United States of America v. Orlando Heart & Vascular Center, LLC

CourtDistrict Court, M.D. Florida
DecidedSeptember 27, 2022
Docket6:19-cv-01884
StatusUnknown

This text of United States of America v. Orlando Heart & Vascular Center, LLC (United States of America v. Orlando Heart & Vascular Center, LLC) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida 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. Orlando Heart & Vascular Center, LLC, (M.D. Fla. 2022).

Opinion

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF FLORIDA ORLANDO DIVISION

UNITED STATES OF AMERICA ex rel. JESSICA ELS,

Plaintiffs,

v. Case No. 6:19-cv-1884-CEM-DCI

ORLANDO HEART & VASCULAR CENTER, LLC and VINEEL SOMPALLI,

Defendants. / ORDER THIS CAUSE is before the Court on Defendants’ Amended Motion to Dismiss (“Motion,” Doc. 34), to which Relator filed a Response in Opposition (Doc. 35) and a Corrected Response in Opposition (Doc. 36), and Defendant filed a Reply (Doc. 40). For the reasons stated herein, the Motion will be granted in part and denied in part. I. BACKGROUND This action arises under the False Claims Act, 31 U.S.C. § 3729 et seq. (Am. Compl., Doc. 12, at 1). “[T]he False Claims Act imposes civil liability on ‘any person’ who ‘knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval’ to the Government or to certain third parties acting on the Government’s behalf.” Cochise Consultancy, Inc. v. United States ex rel. Hunt, 139 S. Ct. 1507, 1510 (2019) (quoting 31 U.S.C. § 3729(a), (b)(2)). The Act

authorizes “a private person, known as a relator, [to] bring a qui tam civil action ‘for the person and for the United States Government’ against the alleged false claimant, ‘in the name of the Government.’” Id. (quoting 31 U.S.C. § 3730(b)).

In the instant action, Relator, a former employee of Defendant Orlando Heart & Vascular Center, LLC (“OHVC”), filed this qui tam action against Defendants, alleging violations of the False Claims Act. (Doc. 12 at 1). OHVC “specializes in cardiovascular care,” and Defendant Vineel Sompalli is a medical doctor and the

Managing Member of OHVC. (Id. at 4–5). Relator began her employment on May 6, 2019, “as the Technical Director of OHVC’s Echo Lab.” (Id. at 5). In this role, Relator alleges that she “observed the falsification of information in medical records

including, for example, inputting false symptoms and diagnosis codes to support the provision of medically unnecessary and/or non-covered services, as well as falsification of the identity of the rendering provider” and that she “personally witnessed” OHVC and Sompalli “submit[] claims to Medicare for medically

unnecessary, non-covered, upcoded, and/or non-rendered services.” (Id.). Upon observing these actions by Defendants, Relator alleges that she “complained, both orally and in writing, to OHVC management and Dr. Sompalli,” and “[a]s a direct result of her complaints,” her employment was terminated on June 26, 2019. (Id. at 17).

Relator asserts five counts—four counts for alleged violations of the False Claims Act and a single count for an alleged violation of the Florida Whistleblower Protection Act (“Whistleblower Act”), Fla. Stat. § 448.101 et seq. (Id. at 18–21).

Defendants move to dismiss the Amended Complaint pursuant to Federal Rule of Civil Procedure 12(b)(6). (Doc. 34 at 1). II. LEGAL STANDARD “A pleading that states a claim for relief must contain . . . a short and plain

statement of the claim showing that the pleader is entitled to relief.” Fed. R. Civ. P. 8(a)(2). Additionally, “[i]n alleging fraud or mistake, a party must state with particularity the circumstances constituting fraud or mistake.” Fed. R. Civ. P. 9(b).

Pursuant to Federal Rule of Civil Procedure 12(b)(6), a party may move to dismiss a complaint for “failure to state a claim upon which relief can be granted.” In determining whether to dismiss under Rule 12(b)(6), a court accepts the factual allegations in the complaint as true and construes them in a light most favorable to

the non-moving party. See United Techs. Corp. v. Mazer, 556 F.3d 1260, 1269 (11th Cir. 2009). Nonetheless, “the tenet that a court must accept as true all of the allegations contained in a complaint is inapplicable to legal conclusions,” and

“[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). Furthermore, “[t]o survive a motion to dismiss, a complaint must contain sufficient

factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Id. (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court

to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. Ordinarily, in deciding a motion to dismiss, “[t]he scope of the review must be limited to the four corners of the complaint.” St. George v. Pinellas Cnty., 285 F.3d 1334, 1337 (11th Cir. 2002).

III. ANALYSIS Counts I through III allege violations of the False Claims Act for the submission of false claims to Medicare, false statements to Medicare, and failure to

repay overpayment from Medicare, respectively. (Doc. 12 at 18–20). Count IV alleges a claim for wrongful retaliation under the False Claims Act. (Id. at 20–21). And Count V is a state law claim under the Whistleblower Act alleging retaliatory discharge. (Id. at 21). Counts I through III are subject to Rule 9(b)’s heightened

pleading standard, whereas Counts IV and V are only subject to Rule 8(a)’s pleading standard. United States ex rel. Clausen v. Lab’y Corp. of Am., 290 F.3d 1301, 1309– 10 (11th Cir. 2002) (noting that it is “‘well settled’ and ‘self-evident’ that the False

Claims Act is ‘a fraud statute’ for the purposes of Rule 9(b)” (citation omitted)); United States ex rel. Sanchez v. Lymphatx, Inc., 596 F.3d 1300, 1304 (11th Cir. 2010) (holding that a False Claims Act retaliation claim is not subject to Rule 9(b)’s

heightened pleading standard); Johannaber v. Emory Univ., No. 1:08-cv-2201- TWT, 2009 U.S. Dist. LEXIS 138359, at *8 (N.D. Ga. Dec. 14, 2009) (“Unlike [Relator]’s fraud claim, her retaliation claim is not subject to Rule 9(b)’s heightened

pleading standard.”). A. Counts I through III—Rule 9(b) Heightened Pleading Standard Defendants argue that the Amended Complaint fails to satisfy Rule 9(b)’s heightened pleading standard because Relator has not “identif[ied] even a single

record presented or false claim submitted to Medicare” and “[b]ecause Relator’s amended complaint lacks any indicia of reliability.” (Doc. 34 at 9, 18). Defendants’ argument is twofold, so the Court will address each argument in turn.

1. Specific Sample False Claim First, Defendants argue that Relator has not provided sufficient information regarding a specific false claim submitted to the government.

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