United States of American v. Kansal MD

CourtDistrict Court, N.D. Indiana
DecidedOctober 28, 2024
Docket2:15-cv-00307
StatusUnknown

This text of United States of American v. Kansal MD (United States of American v. Kansal MD) is published on Counsel Stack Legal Research, covering District Court, N.D. Indiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States of American v. Kansal MD, (N.D. Ind. 2024).

Opinion

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF INDIANA HAMMOND DIVISION

UNITED STATES OF AMERICA and STATE OF INDIANA ex rel. BRADLEY A. STEPHENS,

Plaintiffs,

v. CAUSE NO.: 2:15-CV-307-TLS

DR. ARSHAD MALIK, DR. ERNEST MIRICH, DR. ZHAFAR KHALID and NUCLEAR CARDIOLOGY ASSOCIATES,

Defendants.

OPINION AND ORDER The Relator Bradley A. Stephens brings an Amended Complaint [ECF No. 15] against Defendants Dr. Rakesh Kansal, Dr. Arshad Malik, Dr. Ernest Mirich, Dr. Zhafar Khalid, and Nuclear Cardiology Associates (NCA), alleging that these doctors knowingly made false claims to Medicaid for payment for myocardial stress tests and/or nuclear imaging services when they self-referred their patients to NCA—an entity that each doctor shares an ownership interest in— for those services, which NCA performed. The Relator arranges his allegations into three Counts involving four separate schemes implicating the federal False Claims Act (FCA), the federal Stark Law, and the Indiana False Claims Act. Count I contains two separate schemes.1 The first scheme involves unlawful referrals and billing to Medicaid by the Doctors for falsely certifying

1 Because “[o]ne set of facts producing one injury creates one claim for relief, no matter how many laws the deeds violate[,]” the Court assumes each scheme constitutes a distinct claim for relief. N.A.A.C.P. v. Am. Fam. Mut. Ins. Co., 978 F.2d 287, 292 (7th Cir. 1992) (citations omitted); see also Fed. R. Civ. P. 10(b) (“If doing so would promote clarity, each claim founded on a separate transaction or occurrence— and each defense other than a denial—must be stated in a separate count or defense.”). compliance with the Stark Law. The second scheme involves NCA causing the unlawful billing to Medicaid by the Doctors. Count II contains the third scheme, which involves unlawful billing to Medicaid by the Doctors for services they did not supervise or provide but that NCA provided instead. Count III contains the fourth scheme, which involves a conspiracy among the Doctors to submit false claims to Medicaid. The United States elected to intervene in the part of the action related to allegations involving Dr. Kansal. ECF No. 70. However, the United States declined to intervene in the part of the action related to allegations involving Defendants Drs. Malik, Mirich, and Khalid (the

Doctor Defendants). Id. The State of Indiana declined to intervene at all. ECF No. 73. The United States and the Relator filed a Joint Notice of Voluntary Dismissal of Defendant Dr. Rakesh Kansal [ECF No. 71], on June 12, 2023, which the Court granted on September 15, 2023 [ECF No. 84], dismissing Defendant Dr. Kansal from the instant action. This matter is now before the Court on Defendant Dr. Ernest Mirich’s Motion to Dismiss First Amended Complaint [ECF No. 96], Defendants Dr. Arshad Malik and Nuclear Cardiology Associates’ Motion to Dismiss Plaintiff’s Amended Complaint [ECF No. 98], and the Motion to Dismiss of Dr. Zhafar Khalid [ECF No. 100], each brought pursuant to Federal Rules of Civil Procedure 9(b) and 12(b)(6). The Motions are fully briefed and ripe for ruling. For the reasons set forth below, the Court grants the motions.

2 Although “the Doctors” referred to Drs. Kansal, Malik, Mirich, and Khalid in the Amended Complaint, because Dr. Kansal has been dismissed from the instant litigation, see ECF No. 84, “the Doctors” now refers to only Drs. Malik, Mirich, and Khalid. LEGAL AND STATUTORY STANDARDS A. Motion to Dismiss “A motion to dismiss pursuant to Federal Rule of Civil Procedure 12(b)(6) challenges the viability of a complaint by arguing that it fails to state a claim upon which relief may be granted.” Camasta v. Jos. A. Bank Clothiers, Inc., 761 F.3d 732, 736 (7th Cir. 2014) (citing Fed. R. Civ. P. 12(b)(6); Gen. Elec. Cap. Corp. v. Lease Resol. Corp., 128 F.3d 1074, 1080 (7th Cir. 1997)). When reviewing a complaint attacked by a Rule 12(b)(6) motion, a court construes the complaint in the light most favorable to the non-moving party, accepts the factual allegations as

true, and draws all inferences in the non-moving party’s favor. Bell v. City of Chicago, 835 F.3d 736, 738 (7th Cir. 2016). “Factual allegations must be enough to raise a right to relief above the speculative level . . . on the assumption that all the allegations in the complaint are true (even if doubtful in fact).” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555 (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.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citing Twombly, 550 U.S. at 556). Claims of fraud brought under the FCA and the Indiana False Claims Act are subject to the heightened pleading standard of Federal Rule of Civil Procedure 9(b), which requires a relator to “state with particularity the circumstances constituting fraud or mistake.” Lanahan v.

County of Cook, 41 F.4th 854, 861–62 (7th Cir. 2022) (quoting Fed. R. Civ. P. 9(b)). The “precise level of particularity required under Rule 9(b) depends upon the facts of the case,” but the pleadings generally should describe “the who, what, when, where, and how of the fraud.” Camasta, 761 F.3d at 737; see United States ex rel. Prose v. Molina Healthcare of Ill., Inc., 17 F.4th 732, 739 (7th Cir. 2021) (recognizing that a plaintiff’s allegations must be “precise” and “substantiated,” though “courts and litigants should not ‘take an overly rigid view of the formulation’” (cleaned up)). “Malice, intent, knowledge, and other conditions of a person’s mind may be alleged generally.” Fed. R. Civ. P. 9(b). B. False Claims Act “The FCA imposes civil liability on a series of actions related to fraudulent treatment of government funds.” Lanahan, 41 F.4th at 861 (citing 31 U.S.C. § 3729(a)(1)). A private citizen, referred to as a “relator,” may bring an action under the FCA “in the name of the Government.” Id. (quoting 31 U.S.C. § 3730(b)(1)). Although the Relator references § 3729(a)(1) and § 3729(a)(1)(A) in the Amended Complaint, it appears that the Relator is alleging violations of

§ 3729(a)(1)(A), § 3729(a)(1)(B), and § 3729(a)(1)(C). A defendant violates the FCA when it “knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval.” 31 U.S.C.

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