United States of America v. Amedisys Holding LLC

CourtDistrict Court, D. South Carolina
DecidedMay 1, 2023
Docket7:21-cv-03109
StatusUnknown

This text of United States of America v. Amedisys Holding LLC (United States of America v. Amedisys Holding LLC) is published on Counsel Stack Legal Research, covering District Court, D. South Carolina 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 v. Amedisys Holding LLC, (D.S.C. 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF SOUTH CAROLINA SPARTANBURG DIVISION

United States of America ex rel. ) C/A No. 7:21-cv-03109-DCC Jackie Byers, ) ) Plaintiffs, ) ) ) v. ) OPINION AND ORDER ) Amedisys SC LLC, Amedisys Hospice ) LLC, and Amedisys Inc., ) ) Defendants. ) ________________________________ )

This matter is before the Court on Defendants Amedisys Hospice LLC, Amedisys Inc., and Amedisys SC LLC’s (“Defendants”) Motion to Strike Certain Paragraphs in Plaintiffs’ Amended Complaint. ECF No. 132. Relator Jackie Byers filed a Response in Opposition, and Defendants filed a Reply. ECF Nos. 135, 136. For the reasons set forth below, the Motion is denied. BACKGROUND In this action, Relators1 claim Defendants defrauded Medicare through violations of the False Claims Act (“FCA”), 31 U.S.C. § 3729, and the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b. These federal statutes forbid presentment of false or fraudulent claims for payment or approval to the United States Government and prohibit payments

1 “Relators” refers to Relators Jackie Byers, Cathy McGee, Ellyn Ward, and Angela Monroe, who filed the Amended Complaint in this case on October 26, 2021. Following the Court’s September 14, 2022, Order Granting in Part and Denying in Part Defendants’ Amended Motion to Dismiss, only Byers remains a relator in this case. to induce individuals to refer patients insured by federal healthcare programs, such as Medicare. Relators allege that, since at least 2012, Defendants have defrauded the United

States by submitting, or causing to be submitted, false or fraudulent claims to Medicare for ineligible hospice patients. ECF No. 90 at 17. Specifically, Relators assert that Defendants created and used false certifications of terminal illness, false patient charts, and other false records to support the fraudulent billing to the Government for hospice care provided to ineligible patients. Id. at 58. They claim the patients were not assessed

and approved for hospice care by the proper medical professional according to the Medicare regulations and that hospitals, associated employees, and agents were incentivized to provide referrals, admissions, and recertifications of ineligible hospice patients in support of Defendants’ fraudulent scheme. Id. at 57, 61–63. Relator Jackie Byers filed a sealed Complaint in this Court on August 14, 2015.

United States of America ex rel. Jackie Byers v. Amedisys Holding LLC et al, C.A. No. 6:15-cv-03228-BHH (D.S.C. Aug. 14, 2015). Subsequently, Relators Cathy McGee, Angela Monroe, and Ellyn Ward filed separate cases in the United States District Court for the Southern District of West Virginia and the United States District Court for the Eastern District of New York on August 9, 2016, and October 13, 2016, respectively.2 ECF No. 121 at 9. For more than five years, the Government investigated Relators’

2 Two other relators, Diane Casho and Reba Brandon, filed a separate case in the United States District Court for the District of Maryland. Casho and Brandon later voluntarily dismissed their case with prejudice. ECF No. 121 at 9. allegations while this case was under seal. In April 2019, Relators consented to the Government’s request to consolidate and transfer the cases to the United States District Court for the District of Massachusetts. ECF No. 121 at 9. On February 16, 2021, the

Government filed a Notice of Election to decline intervention.3 ECF No. 71. As a result of the Notice of Election, the case was transferred to this Court and unsealed. ECF Nos. 75, 86. On October 26, 2021, Relators filed an Amended Complaint. ECF No. 90. On September 14, 2022, the Court granted in part and denied in part Defendants’ Amended Motion to Dismiss.4 ECF No. 130. Specifically, the Court granted the Motion

as to Monroe and Ward’s claims, dismissed their claims without prejudice, and dismissed them as relators in this action. Id. at 15. The Court also granted the Motion as to Byer’s Reverse False Claim, dismissing the claim without prejudice. Id. The Court denied the Motion as to Byer’s false claims pursuant to 31 U.S.C. § 3729, including her claim for violation of the Anti-Kickback Statute and her FCA Conspiracy claim. Id.

On September 28, 2022, Defendants filed a Motion to Strike Certain Paragraphs in Plaintiffs’ Amended Complaint. ECF No. 132. Byers filed a Response in Opposition, and Defendants filed a Reply. ECF Nos. 135, 136. The Motion is now before the Court.

3 The Court briefly notes that the decision to decline intervention by the Government is not dispositive of the merits of this action. See United States ex rel. Ubl v. IIF Data Solutions, 650 F.3d 445, 457 (4th Cir. 2011) (“Given its limited time and resources, the government cannot intervene in every FCA action, nor can the government pursue every meritorious FCA claim.”).

4 On April 4, 2022, the Court granted Relators’ Motion to Remove Cathy McGee as a Relator in this action. ECF No. 126. Thus, the Court denied as moot the portion of Defendants’ Amended Motion to Dismiss regarding Relator McGee’s claims. ECF No. 130 at 5. APPLICABLE LAW "The court may strike from a pleading an insufficient defense or any redundant, immaterial, impertinent, or scandalous matter" either on its own or on motion made by a

party "before responding to the pleading or, if a response is not allowed, within 21 days after being served with the pleading." Fed. R. Civ. P. 12(f). "Rule 12(f) motions are generally viewed with disfavor 'because striking a portion of a pleading is a drastic remedy and because it is often sought by the movant simply as a dilatory tactic.'" Waste Mgmt. Holdings, Inc. v. Gilmore, 252 F.3d 316, 347 (4th Cir. 2001) (quoting 5A A. Charles Alan Wright & Arthur R. Miller, Federal Practice & Procedure § 1380, 647 (2d ed. 1990)). DISCUSSION

Defendants request that the Court strike the Reverse False Claim in Count Three from Plaintiffs’ Amended Complaint, including the heading and paragraphs 212–214, because the claim has been dismissed. ECF No. 132-1 at 7 n.2. Defendants also ask this Court to strike numerous factual allegations set forth in Plaintiffs’ Amended Complaint related to their alleged fraudulent conduct outside of South Carolina. Id. at 6–10; see ECF No. 132-2 (Defendants’ Exhibit A outlining the paragraphs they request to strike). Specifically, Defendants argue that because Monroe and Ward were dismissed as relators from this case, any factual allegations related to Defendants’ alleged conduct in West Virginia and New Jersey—the states in which the dismissed relators were employed—should also be removed from the case. Id. The Fourth Circuit Court of Appeals has noted that Rule 12(f) motions are generally viewed with disfavor “because striking a portion of the pleading is a drastic remedy . . . .”

Waste Mgmt. Holdings, Inc. v. Gilmore, 252 F.3d 316, 347 (4th Cir. 2001) (internal quotations and citations omitted). “When reviewing a motion to strike, ‘the court must view the pleading under attack in a light most favorable to the pleader.’” Holland v. Beaufort Cnty., C.A. No. 9:20-CV-03479-DCN-MHC, 2021 WL 5991790, at *1 (D.S.C. Jan. 13, 2021) (quoting Piontek v. Serv. Ctrs. Corp., 2010 WL 4449419, at *3 (D. Md.

Nov. 5, 2010)).

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United States Ex Rel. Ubl v. IIF Data Solutions
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