United States Ex Rel. Fox v. Northwest Nephrology Associates

87 F. Supp. 2d 1103, 2000 U.S. Dist. LEXIS 3183, 2000 WL 282468
CourtDistrict Court, E.D. Washington
DecidedFebruary 15, 2000
DocketCS-95-0274-AAM
StatusPublished
Cited by5 cases

This text of 87 F. Supp. 2d 1103 (United States Ex Rel. Fox v. Northwest Nephrology Associates) is published on Counsel Stack Legal Research, covering District Court, E.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States Ex Rel. Fox v. Northwest Nephrology Associates, 87 F. Supp. 2d 1103, 2000 U.S. Dist. LEXIS 3183, 2000 WL 282468 (E.D. Wash. 2000).

Opinion

ORDER RE RELATOR’S MOTION FOR ORDER RE: PERCENTAGE SHARE OF PROCEEDS AND PAYMENT TERMS

McDONALD, Senior District Judge.

BEFORE THE COURT is the Relator’s Motion For Order Re: Percentage Share Of Proceeds And Payment Terms (Ct.Rec.74).

I. BACKGROUND

On July 25, 1995, Stephen D. Fox, M.D., filed under seal a complaint pursuant to the False Claims Act (FCA), 31 U.S.C. § 3729-33. (Ct.Rec.3). The complaint alleged Medicare/Medicaid fraud by defendants Northwest Nephrology Associates, Mark R. Frazier, M.D., Mary Anne McDonald, M.D., Leo E. Obermiller, M.D., Jr., M.D., Katherine R. Tuttle, M.D., and John Taylor. Dr. Fox brought the action as a qui tam relator pursuant to 31 U.S.C. § 3730(b)(1).

*1105 After being granted several requests for continuances, the United States filed a “Notice of Election to Intervene” on January 14, 1998, pursuant to 31 U.S.C. § 3730(b)(2) and (4) (Ct.Rec.31). Upon doing so, the government assumed the “primary responsibility for prosecuting the action.” 31 U.S.C. § 3730(c).

On June 12, 1998, the United States filed a complaint (Ct.Rec.34) which, unlike the complaint filed by Dr. Fox, dropped Dr. Tuttle and John Taylor as defendants and, in addition to alleging causes of action under the FCA, alleged common law causes of action for “Payment Under Mistake of Fact” and “Unjust Enrichment.” The government’s complaint alleged that “[f]rom at least 1989 through 1995,” defendants: 1) presented or caused to be presented claims for payment to the United States knowing such claims were false, fictitious, or fraudulent or acted with reckless disregard or deliberate ignorance of the truth or falsity of such claims; 2) made, used or caused to be made or used, false records or statements to get false or fraudulent claims paid by the United States knowing such statements or records were false, or acted with reckless disregard or deliberate ignorance of the truth or falsity of such statements or record; and 3) “agreed to participate in a scheme to defraud the Government by upcoding claims submitted to the United States” and “[i]n pursuit of that conspiracy, ... submitted improper claims for medical services, and ... caused the United States to make unauthorized payments to defendants .... ” (Paragraphs 39, 44 and 49 at pp. 9-11).

In January and March 1999, the Honorable Lonny R. Suko, U.S. Magistrate Judge, conducted mediation talks between the United States and defendants Frazier, Obermiller and McDonald. Settlements were reached between the government and each of the three defendants. The terms of the settlement agreement between the government and defendant Frazier are incorporated into a “Stipulation of Agreed Judgment” which is part of the record (Ct.Rec.84). Stipulations are proposed for defendants McDonald and Obermiller, although they are not yet formally part of the record.

Frazier has stipulated to a judgment against him in the sum of $600,000, although the terms of the settlement agreement require him to actually pay $442,000. Pursuant to the terms of her settlement agreement with the United States, defendant McDonald has stipulated to a judgment against her in the sum of $500,000, although she is required to actually pay $375,000. The judgment amounts against Frazier and McDonald will be deemed satisfied if they do not default on their payment obligations. The terms of the settlement agreement with defendant Ob-ermiller require him to stipulate to a judgment of $415,000 and actually pay that amount to the United States.

Each settlement agreement specifies an amount from which the United States obligates itself to pay a percentage to the relator (Dr. Fox), to be set by this court, pursuant to 31 U.S.C. § 3730(d)(1). Article XII of the settlement agreement with Frazier indicates this amount is $413,736 ($442,000 less $28,264 payable to the State of Washington as reimbursement for false Medicaid claims). Furthermore, Article XII specifies that the United States will not be obligated to pay the relator unless and until it receives payment from Frazier and that “[wjithin a reasonable time of receiving each of the payments (i.e., pension funds payment and each quarterly payment), the United States will pay Relator a sum equal to such percentage as is set by the Court ... of the amount paid by Frazier.”

Article XIII of the settlement agreement with McDonald specifies that $362,-248 1 is the amount from which the court *1106 should award a percentage to the relator pursuant to 31 U.S.C. § 3730(d)(1). It also specifies that the United States will not be obligated to pay the relator unless and until it receives payment from McDonald and that “[w]ithin a reasonable time of receiving each of the payments (i.e., the net sale proceeds from 1712 East 27th Street house, each quarterly payment, and the Balloon Payment), the United States will pay Relator a sum equal to such percentage as is set by the Court ... of the amount paid by McDonald.”

Article XIII of the settlement agreement with Obermiller specifies that $403,-566 2 is the amount from which the court should award a percentage to the relator pursuant to 31 U.S.C. § 3730(d)(1). It also specifies that the United States will not be obligated to pay the relator unless and until it receives payment from Ober-miller and that “[w]ithin a reasonable time of receiving each of the payments (i.e., the initial payment, each quarterly payment, net sale proceeds from the sale of the Priest Lake, Idaho home, and the Balloon Payment), the United States will pay Relator a sum equal to such percentage as is set by the Court ... of the amount paid by Obermiller.”

II. DISCUSSION

31 U.S.C. § 3730(c)(2)(B) provides:

The Government may settle the action with the defendant notwithstanding the objections of the person initiating the action [the relator] if the court determines, after a hearing, that the proposed settlement is fair, adequate, and reasonable under all the circumstances. Upon a showing of good cause, such hearing may be held in camera.

31 U.S.C. § 3730(d)(1) provides in relevant part:

If the Government proceeds with an action brought by [a private person relator], such person shall ...

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87 F. Supp. 2d 1103, 2000 U.S. Dist. LEXIS 3183, 2000 WL 282468, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-ex-rel-fox-v-northwest-nephrology-associates-waed-2000.