United States of America v. University of Miami

CourtDistrict Court, S.D. Florida
DecidedNovember 16, 2021
Docket1:13-cv-22500
StatusUnknown

This text of United States of America v. University of Miami (United States of America v. University of Miami) is published on Counsel Stack Legal Research, covering District Court, S.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. University of Miami, (S.D. Fla. 2021).

Opinion

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA

CASE NO. 13-22500-CIV-ALTONAGA/McAliley

JONATHAN LORD, M.D.,

Plaintiff, v.

UNIVERSITY OF MIAMI,

Defendant. _________________________/

ORDER

THIS CAUSE is before the Court on Defendant University of Miami’s Motion to Dismiss Third Amended Complaint With Prejudice [ECF No. 114], filed on September 27, 2021. Plaintiff Jonathan Lord, M.D., filed a Response in Opposition [ECF No. 115], and Defendant filed a Reply [ECF No. 116]. The Court has carefully considered the Third Amended Complaint [ECF No. 101], the parties’ written submissions, and applicable law. For the following reasons, the Motion is denied. INTRODUCTION Just one claim remains in this eight-year-old case. Plaintiff asserts that the University of Miami fired him from his position as a high-ranking operations and compliance officer because of his efforts to investigate billing practices that defrauded the federal government. He maintains that his termination violated the anti-retaliation provision of the False Claims Act. See 31 U.S.C. § 3730(h). Defendant moves to dismiss Plaintiff’s retaliation claim on three bases: first, that Plaintiff’s alleged acts are not legally protected; second, that Plaintiff’s employer did not know of his acts even if they are legally protected; and third, that Plaintiff’s allegedly protected acts did not cause his firing. Each of these arguments emphasizes Plaintiff’s role as a compliance employee. Defendant states that Plaintiff’s behavior leading up to his firing was entirely consistent with his role as the University health system’s lead compliance officer, so Defendant could not have had notice that Plaintiff was engaging in whistleblowing efforts rather than simply doing his job.

This suit raises important questions about how compliance officers may give their employers notice of whistleblowing activity before bringing a False Claims Act retaliation claim, particularly in light of congressional amendments to the anti-retaliation provision that broaden employer liability. In resolving these questions, the Court keeps in mind that it must accept Plaintiff’s factual allegations as true and resolve all reasonable doubts in Plaintiff’s favor. BACKGROUND I. Plaintiff’s Early Tenure and Promotion at UHealth The University of Miami operates a variety of well-known medical facilities and medical education institutions. One such institution is the Leonard M. Miller School of Medicine (“Medical School”). (See Third Am. Compl. ¶ 3 (alterations added)). The Medical School houses

within it several clinical and teaching facilities, including Jackson Memorial Hospital (“Jackson”), a non-profit organization that serves the Medical School as a teaching hospital. (See id. ¶¶ 3, 34). In turn, Jackson operates the Miami Transplant Institute, “one of the leading organ transplant centers in the United States.” (Id. ¶ 3). The Medical School’s Department of Surgery provides medical professionals and expertise to Jackson and the Miami Transplant Institute. (See id. ¶ 4). The Medical School’s “clinical delivery component” is sometimes broadly referred to as the University of Miami Health System, or “UHealth.” (Id. ¶ 1). In February 2012, the Dean of the Medical School, Dr. Pascal Goldschmidt, offered Plaintiff a job as Chief Operations Officer (“CCO”) of UHealth. (See id. ¶ 43). Plaintiff accepted, bringing with him an “extensive background in compliance[.]” (Id. ¶ 43–44 (alteration added)). Within days of his hire, Plaintiff met with key leaders, including University of Miami President Donna Shalala, to discuss financial issues facing the University. (See id. ¶ 44). Plaintiff’s early tenure as COO was busy. He soon hired Dr. Jennifer McCafferty-

Fernandez “to lead medical compliance activities for UHealth.” (Id. ¶ 48). Plaintiff also spearheaded several new financial initiatives “with the full support of President Shalala, Dean Goldschmidt, and the [University] Board of Trustees” in the first three months of his employment. (Id. ¶ 49 (alteration added)). Throughout this period, Plaintiff had weekly meetings with Shalala, Goldschmidt, and other University leaders about financial matters and other issues, including collective bargaining negotiations with certain UHealth employees and the negotiation of an annual operating agreement with Jackson. (See id. ¶ 50). These efforts earned Plaintiff praise and a promotion. In July 2012, Goldschmidt, “with the support of President Shalala and [the University]’s Board of Trustees,” promoted Plaintiff to Chief Compliance Officer of the Medical Center and University Vice President for Medical

Administration. (Id. ¶ 51 (alteration added)). Plaintiff’s responsibilities in his new roles included, among other tasks, “structuring the governance of the various departments within UHealth” and “overseeing and implementing policies on compliance with various laws including the Medicare and Medicaid programs[.]” (Id. ¶ 1 (alteration added)). II. Investigation of Billing Practices In Plaintiff’s telling, the events that led to his termination center around the conduct of another prominent UHealth employee, Dr. Alan Livingstone. Livingstone was an influential member of the Medical School faculty, the chairperson of the Department of Surgery, chief of surgical services at Jackson, and clinical director of the Miami Transplant Institute. (See id. ¶ 7). In 2007, Livingstone moved pathology testing and oversight for organ transplant patients from Jackson to facilities within the Department of Surgery, including the Immuno-Monitoring Laboratory (“IML”). (See id. ¶ 4). Yet Livingstone also resisted efforts by University pathologists to transfer “transplant pathology testing and oversight” to the University’s Pathology Department.

(Id. ¶ 55). These decisions created tension between the Department of Surgery and Pathology Department. (See id.). In the midst of this interdepartmental struggle, some members of the University community suggested that the Department of Surgery was overbilling Medicare for medically unnecessary services. (See id.). By the spring of 2012, Goldschmidt had grown disappointed with the transplant facilities at Jackson. (See id. ¶ 56). He decided to pursue state approval of a new transplant facility at the University of Miami Hospital — the flagship hospital of UHealth, separate from Jackson’s Miami Transplant Institute. (See id. ¶¶ 41, 56). This decision allegedly upset Livingstone because the “proposed . . . transplant facility would directly compete with and significantly impair” the Miami Transplant Institute where Livingstone served as director. (Id. ¶ 56 (alteration added)).

Goldschmidt backed away from his initial plan after Jackson agreed to improve its transplant facilities. (See id.). But allegations of Medicare overbilling in the Department of Surgery continued to linger. (See id.). Not much later, Goldschmidt recommended that Dr. Gaetano Ciancio replace Livingstone as director of the Miami Transplant Institute. (See id. ¶¶ 57–58). Goldschmidt planned for IML employees to report to Ciancio because, as he put it, “the functioning of the IML needs to be compliant with good clinical laboratory practice and partner successfully with the Department of Pathology to ensure standardization of testing and reporting.” (Id. ¶ 58 (quotation marks omitted)). Around the same time, Plaintiff and Goldschmidt assigned McCafferty-Fernandez and a colleague the task of recommending a firm to review and investigate the practices of the transplant program, including those of the IML. (See id. ¶ 59). McCafferty-Fernandez and her counterpart ultimately recommended that Transplant Management Group, LLC (“TMG”) do the job. (See id.).

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