United States of America Ex Rel. Robert J. Merena v. Smithkline Beecham Corporation United States of America, United States of America Ex Rel. Kevin J. Spear the Berkeley Community Law Center Jack Dowden v. Smithkline Beecham Clinical Laboratories, Inc. United States of America, United States of America Ex Rel. Glenn Grossenbacher Charles W. Robinson, Jr. v. Smithkline Beecham Clinical Laboratories, Inc. United States of America

205 F.3d 97
CourtCourt of Appeals for the Third Circuit
DecidedApril 21, 2000
Docket98-1497
StatusPublished
Cited by2 cases

This text of 205 F.3d 97 (United States of America Ex Rel. Robert J. Merena v. Smithkline Beecham Corporation United States of America, United States of America Ex Rel. Kevin J. Spear the Berkeley Community Law Center Jack Dowden v. Smithkline Beecham Clinical Laboratories, Inc. United States of America, United States of America Ex Rel. Glenn Grossenbacher Charles W. Robinson, Jr. v. Smithkline Beecham Clinical Laboratories, Inc. United States of America) is published on Counsel Stack Legal Research, covering Court of Appeals for the Third Circuit 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. Robert J. Merena v. Smithkline Beecham Corporation United States of America, United States of America Ex Rel. Kevin J. Spear the Berkeley Community Law Center Jack Dowden v. Smithkline Beecham Clinical Laboratories, Inc. United States of America, United States of America Ex Rel. Glenn Grossenbacher Charles W. Robinson, Jr. v. Smithkline Beecham Clinical Laboratories, Inc. United States of America, 205 F.3d 97 (3d Cir. 2000).

Opinion

205 F.3d 97 (3rd Cir. 2000)

UNITED STATES OF AMERICA EX REL. ROBERT J. MERENA
v.
SMITHKLINE BEECHAM CORPORATION United States of America, Appellant
UNITED STATES OF AMERICA EX REL. KEVIN J. SPEAR; THE BERKELEY COMMUNITY LAW CENTER; JACK DOWDEN
v.
SMITHKLINE BEECHAM CLINICAL LABORATORIES, INC.
United States of America, Appellant
UNITED STATES OF AMERICA EX REL. GLENN GROSSENBACHER; CHARLES W. ROBINSON, JR.
v.
SMITHKLINE BEECHAM CLINICAL LABORATORIES, INC.
United States of America, Appellant

No. 98-1497, No. 98-1498, No. 98-1499

UNITED STATES COURT OF APPEALS FOR THE THIRD CIRCUIT

Argued: March 5, 1999
Filed February 29, 2000
Amended April 21, 2000

ON APPEAL FROM THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA (Dist. Ct. Nos. 93--cv--5974 and 95-cv-6551) District Judge: The Honorable Donald W. VanArtsdalenDouglas N. Letter Freddi Lipstein (argued) United States Department of Justice Civil Division, Appellate Staff 601 D. Street, N.W. Washington, D.C. 20530-0001 Attorneys for Appellant United States of America

Marc S. Raspanti (argued) Miller, Alfano & Raspanti 1818 Market Street Suite 3402 Philadelphia, PA 19103 Attorney for Appellee Robert J. Merena

Thomas H. Lee, II Dechert, Price & Rhoads 1717 Arch Street 4000 Bell Atlantic Tower Philadelphia, PA 19103 Attorney for Appellee Smithkline Beecham

Normand F. Pizza Nyda S. Brook Christopher J. Shenfield Brook, Pizza, & Van Loon 400 Poydras Street Suite 2500 New Orleans, LA 70130 Attorneys for Appellee William, St. John & LaCorte

John E. Clark Goode, Casseb & Jones 700 North St. Mary's Street Suite 1700 San Antonio TX 78205 Attorney for Appellees Charles W. Robinson, Jr., and Glenn Grossenbacher

Peter W. Chatfield Phillips & Cohen 2000 Massachusetts Avenue, N.W. Washington, DC 20036 Attorney for Appellees Kevin J. Spear, Berkeley Community Law Center, and Jack Dowden

Carol S. Dew Dew & Smith 100 Court Street P.O. Box 30 Monroe, GA 30655-0030 Attorney for Appellee Jeffrey Clausen

Lisa R. Hovelson Taxpayers Against Fraud Suite 501, 1220 Nineteenth Street, N.W. Washington D.C. 20036 Attorney for Amicus Curiae Taxpayers Against Fraud, The False Claims Act Legal Center

Daniel Popeo Paul D. Kamenar Washington Legal Foundation 2009 Massachusetts Avenue, N.W. Washington, D.C. 20036 Attorneys for Amicus Curiae Washington Legal Foundation

Before: ALITO, McKEE, AND GARWOOD,* Circuit Judges

OPINION OF THE COURT

ALITO, Circuit Judge:

In this appeal, the United States challenges the District Court's decision to award a group of qui tam relators approximately $52 million of the government's settlement with defendant SmithKline Beecham Clinical Laboratories of a variety of claims under the False Claims Act, 31 U.S.C. S 3729 et seq. For the reasons explained below, we reverse and remand for further proceedings.

I.

A. In 1992, the United States began to suspect that SmithKline Beecham Clinical Laboratories ("SKB") and several other medical laboratories had adopted the following scheme that allowed them to bill the federal government for unauthorized and unnecessary laboratory tests. The laboratories had "bundled" a standard grouping of blood tests with some additional tests and had then marketed this grouping to doctors by leading them to believe that the additional tests would not increase costs to Medicare and other government-sponsored health programs.

After the tests were ordered, the laboratories "unbundled" the additional tests from the standard grouping for purposes of billing. In many instances, treating physicians had made no determination that the additional tests were medically necessary for the diagnosis or treatment of patients; instead, the physicians had ordered the tests solely because they were sold as a package with other tests that they had deemed necessary. As a result, the laboratories submitted bills--and received payment-for tests that were medically unnecessary.

This scheme, which later became known as the "automated chemistry" scheme, attracted national attention in December 1992 when one of the contractors that had engaged in the practice, National Health Laboratories, settled a lawsuit brought under the False Claims Act for $111 million. See Joint App. at 1432-1441. Public interest grew as the news media reported that the government had issued comprehensive subpoenas to SKB and other laboratories. See Joint App. at 1442-1450, 1451-1457, 1470-1473.

B. In November 1993, relator Robert Merena, an SKB employee, filed a qui tam action against SKB in the United States District Court for the Eastern District of Pennsylvania. His complaint contained eight separate claims under the False Claims Act. Merena's complaint alleged that SKB had defrauded the government by, inter alia, billing for tests that were not performed, double billing, paying illegal kickbacks to health care professionals, and adding tests to "automated chemistry" profiles and then separately billing for those tests. App. at 75-103.

One month later, relator Glenn Grossenbacher, an attorney, filed a second qui tam action against SKB in the United States District Court for the Western District of Texas.1 Relators Kevin Spear, Jack Dowden, and the Berkeley Community Law Center (collectively, "the Spear relators") followed in February of 1995 with a suit in the Northern District of California. The courts in Texas and California transferred these actions to the Eastern District of Pennsylvania for consolidation with the Merena case.

After Merena's action was filed, the government commenced an investigation into a series of new claims that were not part of its original investigation. At the same time, the government continued to pursue the original "automated chemistry" investigation that it had begun after the 1992 settlement with National Health Laboratories.

C. In August 1995, the government began formal settlement negotiations with SKB. The government presented SKB with a written settlement framework that allocated a specific dollar amount for each alleged false claim. Joint App. at 1476-1491.

By early 1996, SKB and the government had reached a tentative agreement to settle, for $295 million, certain federal and state claims for losses occurring through December 31, 1994. This agreement was intended to settle claims related to the government's original "automated chemistry" investigation, along with additional claims in the qui tam actions filed by relators Merena, Grossenbacher, and Spear. At a meeting on March 22, 1996, counsel for the United States explained to the relators the components of the proposed settlement. See Joint App. at 1537, 15381549. During the summer of 1996, the United States negotiated an additional payment from SKB of $30 million to resolve additional claims that arose during 1995 and 1996. Joint App. at 859, 1223.

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