United States ex rel. Hendrickson v. Bank of Am., N.A.
This text of 343 F. Supp. 3d 610 (United States ex rel. Hendrickson v. Bank of Am., N.A.) is published on Counsel Stack Legal Research, covering District Court, N.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
Opinion
KAREN GREN SCHOLER, UNITED STATES DISTRICT JUDGE
This Order addresses Defendants'1 Motion to Dismiss [ECF No. 92]. For the reasons below, the Motion is granted in part and denied in part.
*617I. BACKGROUND
A. The Federal Benefit Payment System
This qui tam action arises out of alleged violations of the False Claims Act ("FCA") by sixteen banks that process benefit payments for the recipients of federal benefits. Certain federal entitlement programs contemplate lifetime benefit payments, Am. Compl. ¶ 15. These include programs administered by the Social Security Administration ("SSA"), the Office of Personnel Management ("OPM"), the Railroad Retirement Board ("RRB"), and the Department of Veterans Affairs ("VA"). Id. The recurring benefit payments from these agencies are intended to cease once the person receiving the payments (the "Recipient")2 dies. Id. Relator Edward Hendrickson ("Relator") alleges that, due to fraud by Defendants, the payments often continue long after the Recipient has died and that a large percentage of the overpayments are never returned to the Government.
The process by which federal agencies make recurring benefit payments entails several steps. First, the agencies transmit the funds to the Automated Clearing House ("ACH") network. Am. Compl. ¶ 19. The bank where the Recipient has an account receives the funds from the ACH network and then deposits the payment into the Recipient's account. Id. ¶ 20. The banks participating in the ACH network are referred to as "Receiving Depository Financial Institutions" ("RDFI"). Id. ¶ 23. All of the banks named as defendants in the instant case are RDFIs. When an RDFI accepts a benefit payment, it agrees to be bound by applicable Department of Treasury ("Treasury") rules and regulations. Id. ¶ 21. The main sources of such regulations are 31 C.F.R. Part 210 ("Part 210") and the "instructions and procedures" issued under Part 210, including the Treasury Financial Manual and the Green Book.
Relator posits that RDFIs typically learn of Recipients' deaths when they receive Death Notification Entries ("DNEs").
When the Government finds out that a payment was made to a deceased Recipient, *618it can issue a Notice of Reclamation ("NOR") to the appropriate RDFI. Am. Compl. ¶ 55. Upon receiving the NOR, the RDFI can limit its liability by certifying, on the NOR, the date it learned of the Recipient's death.
B. Relator's Allegations
Relator alleges that Defendants routinely violated the FCA by ignoring DNEs and falsely certifying on NORs that they had learned of Recipients' deaths after receiving DNEs.
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KAREN GREN SCHOLER, UNITED STATES DISTRICT JUDGE
This Order addresses Defendants'1 Motion to Dismiss [ECF No. 92]. For the reasons below, the Motion is granted in part and denied in part.
*617I. BACKGROUND
A. The Federal Benefit Payment System
This qui tam action arises out of alleged violations of the False Claims Act ("FCA") by sixteen banks that process benefit payments for the recipients of federal benefits. Certain federal entitlement programs contemplate lifetime benefit payments, Am. Compl. ¶ 15. These include programs administered by the Social Security Administration ("SSA"), the Office of Personnel Management ("OPM"), the Railroad Retirement Board ("RRB"), and the Department of Veterans Affairs ("VA"). Id. The recurring benefit payments from these agencies are intended to cease once the person receiving the payments (the "Recipient")2 dies. Id. Relator Edward Hendrickson ("Relator") alleges that, due to fraud by Defendants, the payments often continue long after the Recipient has died and that a large percentage of the overpayments are never returned to the Government.
The process by which federal agencies make recurring benefit payments entails several steps. First, the agencies transmit the funds to the Automated Clearing House ("ACH") network. Am. Compl. ¶ 19. The bank where the Recipient has an account receives the funds from the ACH network and then deposits the payment into the Recipient's account. Id. ¶ 20. The banks participating in the ACH network are referred to as "Receiving Depository Financial Institutions" ("RDFI"). Id. ¶ 23. All of the banks named as defendants in the instant case are RDFIs. When an RDFI accepts a benefit payment, it agrees to be bound by applicable Department of Treasury ("Treasury") rules and regulations. Id. ¶ 21. The main sources of such regulations are 31 C.F.R. Part 210 ("Part 210") and the "instructions and procedures" issued under Part 210, including the Treasury Financial Manual and the Green Book.
Relator posits that RDFIs typically learn of Recipients' deaths when they receive Death Notification Entries ("DNEs").
When the Government finds out that a payment was made to a deceased Recipient, *618it can issue a Notice of Reclamation ("NOR") to the appropriate RDFI. Am. Compl. ¶ 55. Upon receiving the NOR, the RDFI can limit its liability by certifying, on the NOR, the date it learned of the Recipient's death.
B. Relator's Allegations
Relator alleges that Defendants routinely violated the FCA by ignoring DNEs and falsely certifying on NORs that they had learned of Recipients' deaths after receiving DNEs.
Relator filed this case under the qui tam provisions of the FCA on February 2, 2016. On March 30, 2017, the United States notified the Court that it declined to intervene in the case. See Notice of Declination [ECF No. 11]. Relator filed his Amended Complaint on July 20, 2017. The Amended Complaint contains two causes of action. In Count I, Relator alleges a violation of
C. The Reverse False Claims Act
A reverse false claim consists of "knowingly mak[ing], us[ing], or caus[ing] to be made or used, a false record or statement material to an obligation to pay or transmit money or property to the Government, or knowingly conceal[ing] or knowingly and improperly avoid[ing] or decreas[ing] an obligation to pay or transmit money or property to the Government."
II. DISCUSSION
A. Standing
Under the Constitution, a federal court may decide only actual cases or controversies. U.S. CONST. art. III, § 2. A *619court properly dismisses a case where it lacks the constitutional power to decide it. See Home Builders Ass'n of Miss., Inc. v. City of Madison ,
Standing is a component of subject-matter jurisdiction that is properly raised by a motion to dismiss under Rule 12(b)(1). See Hollis v. Lynch ,
i. Preemption
First, Defendants argue that Relator lacks standing because Part 210 provides the exclusive remedy for liability arising out of benefit payments over the ACH network. See
However, Defendants' argument contravenes "well-established law that strongly disfavors preclusion of one federal statute by another absent express manifestations of preclusive intent." United States v. Sforza ,
This Court declines to deviate from the aforementioned legal principles in the instant case. Neither the text of Part 210 nor its legislative history contains an "express manifestation[ ] of preclusive intent." Sforza ,
The cases cited by Defendants in support of their argument do not stand for the proposition that the existence of a comprehensive regulatory scheme displaces the FCA, but rather that mere regulatory violations with nothing more are insufficient to support a finding that the FCA has been violated. See, e.g., Conner ,
Moreover, the cases cited by Relator support the notion that the FCA and Part 210 can coexist. First, each provides for different remedies. See Fallon ,
Because the FCA and Part 210 provide different remedies for different conduct, and because of the strong presumption against preemption, the Court denies Defendants' Motion to Dismiss the Amended Complaint on this ground.
ii. Assignment
Second, Defendants argue that Relator lacks standing because he is not an assignee of the claim for damages. "[T]he Art. III judicial power exists only to redress or otherwise to protect against injury to the complaining party ." Vt. Agency of Nat. Res. v. United States ex rel. Stevens ,
If an RDFI does not return the full amount of the outstanding total or any other amount for which the RDFI is liable under this subpart in a timely manner, the Federal Government will collect the amount outstanding by instructing the appropriate Federal Reserve Bank to debit the account utilized by the RDFI.
Defendants argue that the Federal Reserve Banks' ability to debit the account constitutes an assignment for collection by the Government. Thus, Defendants conclude, the Government cannot re-assign the same right to Relator for purposes of the FCA. See Salem Tr. Co. v. Mfrs.' Fin. Co. ,
The Court disagrees with Defendants. The alleged injury in fact that confers standing on Relator is fraud, which, as discussed above, is not addressed in Part 210. See Sprint Commc'ns ,
*622Even if Part 210 were somehow implicated, the mere ability to instruct a Federal Reserve Bank to collect the Government's damages does not cause legal title to those damages to vest in the Federal Reserve Bank. In Sprint Commc'ns , the Supreme Court of the United States repeated that the assignee's possession of legal title to the claim gave rise to standing. See
In sum, the Court rejects Defendants' theory, which would render relators unable to bring FCA actions based on conduct governed by Part 210. If the Government had already assigned to the Federal Reserve Banks its right to collect damages for any failure by an RDFI to return funds, the Government would lose the right to rely on a qui tam suit to remedy fraud perpetrated by an RDFI. Qui tam suits must be brought by private citizens, and the Federal Reserve Banks clearly are not private citizens. See
B. Public Disclosure
Defendants claim that sixteen sources constitute public disclosures that bar Relator's lawsuit. The FCA sets forth criteria for public disclosures. Two versions of the public-disclosure bar apply to the claims at issue in this case because of statutory amendments that took effect in 2010. For claims arising prior to March 23, 2010, the bar is as follows:
No court shall have jurisdiction over an action under this section based upon the public disclosure of allegations or transactions in a criminal, civil, or administrative hearing, in a congressional, administrative, or Government Accounting Office report, hearing, audit, or investigation, or from the news media, unless the action is brought by the Attorney General or the person bringing the action is an original source of the information.
The court shall dismiss an action or claim under this section ... if substantially the same allegations or transactions as alleged in the action or claim were publicly disclosed ... (i) in a Federal criminal, civil, or administrative hearing in which the Government or its agent is a party; (ii) in a congressional, Government Accountability Office, or other Federal report, hearing, audit, or investigation; or (iii) from the news media, unless the action is brought by the Attorney General or the person bringing the action is an original source of the information.
*623There are several differences between the two versions, none of which alter the outcome of this Court's analysis. First, the bar no longer contains jurisdictional language; instead it requires a court to dismiss barred actions. This is a difference without a distinction in the instant case. Prior to the 2010 amendments, courts viewed a jurisdictional challenge under the FCA as "the equivalent of a motion for summary judgment because it [was] necessarily intertwined with the merits." United States ex rel. Solomon v. Lockheed Martin Corp. ,
The Court would reach the same conclusion in the instant case regardless. If the Court required Defendants to carry the affirmative defense burden of proof, Defendants would still prevail, and the public-disclosure bar would prohibit Relator from moving forward with his lawsuit.7 Thus, the Court need not, and declines to, decide whether the 2010 amendment changes the public-disclosure bar from a jurisdictional inquiry to an affirmative defense.
Second, the action no longer is required to be "based upon" publicly disclosed transactions-it must instead be "substantially the same." This change has no real impact, as courts considering the term "based upon" interpreted it to mean "substantially the same." See, e.g., Lockey ,
Finally, the definition of "original source" differs between the two versions. Under the 1986 version, an original source is someone "who has direct and independent knowledge of the information on which the allegations are based and has voluntarily provided the information to the Government before filing an action under this section which is based on the information."
The Fifth Circuit employs an overarching, three-part test to guide the analysis of whether the public-disclosure bar applies: "1) whether there has been a 'public disclosure' of allegations or transactions, 2) whether the qui tam action is 'based upon' such publicly disclosed allegations, and 3) if so, whether the relator is the 'original source' of the information." United States ex rel. Jamison v. McKesson Corp. ,
i. Original vs. Amended Complaint
As an initial matter, the Court must consider whether its jurisdictional analysis should proceed under the original or amended version of the complaint. Some courts have analyzed only the original complaint in determining whether jurisdiction exists under the 1986 version of the public-disclosure bar. See, e.g., Jamison ,
ii. Public Disclosure of Allegations or Transactions
The first issue for this Court to consider is whether there was a public disclosure of the allegations or transactions at issue that predated the filing of Relator's complaint. Courts look for three *625required elements: "(1) public disclosure; (2) in a particular form specified in the statute; and (3) of allegations or transactions." Colquitt ,
Defendants identify a litany of public disclosures that they contend are in the form specified by the FCA, including state and federal court cases, government administrative reports, and news articles. As both parties agree, the state court case cited by Defendants, Derryberry v. NationsBank of Tex., N.A. ,8 only constitutes a public disclosure for purposes of the 1986 version of the public-disclosure bar.
Relator contests Defendants' assertion that the 1987 Banking Circular,9 the Green Book,10 and the SSA Programs Operations Manual System ("POMS")11 constitute public disclosures. See Defs.' App. Exs. G, K-M. Defendants argue that these sources are "administrative reports" and thus constitute public disclosures. Defs.' Reply 13. "[T]o be an administrative report within the meaning of the FCA, a document must (1) constitute official government action and (2) provide information." Colquitt ,
iii. "Based Upon"
Next, the Court must determine whether Relator's complaint is "based upon" (or substantially similar to) any of the public disclosures identified by Defendants. Because the Court combined the first and second steps, the essential question for the Court is now "whether the scope of Relators' action is similar to the allegations or transactions that are publicly disclosed." Lockey ,
The Fifth Circuit has adopted the United States ex rel. Springfield Terminal Ry. Co. v. Quinn12 test "for determining whether public disclosures contain sufficient indicia of an FCA violation to bar a subsequently filed FCA complaint." Solomon ,
"An irreducible minimum is that the disclosures furnish evidence of the fraudulent scheme alleged." Little v. Shell Expl. & Prod. Co. ,
Relator argues that none of the sources cited by Defendants disclosed the particular scheme alleged in his complaint. "By blaming the Government (and others)," Relator argues, "the Banks are actually highlighting the truth that they have no 'public disclosure' of misconduct by the financial industry. " Rel.'s Mem. in Opp'n at 6-7 [ECF No. 106]. The Court disagrees. Certain of the disclosures cited by Defendants, when considered collectively,13 publicly disclose the allegations or transactions alleged by Relator, and the Court finds that Relator's Amended Complaint is based upon these disclosures.
a. Sources That Are not Public Disclosures
Two of the documents identified by Defendants-the Green Book and the SSA POMS-do no more than "merely restate the law applicable to" RDFIs and thus do not publicly disclose the fraudulent scheme alleged by Relator. Jamison ,
The 2015 SSA Audit, 2015 O'Carroll Statement, 2011 OPM Audit, VA OIG Report, and the news articles fail to implicate banks at all, instead identifying agencies' and/or individuals' actions or omissions as the causes of improper overpayments. Thus, while these sources might "set the [G]overnment on the trail of fraud," they do not set the Government on the trail of fraud by financial institutions. Jamison ,
The 2015 SSA Audit,14 for example, identifies issues with the SSA's procedure for *627determining whether suspended Recipients had died. See Defs.' App. Ex. H, at 41. The audit concluded that "SSA did not effectively recover direct deposit payments to bank accounts after beneficiaries' deaths because the [SSA] did not always determine when suspended beneficiaries had died." Defs.' App. Ex. H, at 46. Similarly, the 1990 General Accounting Office Report15 identifies the VA's inability to obtain the SSA's death information and certain Recipients' lack of Social Security numbers as the driving force behind the VA's payments to deceased Recipients. See Defs.' App. Ex. N, at 147-48.
The 2015 O'Carroll Statement16 suffers from the same defects. It identifies "fraud, ... poor understanding of reporting responsibilities or inability to report, administrative errors, and other reasons" as the causes of improper payments. Defs.' App. Ex. Q, at 203. Although this statement does identify fraud as a cause of overpayments, it clarifies that the fraud identified is perpetrated by "individuals who have concealed a family member's or other person's death to collect the deceased's Social Security benefits." See id. at 206. The 2010 VA Report17 identifies causes of overpayments and identifies VA programs that are susceptible to significant improper payments. Defs.' App. Ex. J, at 84. The report does not mention banks and does not distinguish between overpayments caused by "a beneficiary d[ying] too late in the month to stop the release of the payment" and those caused by the VA not being "timely notified of the death of a beneficiary." Id.
The 2011 OPM Audit18 also does not indicate any wrongdoing on the part of banks. The only substantive mention of banks' role in the benefit payment process comes in a section discussing OPM establishing working relationships with Defendant Wells Fargo and Defendant Bank of America "to uncover inactive annuitant accounts, as well as explore ways to proactively recover improper payments that have been escheated to the States." Defs.' App. Ex. O, at 175. Rather than suggest wrongdoing by these banks, the audit notes that "Wells Fargo was not able to verify if the account holders were deceased." Id.
Defendants rely heavily on the VA OIG Report,19 as it discloses one of the examples Relator proffers in his complaint. See Defs.' App. Ex. I, at 76-77. However, the short summary of this instance places the blame for any fraud squarely on the deceased Recipient's daughter. See id. at 77 ("The daughter of a deceased VA beneficiary *628pled guilty to theft of Government funds.").
Finally, the Washington Post Article20 and the Government Executive Article21 both identify "mistakes the government makes," rather than fraud by banks, as the culprit for payments being made to deceased Recipients. Defs.' App. Ex. R, at 209; see also Defs.' App. Ex. S, at 214 (citing report from SSA Inspector General "that found that more than 180,000 deceased individuals had not been added to the Death Master File, even though these same individuals had been reported as deceased to the SSA Supplemental Security Records.").
b. Sources That Are Public Disclosures
The Court finds that Relator's Amended Complaint is based upon public disclosures in the six remaining sources. In Thomas v. Sec. of HHS , three widows challenged the procedure by which the Government recovers inaccurate social security direct deposit payments. No. C 81-
In Derryberry , one bank failed and was taken over by another bank.
In United States v. Morris , the bank advised the deceased Recipient's daughter that it was her responsibility to notify the VA of the Recipient's death and close her mother's account.
*629
The final three sources, United States v. Walker , the 1987 Banking Circular, and the 2012 SSA Report, furnish even more evidence of the alleged fraudulent scheme. Walker discloses the crux of Relator's alleged scheme-a bank knew of a Recipient's death but failed to properly close his account.
The 1987 Banking Circular warned that "some financial institutions" had accumulated funds that could not be posted to a customer's account. Defs.' App. Ex. G, at 26. The Banking Circular noted that "some financial institutions, upon learning of the death of a recipient or beneficiary, place[d] payments in holding ("suspense") accounts until a reclamation action [was] received." Id. at 27. This document discloses evidence of the scheme alleged by Relator-that banks knew of Recipients' deaths yet failed to stop accepting benefit payments. The Banking Circular adds to the cases discussed above, as it makes clear that the problem is not limited to one or two specific banks.
Similarly, the 2012 SSA Report23 noted that the OIG "identified several instances where banks were maintaining accounts that had been inactive for many years, with the exception of direct deposits of SSA benefit payments." Defs.' App. Ex. P, at 186. An account being inactive may provide a bank with constructive knowledge that the accountholder has died. Although this report does not dictate a finding that fraud has occurred, it details the critical elements of the scheme alleged by Relator with the same level of specificity as does the Amended Complaint. See Jamison ,
Considering these public disclosures as a whole, the Court finds that the critical elements of the alleged fraudulent scheme were in the public domain and that the allegations in Relator's Amended Complaint are based upon and substantially the same as the allegations contained in certain of the public disclosures.
iv. Original Source
Because the Court has found that there has been a public disclosure and that the instant action is based upon that disclosure, the Court cannot maintain the action unless Relator is the original source of the information. Under the 1986 version of the FCA, an original source is an individual who voluntarily provides information to the Government and who has direct and independent knowledge of the information on which his allegations are based. United States ex rel. Reagan v. E. Tex. Med. Ctr. Reg'l Healthcare Sys. ,
a. Voluntary Disclosure
The Court finds that Relator's disclosure was not voluntary, As such, Relator cannot be an original source. The Fifth Circuit has held that "the fact that a relator 'was employed specifically to disclose fraud is sufficient to render his disclosures nonvoluntary.' " See Little ,
b. Knowledge
Additionally, for purposes of conduct occurring prior to March 23, 2010, the Court finds that Relator does not have direct and independent knowledge about post-death payments from agencies other than the VA. Relator's work at the VA may have provided him with direct and independent knowledge of VA payments, but it is difficult to imagine how he would have gained such knowledge of payments from other agencies. Only one of the examples in the Amended Complaint involves a loss by an agency other than the VA, yet the Amended Complaint purports to disclose a widespread fraudulent scheme impacting the SSA, OPM, and RRB, in addition to the VA. Relator has failed to provide facts from which the Court could determine that he had direct and independent knowledge of fraud impacting agencies other than the VA.
Relator also cannot establish that he is an independent source under either provision of the 2010 version of the public-disclosure bar. For the same reasons listed above, the Court finds that Relator does not have independent knowledge. Further, the Court finds that Relator's knowledge does not materially add to the publicly disclosed transactions. The burden is on Relator "to show that the information and allegations he discovered were 'qualitatively different information than what had already been discovered' and not merely the 'product and outgrowth' of publicly disclosed information." United States ex rel. Fried v. West Indep. Sch. Dist. ,
Because the Court finds, under both versions of the public-disclosure bar, that there has been a disqualifying public disclosure and that Relator is not an original source, the Court grants Defendants' Motion to Dismiss on public disclosure grounds.24
*631C. Failure to State a Claim
Because it is unclear whether the public-disclosure bar remains jurisdictional, it is also unclear whether it is appropriate for the Court to further analyze the Motion to Dismiss after determining that the bar applies. For the sake of completeness, however, the Court will briefly address Defendants' Motion to Dismiss on Rule 12(b)(6) and Rule 9(b) grounds. Even if there was no public disclosure, the Court would dismiss Relator's action for failure to allege details of the purported scheme with the particularity required by Rule 9(b).
i. The Rule 12(b)(6) Standard
To defeat a motion to dismiss filed pursuant to Federal Rule of Civil Procedure 12(b)(6), a plaintiff must plead "enough facts to state a claim to relief that is plausible on its face." Bell Atl. Corp. v. Twombly ,
In ruling on a Rule 12(b)(6) motion, the court limits its review to the face of the pleadings. See Spivey v. Robertson ,
The ultimate question is whether the complaint states a valid claim when viewed in the light most favorable to the plaintiff. Great Plains Tr. Co. v. Morgan Stanley Dean Witter & Co. ,
ii. The Rule 9(b) Standard
"[A] complaint filed under the False Claims Act must meet the heightened pleading standard of Rule 9(b)[.]" United States ex rel. Grubbs v. Kanneganti ,
As discussed above, Relator asserts a reverse false claim under § 3729(a)(3)(G) of the FCA. Where, as here, a relator alleges that a defendant failed to disclose and return an overpayment, liability requires proof of the following elements: (1) a false record is created; (2) the provider knows the record is false; (3) the false record or statement is made, used, or caused to be made or used; (4) to conceal, decrease, or avoid an obligation to pay the Government; and (5) the misrepresentation is material. United States ex rel. Ramsey-Ledesma v. Censeo Health, L.L.C. , Civ. A. No. 3:14-CV-00118-M,
iii. Analysis
a. Failure to Satisfy Rule 9(b)
Defendants argue that the Amended Complaint fails to satisfy the strictures of Rule 9(b). Defendants argue that Relator has failed to plead particular details of the overall scheme and attack the element of scienter. Under the Grubbs standard, which both parties agree applies in the instant case, Relator may survive a motion to dismiss by alleging "particular details of a scheme ... paired with reliable indicia that lead to a strong inference that" Defendants *633actually violated the FCA.
The scheme alleged by Relator is as follows: "(1) The Banks received DNEs for deceased individuals that kept getting Government payments; (2) The Banks had an obligation to return those funds and tell the Government agency to stop paying because the person died; (3) The Banks did not do so; and (4) The Banks acted with the requisite False Claims Act 'knowledge[.]' " Rel.'s Suppl. Mem. in Opp'n 16 [ECF No. 129]. Relator also alleges a separate but closely linked violation: banks falsely certified when they had learned of Recipients' deaths when responding to NORs. Applying the Grubbs standard, the Court finds that Relator's allegations do not include "particular details" of the alleged scheme and lack the "reliable indicia" necessary to satisfy the strictures of Rule 9(b).
1. Particular Details
As Defendants aptly state, Relator fails to include almost any particular details of the alleged scheme, such as "the subset of recipient deaths that Defendants supposedly exploited[,]" the "person at each bank who may have driven the scheme, or any characteristic of the recipients that made them ripe for the purported fraudulent scheme." Defs.' Br. 37 [ECF No. 94].
Relator's Amended Complaint is especially deficient with regard to the "who" of the alleged scheme. Other than in the representative list of examples he provides, Relator entirely fails to distinguish between Defendants. See In re Parkcentral Glob. Litig. ,
The Amended Complaint also lacks necessary details with regard to the "what" and "how." Critically, Relator omits particular details about the allegation upon which the entire scheme alleged by Relator relies: that Defendants received notice of Recipients' deaths through the receipt of DNEs. "In accordance with SSA DNE procedures," Relator contends, "the Defendant banks receive a SSA DNE on the day after a death termination is displayed.... By virtue of this procedure, each Defendant bank would have been in possession of an electronic record notifying it of the beneficiary's death." Am. Compl. ¶ 39. Relator does not, and cannot, allege that a DNE was indeed sent or received every time Defendants failed to stop accepting payments and notify federal agencies that a Recipient had died. Instead, he relies on the SSA's policy, as reflected in the agency's POMS, GN 02408.605. See Defs.' App. Ex. M. The manual states that "a DNE normally goes out as soon as SSA receives" information about a Recipient's death. Id. at 140 (emphasis added). Further, the manual states that, "On the day after a death termination is displayed ..., SSA passes a DNE to the Richmond Federal *634Reserve Bank (RFRB) .... RFRB then passes the information through the [ACH] to the [RDFI]." Id. at 141. Then, the RDFI is supposed to "return[ ], within three days, any additional government benefit payments that arrive for this [Recipient]." Id. For already-posted payments, the RDFI "has the option of waiting for a [NOR] before returning the funds to the agency." Id.
Defendants repeatedly counter that the DNE process is woefully inadequate because not all agencies issue DNEs and because the Government has a difficult time keeping track of Recipient deaths. And, in the examples provided by Relator, there is no allegation that a DNE was sent to or received by any of the Defendants. Without more information, the Court cannot assume that a DNE is sent and received every time a Recipient dies. Therefore, the Court finds that this allegation is insufficient to "raise a right to relief above the speculative level." Twombly ,
Even if the Court accepts as true Relator's allegation that SSA sent a DNE each time a Recipient died, there is no explanation of, much less any particulars of the alleged fraud, how the scheme operated from that point forward. Relator fails to allege any details, such as who at the bank would receive the DNE, how it would be processed, or how the notification system should have worked. In sum, the Amended Complaint is devoid of the particular details required by Rule 9(b) and Grubbs that would demonstrate that the failure to stop accepting payments or to return payments already posted resulted from fraud, as opposed to administrative oversight or mistake.
2. Reliable Indicia
Even assuming that Relator has included particular details of the alleged scheme, the Amended Complaint lacks the "reliable indicia" needed to satisfy the requirements of Rule 9(b) with respect to each defendant. " Rule 9(b) is intended to give a defendant a reasonable ability to investigate and to respond when charged with something as serious as fraud." Dalwadi v. Holiday Hosp. Franchising, Inc. , Civ. A. No. H-16-2588,
Relator, relying on Grubbs , argues that pleading details of his personal knowledge of the recurring problem he uncovered satisfies his obligation to offer "reliable indicia" that an FCA violation occurred. See Rel.'s Mem. in Opp'n 30 [ECF No. 102] ("Relator's experience and position establishes ... sufficient 'reliable indicia' to support his allegations ... that the Banks received the DNEs as claimed."). The Grubbs court found that, in a situation where "the particular workings of a scheme [were] communicated directly to the relator by those perpetrating the fraud," the relator's personal knowledge sufficed.
By contrast, Relator offers a sweeping description of an alleged scheme implicating many financial institutions and involving several federal agencies. His allegations are corroborated only by unadorned *635examples of instances in which VA payments continued after SSA payments had stopped and conclusory allegations that unnamed representatives of unidentified banks confirmed that those banks intentionally continued making payments after learning of a Recipient's death. These allegations simply are not sufficient, under any reading of Rule 9(b), to support the inference that Defendants' actions constituted fraud, rather than innocent mistake, negligence, or a regulatory violation.
Rule 9(b), in addition to ensuring fair notice, "also prevents nuisance suits and the filing of baseless claims as a pretext to gain access to a 'fishing expedition.' " Grubbs ,
3. Strong Inference that Defendants Violated the FCA
Because Relator's Amended Complaint lacks both particular details and reliable indicia, it does not lead to a strong inference that the FCA has been violated. Relator's allegations fail to move the needle from "innocent mistakes or negligence" to affirmative fraud. United States v. Southland Mgmt. Corp. ,
4. Scienter
Relator's vague group pleading approach cripples his ability to establish scienter. To establish scienter, Relator must allege that Defendants acted "knowingly."
Defendants argue that banks are incentivized not to lie because they bear any loss to the Government first, even if they are blameless. See
As noted above, the Court finds that Relator has insufficiently pleaded the alleged misconduct. Therefore, the Court cannot conclude that there was any routine misconduct. Relator fails to identify which banks' representatives allegedly confirmed misconduct to investigators, so that alleged fact also does not support an individualized finding of scienter. And, as Defendants note, RDFIs have an incentive not to continue receiving payments. The competing incentives faced by RDFIs undercut Relator's argument that the Court can infer scienter based on what Defendants stand to gain.
The argument that Defendants are knowledgeable ACH participants has weaknesses as well. While Relator points to one provision of the Green Book, 5-8, that requires RDFIs to immediately return payments after a Recipient dies, Defendants point to another provision of the Green Book, 5-9, that uses more lenient language. FCA liability does not attach when a defendant reasonably, yet erroneously, interprets its legal obligations. United States ex rel. Purcell v. MWI Corp. ,
For the foregoing reasons, the Court finds that Relator has not sufficiently pleaded scienter. Because of this deficiency, along with those discussed above, the Court grants Defendants' Motion to Dismiss based on Rules 12(b)(6) and 9(b).
b. Arguments not Reached
Defendants also allege that many of the examples of specific misconduct are time-barred under Part 210 and that that the claims against Citibank, M & T Bank, PNC Bank, Frost Bank, American National Bank, Centrue Bank, and Amarillo National Bank should be dismissed. Because the Court has already elucidated two separate and independent grounds for dismissal, the Court declines to reach these arguments and expresses no opinion on them.
c. Conflict of Interest
Defendants argue that Relator's request for a share of any monetary relief won should be stricken pursuant to federal conflict-of-interest rules. Because the Court grants Defendants' Motion to Dismiss, it need not consider this request and finds that it is moot.
D. Statute of Limitations
Defendants move for dismissal of all claims arising more than before six years before Relator filed his complaint on February 2, 2016. At the hearing held on May 10, 2018, counsel for Relator stipulated that Relator was not "seeking damages prior to six years from the filing of the original complaint." Hr'g Tr. 85:18-19. Thus, only claims that arose on or after February 2, 2010, remain at issue in this case, and Defendants' Motion to Dismiss on limitations grounds is moot.
*637III. CONCLUSION
For the foregoing reasons, the Court denies the Motion to Dismiss on standing grounds. The Court denies as moot Defendants' Motion to Dismiss on statute of limitations grounds. The Court grants the Motion to Dismiss on public disclosure grounds and for failure to state a claim. Because there has been a disqualifying public disclosure, the Court finds that amendment would be futile and dismisses Relator's lawsuit with prejudice.
SO ORDERED.
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Cite This Page — Counsel Stack
343 F. Supp. 3d 610, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-ex-rel-hendrickson-v-bank-of-am-na-txnd-2018.