United States v. Genesis Global Healthcare

CourtDistrict Court, S.D. Georgia
DecidedMay 25, 2023
Docket4:18-cv-00128
StatusUnknown

This text of United States v. Genesis Global Healthcare (United States v. Genesis Global Healthcare) is published on Counsel Stack Legal Research, covering District Court, S.D. Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. Genesis Global Healthcare, (S.D. Ga. 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF GEORGIA SAVANNAH DIVISION

UNITED STATES OF AMERICA, et al.,

Plaintiffs, CIVIL ACTION NO.: 4:18-cv-128

v.

GENESIS GLOBAL HEALTHCARE, et al.,

Defendants.

O R D E R This is a qui tam action brought by Jerry Cohn Jr., M.D., and Sharon Bell as Relators on behalf of the United States under the False Claims Act (the “FCA”) and on behalf of the state of Georgia under the Georgia False Medicaid Claims Act (the “GFMCA”).1 Relators bring suit against Defendants Genesis Vascular of Pooler, LLC (“GVP”);2 Genesis Global Healthcare, LLC; Genesis Healthcare Management, LLC; Genesis Vascular, LLC; Statesboro Cardiology, P.A.; James O’Dare; Barbara O’Dare; Donald Geer; Dr. Abraham Lin; C3 of Bulloch, Inc.; Dr. Stanley J. Shin; Alexis M. Shin, as trustee of the Stanley J. Shin Family Trust; Dr. Todd Newsom; Dr. Howard Gale; Dr. Leonard Talarico; Pooler Property Holdings, LLC; Dr. David Nabert; and Dr.

1 The FCA allows a private person, known as a relator, to bring an FCA suit on behalf of the United States in a qui tam action. 31 U.S.C. § 3730(b)(1). A relator serves the United States with a copy of the complaint, and the United States then has sixty days to intervene and proceed with the action once served. Id. § 3730(b)(2). If the United States does not intervene, the relator may proceed individually with the action. Id. § 3730(b)(4). Similarly, the GFMCA permits a private person to act as a relator on behalf of the state of Georgia and continue with the suit even after the state of Georgia declines to intervene. See O.C.G.A. § 49-4-168.2(b), (f).

2 Relators voluntarily dismissed their claims against GVP without prejudice on February 16, 2021. (Doc. 112.) Todd Becker3 for alleged violations of the FCA and the GFMCA. (See doc. 131, p. 2.) Various Defendants previously filed motions to dismiss the First Amended Complaint. (Docs. 72, 73, 74, 75, 80, 81.) The Court entered an Order granting in part and denying in part the motions to dismiss and directing Relators to file a Second Amended Complaint to cure multiple pleading deficiencies.

(Doc. 130 (the “Order”).) Presently before the Court are three Motions to Dismiss the Second Amended Complaint: one filed by Defendants Statesboro Cardiology, P.A., Dr. Abraham Lin, C3 of Bulloch, Inc., Dr. Stanley J. Shin, Alexis M. Shin as trustee for the Stanley J. Shin Family Trust, Dr. Leonard Talarico, Pooler Property Holdings, LLC, and Dr. David Nabert (collectively, the “Moving Defendants”), (doc. 139); one filed by Defendant Barbara O’Dare, (doc. 158); and one filed by Defendant James O’Dare, (doc. 159). (The Court will refer to Barbara O’Dare and James O’Dare collectively as the “O’Dare Defendants.”) All of the at-issue Motions argue that the Second Amended Complaint failed to remedy the pleading deficiencies identified in the Order. (See generally docs. 139, 158, 159.) Relators filed Responses to the Motions to Dismiss. (Docs. 157,

160.) The O’Dare Defendants collectively filed a Reply, (doc. 166), but the Moving Defendants did not. For the reasons more fully explained herein, the Court DENIES all three of the Motions to Dismiss. (Docs. 139, 158, 159.)

3 Brian Moogerfield was also originally listed as a named Defendant in this case. (See doc. 3.) However, he is not named in either the First Amended Complaint or the Second Amended Complaint. (See docs. 32, 131.) He also does not appear to be represented in this case and has not joined on any of the Motions. Plaintiffs shall update the Court on the status of all claims against Brian Moogerfield within fourteen (14) days of the date of this Order. BACKGROUND I. Factual Background of the Allegedly Fraudulent Scheme According to the Second Amended Complaint, in December 2014, the “Genesis Individual Defendants” (the O’Dare Defendants and non-moving Defendants Geer and Yanes), formed the

“Genesis Entities” (consisting of non-moving Defendants Genesis Vascular, Genesis Global, and Genesis Management) with the intention of forming a vascular surgical center in Pooler, Georgia: GVP. (Doc. 131, pp. 29–30.) To form GVP, the Genesis Individual Defendants recruited medical physicians in the greater Savannah area as investors, and ultimately retained Defendants Drs. Lin, Shin, Newsom, Gale, Talarico, Nabert, and Becker as investors in GVP (collectively the “Physician Investors”). (Id. at pp. 10, 30–31.) According to the Second Amended Complaint, Lin’s investment was made through his company, Defendant C3 of Bulloch, Inc., (“C3 of Bulloch”), of which he is the sole owner, employee, and beneficiary, and which is operated out of his home. (Id. at pp. 6–7, 10.) Talarico likewise invested through his company, Defendant Pooler Property Holdings, LLC (“Pooler Property Holdings”), of which he is allegedly the sole owner

and agent, and which is operated out of his medical office. (Id. at pp. 9–10.) Shin’s investment was made through his family trust, the Stanley J. Shin Family Trust (the “Trust”). (Id. at p. 8.) The Second Amended Complaint alleges that, following the creation of GVP, the Physician Investors would refer patients to GVP for “expensive and invasive vascular procedures” in exchange for profit distributions and “other payments” from GVP. (Id. at p. 31.) According to the Second Amended Complaint, the profit distributions for Physician Investors Lin, Talarico, and Shin were paid out not to the individuals but to C3 of Bulloch, Pooler Property Holdings, and the Trust, respectively. (Id. at pp. 7–10.) Following the referrals, GVP would then file claims with Medicare and Medicaid seeking reimbursements for services rendered to the referred patients. (Id. at p. 39.) The Second Amended Complaint contends that this scheme violated the Anti-Kickback Statute (“AKS”), 42 U.S.C. § 1320(a)-7b(b)(2)(A), and, in turn, the FCA. (Id. at pp. 31, 34–35.) Relators additionally allege that this scheme violated the Stark Act, 42 U.S.C. § 1395nn, and, in turn, the FCA.4 (Id. at pp. 47–50, 53.) They allege that Defendant Statesboro Cardiology

and GVP engaged in a “billing scheme that disguised the location of certain billings that [GVP] could not make without violating the Stark [Act]’s prohibition against self-referral of designated services.” (Id. at p. 48.) According to the Second Amended Complaint, Talarico referred patients to GVP for medical procedures that qualify as “designated health services” under the Stark Act, and Lin, as lead interventionist at GVP, then performed those procedures on the patients or, alternatively, referred those patients to Statesboro Cardiology (where Dr. Lin had an additional established practice and Drs. Shin and Nabert also had established practices) to undergo those procedures. (Id. at p. 49.) However, according to the Second Amended Complaint, regardless of whether Lin performed those procedures at GVP or referred the patients to Statesboro Cardiology, Statesboro Cardiology billed Medicare for those services. (See id. at p. 50.) As a result, according

to the Second Amended Complaint, the associated claims either falsely stated the location of service, rendering the claims in violation of the FCA, or violated the Stark Act’s prohibition against self-referrals because Lin would have referred patients to Statesboro Cardiology, where Defendant Lin holds his principal office. (Id. at pp. 7–8, 50.)

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United States v. Genesis Global Healthcare, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-genesis-global-healthcare-gasd-2023.