United States Ex Rel. Vuyyuru v. Jadhav

555 F.3d 337, 2009 U.S. App. LEXIS 2852, 2009 WL 331967
CourtCourt of Appeals for the Fourth Circuit
DecidedFebruary 12, 2009
Docket07-1455, 07-1922
StatusPublished
Cited by365 cases

This text of 555 F.3d 337 (United States Ex Rel. Vuyyuru v. Jadhav) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fourth Circuit 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. Vuyyuru v. Jadhav, 555 F.3d 337, 2009 U.S. App. LEXIS 2852, 2009 WL 331967 (4th Cir. 2009).

Opinions

Affirmed by published opinion. Senior Judge HAMILTON wrote the opinion, in which Judge KING joined. Judge REIDINGER wrote a dissenting opinion.

OPINION

HAMILTON, Senior Circuit Judge:

Relator Lokesh B. Vuyyuru (Relator Vuyyuru) appeals the district court’s dismissal of, for lack of subject matter jurisdiction, his Third Amended Complaint, which complaint alleges various claims under the False Claims Act (FCA), 31 U.S.C. §§ 3729-3733, and Virginia state law. He also challenges the district court’s award of attorneys’ fees and costs to one of the defendants. We affirm.

I.

On March 13, 2006, Relator Vuyyuru filed this qui tarn action under the FCA. After amending the complaint three times, Relator Vuyyuru ultimately named Gopi-nath Jadhav, M.D. (Dr. Jadhav), Southside Gastroenterology Associates, Ltd. (the SGA Practice), Petersburg Hospital Com[341]*341pany, L.L.C., The Cameron Foundation, and Columbia/HCA John Randolph, Inc. as defendants (collectively Defendants).1

Of relevance in the present appeal, in his Third Amended Complaint, Relator Vuyyuru alleged three separate counts under the FCA. In the first count, Relator Vuyyuru alleged Defendants “knowingly presented, or caused to be presented and filed, a false or fraudulent claim for payment or approval with the United States Government,” in violation of 31 U.S.C. § 3729(a)(1). (J.A. 139). In the second count, Relator Vuyyuru alleged Defendants “knowingly made [or] used or caused to be made or used a false record or statement to get a false or fraudulent claim paid or approved by the Government,” in violation of 31 U.S.C. § 3729(a)(2). (J.A. 139). In the third count, Relator Vuyyuru alleged that Defendants “conspired to defraud the United States government in violation of 31 U.S.C. § 3729(a)(3) by getting false or fraudulent claims allowed or paid to the damage of the United States’ government.” (J.A. 140). With respect to these three counts, Relator Vuyyuru sought an undetermined amount “duly trebled in addition to a fine of not less than $5,000 per violation and not more than $10,000 together with attorneys’ fees and costs.” (J.A. 142).

According to the Third Amended Complaint, Dr. Jadhav is a gastroenterologist, who practices medicine in Virginia at Southside Regional Medical Center2 (SRMC) and John Randolph Medical Center3 (JRMC), through the SGA Practice. Dr. Jadhav is the president and sole shareholder of the SGA Practice. As part of his practice, Dr. Jadhav performed medical procedures such as colonoscopies, endosco-pies, esophago gastro duodonoscopies (EDG), percutaneous endoscopic gastrosto-my tube placements (PEG tube placement), and biopsies.

We note, as did the district court, that the Third Amended Complaint is inartfully drafted. Nonetheless, we state with fair assurance that the crux of Relator Vuyyu-ru’s claims under the FCA is that Defendants fraudulently billed the government, through the Medicare and Medicaid programs, for unnecessary or incomplete medical procedures performed by Dr. Jad-hav. With respect to the nature of the alleged unnecessary medical procedures, the Third Amended Complaint alleges: (1) through March 2005, Dr. Jadhav, while performing colonoscopies, routinely took an unnecessary biopsy of the Ileocecal Valve (IC Valve) when he was unable to find a polyp; (2) Dr. Jadhav unnecessarily performed an EDG on a patient and a PEG tube replacement on consecutive days, when the two procedures could have been performed on the same day for a lower rate; (3) during sometime in the first half of 2002, Dr. Jadhav performed an unnecessary colonoscopy and biopsy of the IC Valve on a sixty-five year old female; [342]*342(4) in August 1997, Dr. Jadhav performed an unnecessary endoscopy on a seventy-two year-old female; (5) on November 27, 2001, Dr. Jadhav performed an unnecessary EDG with biopsy on a seventy-two year old female, and thirteen days later performed an unnecessary colonoscopy with biopsy on the same patient; and (6) on January 3, 2000, Dr. Jadhav performed an unnecessary colonoscopy on a seventy-one year old female. With respect to each alleged unnecessary medical procedure just listed in (2) through (6), the Third Amended Complaint alleges that Dr. Jad-hav performed such unnecessary procedure “for the sole purpose of enhancing his income and that of SRMC and JRMC.” (J.A. 133) (emphasis added).

With respect to the procedures allegedly not completed by Dr. Jadhav, but for which Defendants allegedly fraudulently billed the government, the Third Amended Complaint offers no information regarding individual patients. Rather, it alleges in general that “Dr. Jadhav frequently billed for the procedure of a colonoscopy and upper-endoscopy when Dr. Jadhav failed to complete the procedure.” (J.A. 134). Moreover, almost as an aside, the Third Amended Complaint alleges:

Defendant Dr. Jadhav for a period of nearly 10 years failed to dictate the required consult note before billing, making minor notations only in the chart, while billing for a level 3 to 5 consult. At SRMC (different than his practice at JRMC) [] Dr. Jadhav routinely and in most cases did not provide a dictation for consults and failed to perform general multi-system examinations failing to follow CMS guidelines since 1997 for which he billed or caused to be billed to the United States Government as though the CMS guidelines were being met.

(J.A. 136).4

Of relevance to the issues in the present appeal, on October 6, 2006, Defendants moved to dismiss the Third Amended Complaint under Federal Rule of Civil Procedure 12(b)(1), contending that the jurisdictional bar set forth in 31 U.S.C. § 3730(e)(4) operated to bar Relator Vuyyuru’s FCA claims.5 Defendants attached evidentiary exhibits to their Consolidated Memorandum of Law in support of such motion, which exhibits they asked the district court to consider in resolving their jurisdictional challenge. In relevant part, § 3730(e)(4) provides as follows:

(e) Certain Actions barred.—
(4)(A) No court shall have jurisdiction over an action under this section based upon the public disclosure of allegations or transactions ... from the news media, unless ... the person bringing the action is an original source of the information.
(B) For purposes of this paragraph, “original source” means an individual 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.

Id.

In support of their motion to dismiss for lack of subject matter jurisdiction, Defen[343]

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555 F.3d 337, 2009 U.S. App. LEXIS 2852, 2009 WL 331967, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-ex-rel-vuyyuru-v-jadhav-ca4-2009.