United States of America v. Remain at Home Senior Care LLC

District Court, D. South Carolina·Decided September 27, 2021·No. 1:17-cv-01493·Unknown

Opinion

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

United States of America, ) Civil Action No.: 1:17-cv-01493-JMC ) Plaintiff, ) ) Ex rel. Tanja Adams, Kianna Curtis, Mindy ) Roberts, Ashley Segars, and Tamara ) Williford, ) ) ORDER AND OPINION Plaintiffs-Relators, ) ) v. ) ) Remain at Home Senior Care, LLC and ) Tim Collins, ) ) Defendants. ) ____________________________________)

Plaintiffs-Relators Tanja Adams, Kianna Curtis, Mindy Roberts, Ashley Segars, and Tamara Williford (collectively “Plaintiffs-Relators”), on behalf of the United States of America (the “United States” or the “Government”) and themselves, bring this qui tam action against Defendants Remain at Home Senior Care, LLC (“RAH”) and Tim Collins (“Collins”) alleging that their actions violated the False Claims Act (“FCA”), 31 U.S.C. §§ 3729–33.1 (ECF No. 29.) This matter is before the court pursuant to Plaintiffs-Relators’ Motion to Amend their First Amended Complaint. (ECF No. 153.) Specifically, in their proposed Second Amended Complaint (the “SAC”), Plaintiffs-Relators seek to add as Defendants Nuclear Workers Institute of America

1 “Under the FCA, private individuals known as relators may file qui tam civil actions against alleged fraudsters on behalf of the United States [G]overnment.” U.S. ex rel. Lanahan v. Coun[t]y of Cook, Case No. 17 C 5829, 2020 WL 6894395, at *6 (N.D. Ill. Nov. 24, 2020) (citing U.S. ex rel. Watson v. King-Vassel, 728 F.3d 707, 711 (7th Cir. 2013); 31 U.S.C. § 3730)). “If the Government does not intervene in the action, as here, a relator may proceed with the action solo but still on the Government’s behalf.” Id. (citing 31 U.S.C. § 3730(c)(3)). “If successful, a relator is eligible to receive a percentage of the total recovery.” Id. (citing § 3730(d)(1)–(2)). (“NWIA”), Brian Carrigan (“Carrigan”), Dawn Blackwell (“Blackwell”), Dr. Francis Jenkins, II (“Dr. Jenkins”), FHJ PULM, LLC (“FHJ”), Dr. Peter Frank (“Dr. Frank”), A.J. Frank (“A.J. Frank”), Twilight Health, LLC (“Twilight”), and RAH Holdings, LLC (“RAH Holdings”) (collectively “Original Defendants”) for FCA violations, (id.), all of whom the court dismissed from Plaintiffs-Relators’ First Amended Complaint. (See ECF Nos. 94–96; 153-1 at 11–18.)

Plaintiffs-Relators also seek to add a new cause of action pursuant to the Fair Credit Reporting Act (“FCRA”), 15 U.S.C. §§ 1681–1681x, against Carrigan and two (2) new Defendants, RAH DEV, LLC (“RAH DEV”) and Monica Chase (“Chase”). (ECF No. 153-1 at 43 ⁋ 149–44 ⁋ 157.) For the reasons stated herein, the court GRANTS IN PART and DENIES IN PART Plaintiffs-Relators’ Motion to Amend the First Amended Complaint. (ECF No. 153.) I. FACTUAL AND PROCEDURAL BACKGROUND Plaintiffs-Relators are licensed nurses formerly employed by RAH. (ECF No. 29 at 4 ¶ 11.) Plaintiffs-Relators filed their original Complaint on June 7, 2017, alleging that Original Defendants fraudulently submitted claims to the Department of Labor (“DOL”) under the Energy

Employees Occupational Illness Compensation Program Act of 2000 (“EEOICPA”), 42 U.S.C. §§ 7384–85. (ECF No. 1 at 1–2 ¶ 1.) Plaintiffs-Relators allege that the EEOICPA compensates eligible individuals who are diagnosed with certain conditions while employed at specific Department of Energy (“DOE”) facilities or awarded benefits under the Radiation Exposure Compensation Act (“RECA”), 42 U.S.C. § 2210. (ECF No. 1 at 11 ¶ 24.) On September 16, 2019, Plaintiffs-Relators filed a First Amended Complaint, contending that Original Defendants defrauded the United States by: (1) “fraudulently recruiting patients” to participate in the Division of Energy Employees Occupational Illness (“DEEOIC”) Program2; (2) “fraudulently providing letters of medical necessity” to allow patients to receive unnecessary benefits under the EEOICPA; (3) “forging signatures on renewal letters of medical necessity for benefits under the EEOICPA”; (4) fraudulently inducing illegitimate EEOICPA impairment ratings; (5) “receiving kickbacks and paying kickbacks for patient referrals under the EEOICPA”;

(6) “providing illegal payment[s] and gifts to patients in the EEOICPA Program”; (7) billing the DOL for EEOICPA home health care provider services that were actually provided by “unqualified patient relatives”; (8) billing the DOL for registered nurse (“RN”) or licensed practical nurse (“LPN”) services under the EEOICPA when services were actually provided by a certified nurse assistant (“CNA”); (9) billing the DOL for unnecessary medical services under the EEOICPA, and/or; (10) “billing the DOL for services not rendered under the EEOICPA.” (ECF No. 29 at 1– 2 ¶ 1.) Plaintiffs-Relators alleged that Original Defendants conspired to present these false claims to the Government in order to receive payment from federal health care programs. (Id. at 19–21.) In addition, Plaintiffs-Relators maintained that RAH, Twilight, and RAH Holdings retaliated

against them for objecting to the alleged FCA violations. (Id. at 20 ¶ 45–21 ¶ 49.) Consequently, Plaintiffs-Relators claimed that all Original Defendants violated § 3729(a)(1)(A) and (C) of the FCA and RAH, Twilight, and RAH Holdings violated § 3730(h). (ECF No. 29 at 19–21.) In August 2020, the court dismissed without prejudice all claims against Carrigan, Blackwell, Frank, NWIA, Twilight, RAH Holdings, Dr. Frank, Dr. Jenkins, and FHJ as well as the FCA conspiracy claims (§ 3729(a)(1)(C)) against Collins and RAH. (ECF Nos. 94–96.) As a result, only the FCA false presentment claim (§ 3729(a)(1)(A)) against Collins and the FCA false

2 Plaintiff-Relators contend that the DEEOIC Program is a segment of the EEOICPA applicable to DOE employees. (ECF No. 1 at 1-2 n.1.) presentment claim (§ 3729(a)(1)(A)) and retaliation claim (§ 3730(h)) against RAH remained. (ECF Nos. 94–96.) On February 21, 2021, Plaintiffs-Relators filed the instant Motion to Amend the First Amended Complaint. (ECF No. 153.) In the SAC, Plaintiffs-Relators make the same FCA allegations as were asserted in the First Amended Complaint against all Original Defendants,

seeking to re-add NWIA, Carrigan, Blackwell, Dr. Jenkins, FHJ, Dr. Frank, A.J. Frank, Twilight, and RAH Holdings as Defendants. (ECF No. 153-1 at 2–3 ¶ 1.) Plaintiffs-Relators also include a new allegation against Carrigan, RAH, and Chase, asserting they procured unauthorized investigative consumer reports on each of Relators for the purposes of harassment and retaliation in violation of the FCRA. (Id. at 3 ¶ 4.) RAH and Collins filed their Response in Opposition to Plaintiffs-Relators’ Motion to Amend (ECF No. 158) on March 8, 2021, to which Plaintiffs-Relators filed their Reply (ECF No. 165) on March 22, 2021. RAH and Collins filed a Sur Reply on March 29, 2021. (ECF No. 167.) II. JURISDICTION

The court has subject matter jurisdiction over this action pursuant to 28 U.S.C. § 1331, as the claims arise under the laws of the United States, specifically 31 U.S.C. §§ 3732(a) and 3730(b)

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United States of America v. Remain at Home Senior Care LLC, (D.S.C. 2021).

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