United States of America ex rel. Matthew Thomas, Jr. v. Premier Home Health Care Services, Inc.

CourtDistrict Court, S.D. New York
DecidedOctober 27, 2025
Docket1:19-cv-11800
StatusUnknown

This text of United States of America ex rel. Matthew Thomas, Jr. v. Premier Home Health Care Services, Inc. (United States of America ex rel. Matthew Thomas, Jr. v. Premier Home Health Care Services, Inc.) is published on Counsel Stack Legal Research, covering District Court, S.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States of America ex rel. Matthew Thomas, Jr. v. Premier Home Health Care Services, Inc., (S.D.N.Y. 2025).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK

UNITED STATES OF AMERICA ex rel. MATTHEW THOMAS, JR., Plaintiff-Relator, 19-CV-11800 (JPO)

-v- MEMORANDUM & ORDER

PREMIER HOME HEALTH CARE SERVICES, INC., Defendant.

J. PAUL OETKEN, District Judge: Plaintiff-Relator Matthew Thomas, Jr. on behalf of the federal government and seven states, brings this action against Defendant Premier Home Health Care, Inc. (“Premier”) under the False Claims Act, 31 U.S.C. §§ 3729 et seq. (the “FCA”) and analogous state false claims act statutes. Thomas alleges that Premier unlawfully billed state and federal Medicaid programs for personal care services that were not rendered, improperly obtained and failed to refund overpayments from state Medicaid programs, and unlawfully retaliated against and terminated Thomas for raising these violations with Premier senior management. The United States government and the governments of all named states—Connecticut, Florida, Illinois, Massachusetts, New Jersey, New York, and North Carolina—declined to intervene in this action. Now before the Court is Premier’s motion to dismiss Thomas’s First Amended Complaint (the “Amended Complaint”). (ECF No. 20.) For the reasons that follow, the Court grants Premier’s motion in its entirety. I. Background The following facts are taken from the Amended Complaint and are presumed true for the purposes of this motion. Fink v. Time Warner Cable, 714 F.3d 739, 740-41 (2d Cir. 2013). Premier is a for-profit New York corporation that provides in-home healthcare and personal care services to a variety of patient populations, including Medicaid beneficiaries and Managed Medicaid members. (ECF No. 17 (“Am. Compl.”) ¶ 51.) Thomas served as Premier’s Director of Quality Compliance from August 27, 2018, to April 15, 2019. (Am. Compl. ¶¶ 130, 140.) During this time, he discovered that Premier was failing to meet personnel and clinical

compliance requirements, which may have affected Premier’s ability to bill Medicaid properly for health-related services. (Id. ¶¶ 131, 132.) For example, Thomas observed that Premier failed to obtain valid physician orders for service authorizations, neglected to update patient medical profiles and plans of care, and did not conduct the required orientation training for home health aides. (Id. ¶¶ 110, 111.) Thomas identified similar compliance issues at facilities in North Carolina, Illinois, and Massachusetts. (Id. ¶ 137.) Upon discovering these compliance failures, Thomas promptly reported them to Premier senior management, including his direct supervisor and Corporate Compliance & Privacy Officer, Salvatrice Serio-Scerbo; Chief Operating Officer, Gregory Turchan; and General

Counsel, Cesar Perez. (Id. ¶ 131.) He advised that the deficiencies required disclosure to Medicaid and repayment of any overcharges. (Id.) Thomas reiterated these concerns at multiple senior management meetings, warning that the clinical deficiencies “were a massive issue and needed to be corrected immediately.” (Id. ¶¶ 135, 138.) At one quarterly compliance committee meeting, Serio-Scerbo presented a PowerPoint titled “Findings-Trends-Corrections,” which reflected clinical deficiencies of the kind Thomas had identified, including unsigned orders, missing documentation, and late or missing visits. (Id. ¶ 124.) Nevertheless, according to Thomas, Premier “defiantly failed to correct compliance deficiencies and make Medicaid refunds.” (Id. ¶ 127.) As a result, Thomas sent “decisively worded emails” to, among others, Chief Nursing Officer Celestina Cruz, stressing that the problems he had raised needed to be remedied without delay, including by hiring additional nurses to retroactively address the outstanding compliance issues. (Id. ¶ 136.) On or about April 11, 2019, Thomas met with Serio-Scerbo and Premier’s Chief Human Resources Officer Jeannie O’Sullivan. (Id. ¶ 139.) At that meeting, O’Sullivan allegedly

“criticized [Thomas] in a demeaning manner for transmitting strongly worded emails to [Premier’s] officers about the need to remedy compliance deficiencies and address billing issues.” (Id.) Four days later, on April 15, 2019, Premier terminated Thomas’s employment. (Id. ¶ 140.) At the time of his termination, Thomas was told that his “emails about the need to fix compliance and billing issues were too strongly worded” and that Premier “could save money by replacing” him with a less costly employee. (Id.) II. Legal Standards A. Motions to Dismiss Under Federal Rule of Civil Procedure 12(b)(6)

When considering a motion to dismiss under Federal Rule of Civil Procedure 12(b)(6), a court must “draw all reasonable inferences in Plaintiffs’ favor, assume all well-pleaded factual allegations to be true, and determine whether they plausibly give rise to an entitlement to relief.” Faber v. Metro. Life Ins. Co., 648 F.3d 98, 104 (2d Cir. 2011) (quotation marks omitted). A plaintiff’s claim survives a motion to dismiss under 12(b)(6) if it alleges “enough facts to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007); see also In re Elevator Antitrust Litig., 502 F.3d 47, 50 (2d Cir. 2007) (“While Twombly does not require heightened fact pleading of specifics, it does require enough facts to nudge plaintiffs’ claims across the line from conceivable to plausible.” (quotation marks and brackets omitted)). That said, a court is “not bound to accept conclusory allegations or legal conclusions masquerading as factual conclusions.” Rolon v. Henneman, 517 F.3d 140, 149 (2d Cir. 2008) (citation and quotation marks omitted); see also Harris v. Mills, 572 F.3d 66, 72 (2d Cir. 2009) (“[A]lthough a court must accept as true all of the allegations contained in a complaint, that tenet is inapplicable to legal conclusions, and threadbare recitals of the elements of a cause of action,

supported by mere conclusory statements, do not suffice.” (quotation marks and brackets omitted)). Moreover, “[w]here a complaint pleads facts that are ‘merely consistent with’ a defendant’s liability, it ‘stops short of the line between possibility and plausibility of entitlement to relief.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (certain quotations omitted) (quoting Twombly, 550 U.S. at 557). B. Actions Arising Under the False Claims Act

The FCA prohibits false claims related to government funds. See 31 U.S.C. § 3729 et seq. Individuals are authorized to bring a civil action for a violation of the FCA for the complaining person and for the United States government. United States ex rel. Kreindler & Kreindler v. United Tech. Corp., 985 F.2d 1148, 1153 (2d Cir. 1993) (citing 31 U.S.C. § 3730(b)(1) (1988)).

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United States of America ex rel. Matthew Thomas, Jr. v. Premier Home Health Care Services, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-of-america-ex-rel-matthew-thomas-jr-v-premier-home-health-nysd-2025.