United States v. Lori L. Carver

Court of Appeals for the Eleventh Circuit·Decided July 31, 2023·No. 22-13608·Unpublished

Opinion

[DO NOT PUBLISH]

In the

United States Court of Appeals For the Eleventh Circuit

No. 22-13608

Non-Argument Calendar

UNITED STATES OF AMERICA, ex. rel. Lori L. Carver, Plaintiff-Appellee,

LORI L. CARVER, Interested Party-Appellant, versus PHYSICIANS PAIN SPECIALISTS OF ALABAMA, P.C., et al.,

Defendants.

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Appeal from the United States District Court for the Southern District of Alabama D.C. Docket No. 1:13-cv-00392-JB-N

Before ROSENBAUM, NEWSOM, and GRANT, Circuit Judges. PER CURIAM:

Lori Carver filed a qui tam action seeking recovery on behalf of the United States under the False Claims Act (“FCA”), see 31 U.S.C. § 3730, for fraudulent claims paid by government healthcare programs that were submitted by her former employers. The government initially declined to intervene in the case, leaving Carver in charge of prosecuting it. Several years later, though, the government changed its mind and moved to intervene for the purpose of exercising its right to unilaterally dismiss the FCA action under 31 U.S.C. § 3730(c)(2)(A). The government’s motion explained in detail why it had come to believe that the burdens of continued litigation outweighed its benefits. The district court granted that motion , and Carver appeals. Because the government gave good grounds, amply supported by the record, for seeking dismissal of this action, the district court did not abuse its discretion by granting the government’s motion. We affirm.

I. The False Claims Act

The FCA imposes civil liability on any person who “knowingly presents . . . a false or fraudulent claim for payment or approval ” to the federal government, among other things. 31 U.S.C.

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§ 3729(a). The FCA is enforced through a public-private framework : the government may sue alleged violators on its own, id. § 3730(a); or a private person—called a “relator”—may sue “in the name of the [g]overnment,” which is known as a qui tam action. Id. § 3730(b)(1). Either way, the injury asserted is “exclusively to the [g]overnment.” United States ex rel. Polansky v. Exec. Health Res., Inc., 143 S. Ct. 1720, 1727 (2023). Nevertheless, “[i]f the action leads to a recovery, the relator may receive up to 30% of the total.” Id. (citing 31 U.S.C. § 3730(d)(1)–(2)).

A relator is “no ordinary civil plaintiff” and is “subject to special restrictions.” Id. at 1727–28. Among them, the relator must file the complaint under seal, and the government then has 60 days—which can be extended for “good cause”—to “intervene and proceed with the action.” 31 U.S.C. § 3730(b)(2)–(3). “If the [g]overnment, during that so-called seal period, elects to intervene, the relator loses control,” and the government takes over. Polanksy , 143 S. Ct. at 1727–28 (citing 31 U.S.C. § 3730(b)(4)(A), (c)(1)). If that occurs, the government “may dismiss the action notwithstanding the objections” of the relator so long as the relator receives notice and an opportunity for a hearing. 31 U.S.C. § 3730(c)(2)(A).

But the relator “shall have the right to conduct the action” if the government opts not to intervene. Id. § 3730(b)(4), (c)(3). Even if the government declines to intervene during the seal period, though, “the relator is not home free.” Polanksy, 143 S. Ct. at 1728.

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The court may “permit the [g]overnment to intervene at a later date upon a showing of good cause.” 31 U.S.C. § 3730(c)(3).

II. Background

A. Carver files a qui tam case and the government declines to intervene.

From 2010 to 2013, Carver worked at Physician’s Pain Specialists of Alabama, PC (the Clinic), a pain-management clinic in Mobile, Alabama. Two medical doctors, John Patrick Couch and Xiulu Ruan, owned and operated the Clinic. They also ran a pharmacy , C&R Pharmacy, LLC (the Pharmacy). As part of their pain- management practice, Couch and Ruan conducted urine drug screening through an arrangement with Castle Medical, LLC (Castle ).

Carver discovered that Couch and Ruan had submitted fraudulent claims for payment to federal healthcare programs. She took this information to the U.S. Attorney’s office, which encouraged her to bring a qui tam action. See United States v. Couch, 906 F.3d 1223, 1226–27 (11th Cir. 2018) (summarizing this history).

Carver filed the suggested qui tam action in August 2013 and an amended pleading in August 2014. The government repeatedly requested and received extensions of the seal period to decide whether to intervene in the case. Finally, in October 2016, the government filed a notice declining to intervene. Soon after, Carver filed her second amended complaint, after which the government again declined to intervene. The district court unsealed the pleadings and some other filings and ordered the qui tam case to move forward.

USCA11 Case: 22-13608 Document: 29-1 Date Filed: 07/31/2023 Page: 5 of 19

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B. The government prosecutes Couch and Ruan.

Meanwhile, the government began investigating Couch and Ruan based in part on Carver’s information. Couch, 906 F.3d at 1226. In April 2015, it obtained an indictment charging both doctors with conspiracy to distribute controlled substances and conspiracy to commit healthcare fraud. The charges partially overlapped with the allegations in Carver’s qui tam complaint. The government later obtained two superseding indictments, in October 2015 and April 2016, adding new defendants and new charges, including racketeering, Anti-Kickback Statute violations, wire fraud, and drug-distribution offenses. These later indictments “partially overlapped with the allegations in Ms. Carver’s qui tam action,” but “also included charges based on unlawful prescribing practices, which were not alleged in the initial qui tam complaint.” Id.

The criminal case went to trial, and the jury convicted Couch of all charges, and Ruan of all but one. Couch and Ruan both appealed. Carver attempted to intervene in the criminal forfeiture proceedings, but the district court denied intervention, and we affirmed in October 2018. See Couch, 906 F.3d at 1228–29. Still, though, we observed that our ruling “will not disable Ms. Carver from getting her relator’s share,” accepting the government’s assurances that a relator is entitled to a share of forfeited property “[w]here a defendant is found civilly liable for damages in a False Claim Act suit after being found criminally liable for the same fraud.” Id. at 1228–29. C. Carver focuses solely on Castle, which then drops out of the case.

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Meanwhile, back in the qui tam case, in May 2017, the district court ordered Carver to show cause for her failure to seek entry of default against Couch, Ruan, the Clinic, and the Pharmacy. The court noted that these defendants had not responded to the complaint or appeared in the case despite being served with process. In response, Carver filed the necessary motions, and the clerk entered the respective defaults.

Unlike the other defendants, Castle appeared in the case and litigated in its defense. In October 2017, the district court granted Castle’s motion for judgment on the pleadings, dismissing the claims against it.

Soon after, the district court ordered Carver to show cause why she had not moved for default judgment against the defaulted parties—the only remaining defendants at that time—and why the action should not be dismissed for failure to prosecute. Carver responded and moved for entry of default judgment under Rule 55(b), Fed. R. Civ. P. The government filed a notice indicating its interest in the proceeding and requesting a briefing schedule.

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