Wilson v. Alaska Native Tribal Health Consortium

CourtDistrict Court, D. Alaska
DecidedJuly 3, 2019
Docket3:16-cv-00195
StatusUnknown

This text of Wilson v. Alaska Native Tribal Health Consortium (Wilson v. Alaska Native Tribal Health Consortium) is published on Counsel Stack Legal Research, covering District Court, D. Alaska primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Wilson v. Alaska Native Tribal Health Consortium, (D. Alaska 2019).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF ALASKA

JOAN WILSON and PAUL FRANKE, M.D., Case No. 3:16-cv-00195-TMB

Plaintiffs, v. ORDER ON MOTION TO DISMISS FOR LACK OF SUBJECT MATTER ALASKA NATIVE TRIBAL HEALTH JURISDICTION AND FAILURE TO CONSORTIUM; ANDREW TEUBER; and STATE A CLAIM (DKT #50), CROSS ROALD HELGESEN, MOTION FOR JURISDICTIONAL DISCOVERY (DKT #74) AND MOTION Defendants. TO DISQUALIFY (DKT #32)

I. INTRODUCTION The matter comes before this Court on Defendants Alaska Native Tribal Health Consortium’s (“ANTHC”), Andrew Teuber’s (“Teuber”) and Roald Helgesen’s (“Helgesen”) (collectively “Individual Defendants”) Motion to Dismiss for Lack of Subject Matter Jurisdiction and Motion to Dismiss for Failure to State a Claim (“Motion to Dismiss”).1 Plaintiffs Joan Wilson (“Wilson”) and Dr. Paul Franke (“Franke”) opposed the Motion to Dismiss and cross-moved for Jurisdictional Discovery (“Discovery Motion”).2 This matter was fully briefed by the parties, and this Court heard oral argument on the Motion to Dismiss and Discovery Motion on June 12, 2019.3 Also pending before the Court is Defendants’ Motion to Disqualify Counsel and Plaintiffs (“Motion to Disqualify”),4 which is fully briefed and ripe for adjudication. The Parties did not seek oral argument with respect to the Motion to Disqualify, and this Court does not find it necessary

1 Dkt. 50 (Mot. to Dismiss). 2 Dkt. 73 (Opp’n to Mot. to Dismiss); Dkt. 74 (Disc. Mot.). 3 Dkt. 86 (Oral Argument Min. Entry). 4 Dkt. 32 (Mot. to Disqualify). to its analysis. For the reasons explained below, Defendants’ Motion to Dismiss at Docket 50 is GRANTED, Plaintiffs’ Cross-motion for Jurisdictional Discovery at Docket 74 is DENIED, and Defendants’ Motion to Disqualify at Docket 32 is DENIED AS MOOT. II. BACKGROUND A. Factual Background ANTHC is a “Tribal Organization and inter-Tribal consortium of federally recognized

Alaska Tribes and Tribal Organizations”5 which co-manages Alaska Native Medical Center (“ANMC”), a tertiary-care hospital that provides medical services in Anchorage, Alaska.6 From 2014 to 2016, ANTHC employed Wilson as Chief Ethics and Compliance Officer.7 From 2013 to 2016, ANTHC employed Franke by contract as the Chief Medical Officer of ANMC.8 Wilson and Franke assert that they have “intimate knowledge of the day-to-day operations” of ANTHC, including billing practices of ANMC.9 They repeatedly allege that Teuber, President of ANTHC,10 and Helgesen, Chief Executive Officer of ANTHC and Hospital Administrator of ANMC,11 were “well-aware” that ANMC and ANTHC’s various billing practices were fraudulent.12 Specifically, Plaintiffs allege that ANTHC engaged in the following fraudulent

5 Dkt. 49 (Second Am. Compl.) at 3, ¶ 5. 6 Dkt. 52 (Helgesen Aff.) at 3, ¶ 5. 7 Dkt. 49 at 2, ¶ 3. 8 Id. at 2, ¶ 4. 9 Id. at 2–3, ¶¶ 3–4. 10 Id. at 3, ¶ 7. 11 Id. at 3, ¶ 6. 12 See Dkt. 49 at 8 –15. practices: double billing for certain medical services;13 billing for services performed by ineligible providers;14 billing for unauthenticated services;15 and accepting incentive payments from Medicaid and Medicare without satisfying program requirements.16 Plaintiffs allege that Wilson “repeatedly brought these issues to the attention of ANTHC and Helgesen,” “repeatedly attempted to reverse these [inappropriate] practices”17 and “urged ANTHC to return, report and repay

overpayments that ANTHC wrongfully obtained”18 without success. Plaintiffs also allege that Helgesen and Teuber took “no action to stop [these inappropriate billing practices]”19 and even “buried Ms. Wilson’s draft compliance plan designed to remedy billing concerns.”20 On May 6, 2016, Helgesen terminated Wilson’s employment with approval from Teuber, his direct supervisor.21 In June 2016, ANTHC notified Franke that his contract, which was due to expire on June 7, 2016, would not be renewed.22

13 Id. at 7, ¶ 22; at 10, ¶¶ 29–31. 14 Id. at 7, ¶ 23. 15 Id. at 8, ¶ 26. 16 Id. at 11–13, ¶¶ 32–35. 17 Id. at 8, ¶ 23. 18 Id. at 13, ¶ 36. 19 Id. at 15, ¶ 38. 20 Id. at 13–14, ¶ 36. 21 Id. at 17, ¶ 41. 22 Dkt. 49 at 2, ¶ 4; 18, ¶ 43. The Second Amended Complaint fails to provide specific dates or examples of Franke reporting or raising concerns regarding the fraudulent billing practices either internally or externally. B. Procedural History On August 29, 2016, Plaintiffs initiated this action against ANTHC as a qui tam lawsuit on behalf of the government and under seal pursuant to the False Claims Act (“FCA”).23 On December 6, 2017, the United States declined to intervene in the action.24 On June 21, 2018,

Plaintiffs filed an Amended Complaint as a private action on behalf of themselves against ANTHC.25 On December 3, 2018,26 Plaintiffs filed the Second Amended Complaint (“SAC”), adding the Individual Defendants pursuant to federal question jurisdiction.27 Plaintiffs allege that their employment at ANTHC was terminated as a result of Plaintiffs’ opposition to ANTHC’s fraudulent billing practices in violation of federal and state laws. III. LEGAL STANDARD Defendants move to dismiss the SAC pursuant to Fed. R. Civ. P. 12(b)(1) based on tribal sovereign immunity and 12(b)(6) based on a failure to state a claim upon which relief can be granted. A. Motion to Dismiss Under Fed. R. Civ. P. 12(b)(1)

The issue of tribal sovereign immunity is quasi-jurisdictional. When properly raised in a 12(b)(1) motion, a district court is not bound to accept a plaintiff’s allegations as true in resolving

23 Dkt. 1 (Compl.); 31 U.S.C. § 3729 et seq. 24 Dkt. 12 (Notice of United States Election to Decline to Intervene). 25 Dkt. 15 (Am. Compl.). 26 Dkt. 49. 27 28 U.S.C. § 1331. that issue,28 nor is it bound by the four corners of the complaint; however, a Court may consider additional materials in resolving a 12(b)(1) motion.29 Furthermore, once a party raises this defense, “‘the party asserting subject matter jurisdiction has the burden of proving its existence,’ i.e. that immunity does not bar the suit.”30

B. Motion to Dismiss Under Fed. R. Civ. P. 12(b)(6) Under Fed. R. Civ. P. 12(b)(6), a defendant may move to dismiss a claim for lacking a factual basis “upon which relief can be granted.”31 Under the “facial plausibility” pleading standard set forth by the Supreme Court in Ashcroft v. Iqbal, “a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim for relief that is plausible on its face.’”32 A district court must accept as true the material factual allegations contained in the complaint, draw all reasonable inferences in favor of the non-moving party, and only consider the allegations contained in the complaint without looking beyond its four corners.33 IV. ANALYSIS Plaintiffs assert the following four claims: (Count I) Defendants violated the FCA by

terminating Plaintiffs’ employment in retaliation for raising concerns about ANTHC and ANMC’s

28 See, e.g., Pistor v. Garcia, 791 F.3d 1104, 1112 (9th Cir. 2015); Robinson v. United States, 586 F.3d 683, 685 (9th Cir. 2009).

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