Golden Victory Medical LLC, (mnd 2024).

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA

Bryan Stewart, File No. 22-cv-2145 (ECT/LIB)

Plaintiff and Counter-Defendant,

v. OPINION AND ORDER

Golden Victory Medical LLC,

Defendant and Counter-Claimant.

________________________________________________________________________ Emma Denny, HKM Employment Attorneys, LLP, Minneapolis, MN, and Artur Davis, HKM Employment Attorneys, Birmingham, AL, for Plaintiff Bryan Stewart.

Defendant Golden Victory Medical LLC, pro se.

Plaintiff Bryan Stewart filed this lawsuit against Defendant Golden Victory Medical LLC alleging retaliation under the False Claims Act and breach of contract. After less than a year, Golden Victory’s counsel moved to withdraw. The motion was granted, but Magistrate Judge Brisbois ordered Golden Victory to retain new counsel within thirty days. Golden Victory has not retained new counsel or explained its failure to abide by that order. Because organizations are unable to represent themselves in court, Stewart requested, and received, an entry of default from the clerk’s office under Federal Rule of Civil Procedure 55(a). Stewart now moves for default judgment under Rule 55(b). The basic process for determining whether a default judgment should be entered is straightforward. (1) The entry of default means that “the factual allegations of the complaint, except those relating to the amount of damages, will be taken as true.” 10A C. Wright, A. Miller & M. Kane, Federal Practice and Procedure: Civil § 2688.1 (4th ed. & April 2023 Update) (footnotes omitted). (2) Next, it must be determined whether the taken-as-true factual allegations of the complaint “constitute a legitimate cause of action,

since a party in default does not admit mere conclusions of law.” Marshall v. Baggett, 616 F.3d 849, 852 (8th Cir. 2010) (quoting Murray v. Lene, 595 F.3d 868, 871 (8th Cir. 2010)). (3) If the taken-as-true allegations of the complaint constitute a legitimate cause of action, then the amount of the default judgment must be ascertained. See Hagen v. Sisseton-Wahpeton Cmty. Coll., 205 F.3d 1040, 1042 (8th Cir. 2000).

I Start with the factual allegations of Stewart’s Complaint that will be taken as true. Golden Victory is a “privately held Nevada-based limited liability company that operates five clinics in four states” and specializes in mental-health services. Compl. [ECF No. 1] ¶ 7. The co-owners of Golden Victory are Gabriel Luthor and Elizabeth Brown. Id. ¶ 8.

Approximately 65% of Golden Victory’s patients are Medicare or Medicaid beneficiaries. Id. ¶ 11. The Centers for Medicare & Medicaid Services (“CMS”) provides “detailed criteria for the reimbursement of providers for services covered by Medicare and Medicaid.” Id. ¶ 12. In November 2021, Stewart entered into an Employment Agreement (the

“Agreement”) with Golden Victory. See ECF No. 1-1. Stewart, a nationally recognized expert in the field of health services management, was hired as the first Chief Executive Officer of Golden Victory. Compl. ¶¶ 9–10. After starting as Golden Victory’s CEO, Stewart quickly recognized flaws in the coding and billing processes at the organization’s clinics. Id. ¶ 20. In February 2022, he authorized Golden Victory’s general counsel to hire an independent third party to conduct a systematic audit of the organization’s coding and billing processes. Id. ¶ 21. Shortly thereafter, Stewart learned that one of Golden Victory’s

clinics “had been notified in December 2021 by Medicare that the agency was suspending payments to the clinic due to evidence of overbilling.” Id. ¶ 22. Payments to the clinic were placed in escrow pending an inquiry by the CMS and Internal Revenue Service (“IRS”). Id. Luthor, Brown, and their personal attorneys had engaged with the government agencies for three months without informing Stewart about the inquiries. Id. ¶ 23.

On April 28, 2022, the third-party auditor presented an executive summary of the audit’s results to Stewart. Id. ¶ 24. The audit found sweeping errors, including: “coding and billing accuracy levels . . . in the 32.44% range, in comparison with an industry gold standard of 95%,” id. ¶ 25, inadequate documentation to support coding assignments, “frequent errors in the coding process for neurofeedback, and incorrect documentation of

time increments,” id. ¶ 26. The report also found clinics incorrectly coded nonphysician-provider services as physician services (allowing for a higher reimbursement rate), and misused the “incident-to” standard, a rule that allows nonphysician providers to bill at a higher rate when the initial patient visit is performed by a supervising physician, id. ¶¶ 13–16, 26.

Stewart recognized that these errors put Golden Victory at risk of civil and criminal liability, “and strongly communicated these risks in [a] May 4 virtual call with the ownership.” Id. ¶ 27. He proposed an “aggressive remediation strategy, including a potential pause in billing activity until immediate corrective action could be put in place.” Id. ¶ 28. “Luthor and Brown stunned Stewart with their lack of concern.” Id. ¶ 29. The owners claimed a prior audit contradicted the independent auditor’s findings, “but they declined to identify the auditor or share the findings.” Id. The owners also “rejected the

idea of a billing pause as too costly.” Id. Undeterred, Stewart developed a “comprehensive strategy” to mitigate the compliance issues. Id. ¶ 30. He directed the executive leadership team to draft a remediation plan and gave clinical staff a companywide briefing in a conference call on May 9. Id. ¶ 30. Stewart formally recommended to Luthor and Brown that Golden Victory

terminate its relationship with its third-party billing company, but Luthor rejected this idea. Id. ¶ 31. While Stewart sought to mitigate the widespread billing irregularities, Golden Victory’s director of operations reported Stewart’s remediation efforts to Luthor and Brown. Id. ¶ 33. On a June 1, 2022 Zoom call, Brown told Stewart that he was being

terminated immediately, citing allegations of “racism and sexism” and claiming Stewart had falsified timekeeping records. Id. ¶ 34; see also ECF No. 58-1 at 33.1 Though the Complaint is not explicit on the point, Stewart made clear during his evidentiary-hearing testimony that he denies the allegations of racism and sexism leveled against him. ECF No. 58-1 at 34–35, 44, 52. Golden Victory did not follow its personnel handbook for

investigating employee allegations, interview Stewart, or gather any evidence from him. Compl. ¶ 35. Stewart was not given an opportunity to respond to these claims, which the

1 Page cites are to CM/ECF pagination appearing in a document’s upper right corner, not to a document’s original pagination. owners presented to him “for the first time on the day of his termination.” Id. ¶ 36. After Stewart’s termination, Golden Victory abruptly halted the remediation process Stewart had launched to curb coding and billing irregularities. Id. ¶ 41.

Despite terminating Stewart over Zoom without prior notice, a written notice of termination purported to invoke § 14(a) of the Agreement, which provides for separation by mutual written agreement. Id. ¶ 37. Under the Agreement, Golden Victory could terminate Stewart without cause “provided the Company continue[d] to make [base salary] payments for six (6) or twelve (12) months respectively from the date of notice pursuant to

this Section.” ECF No. 1-1 § 14(c)(ii).

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