ZEDIKER v. ORTHOGEORGIA

CourtDistrict Court, M.D. Georgia
DecidedSeptember 25, 2019
Docket5:15-cv-00417
StatusUnknown

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

Bluebook
ZEDIKER v. ORTHOGEORGIA, (M.D. Ga. 2019).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF GEORGIA MACON DIVISION

UNITED STATES OF AMERICA ex rel. ) MELISSA D. ZEDIKER, ) ) And ) ) STATE OF GEORGIA ex rel. MELISSA ) D. ZEDIKER, ) Civil Action No. 5:15-CV-417 (MTT) ) Plaintiff – Relator, ) ) v. ) ) ORTHOGEORGIA. ) ) Defendant. )

ORDER On November 9, 2015, Relator Melissa Zediker brought a qui tam action under the False Claims Act, 31 U.S.C. §§ 3729-3732 (“FCA”), and the Georgia False Medicaid Claims Act, O.C.G.A. § 49-4-168, et seq. (“GFMCA”), alleging the Defendants1 submitted false claims to federal healthcare programs and took illegal kickbacks. See generally Doc. 2. After the Government (the United States and the State of Georgia), intervened with its own complaint and some Defendants were dismissed, the Relator, the Government, and Defendant OrthoGeorgia2 reached a $760,000.00 settlement of the Government’s claims. The only remaining issues are (1) what percentage of the settlement Zediker should recover for her contribution to the qui tam action and (2) what

1 Initially, there were two groups of defendants in the case: OrthoGeorgia and related parties, and Urology Specialists of Georgia (“USG”) and related parties. As discussed below, the Government dismissed the USG group after determining there was not enough evidence to substantiate Zediker’s allegations.

2 OrthoGeorgia, formerly two separate orthopaedic practices known as OrthoGeorgia and Forsyth Street Orthopaedics, is a medical provider of orthopaedic services comprised of 37 entities and individuals listed in the caption of the Complaint. amount Zediker’s counsel should be awarded in attorneys’ fees and costs. For the following reasons, Zediker is awarded a 15% share ($114,000.00) of the $760,000.00 settlement amount, and her counsel are awarded $145,303.37 in attorneys’ fees and costs.

I. BACKGROUND Zediker was employed by OrthoGeorgia for over ten years. Doc. 2 ¶ 30. She initially handled administrative work, then worked her way up to become Chief Operating Officer. Id. After leaving OrthoGeorgia in December 2014, Zediker worked for now-dismissed defendant Urology Specialists of Georgia (“USG”) until she was terminated in July 2015. Id. ¶ 32. Zediker was then arrested and subsequently indicted under state law for stealing from OrthoGeorgia and USG. Coincidentally, or not, between the time of her arrest and indictment, Zediker filed this qui tam action against OrthoGeorgia and USG. Apparently convinced that Zediker had a “near photographic memory,” Zediker’s counsel included in the 158-page complaint a vast and wide array of

allegations, so vast and so wide that the Government argues the complaint was a mostly unhelpful “shotgun” pleading. Docs. 44 at 13; 47 at 14; see generally Doc. 2. Shortly after filing her complaint, Zediker asked the Court to unseal her complaint because of the criminal proceeding. Doc. 52 n.12. While her qui tam complaint may have been of some benefit to Zediker in the criminal prosecution, from that point forward, the Government could not investigate the case covertly. See Doc. 47 at 3. Still, the Government thoroughly investigated Zediker’s myriad theories of liability and concluded most were “not substantiated by other evidence, were not valuable enough to be worthy of pursuit, were not legally viable, or were factually impossible in light of the factual claims submitted by the Defendants.” Doc. 47 at 5. According to the Government, had Zediker complied with Federal Rule of Civil Procedure 9(b)’s pleading requirements for fraud, she would have made the Government’s job much easier. For example, a properly drafted complaint could have likely eliminated the need for the

Government to ask extensive follow-up questions about the allegations and “expend a disproportionate number of resources at the outset of the case to develop a meaningful investigative plan.” Id. at 4-5. But even then, Zediker’s responses were not satisfactory. For example, Zediker misidentified a key witness for one of her claims. Id. at 5-6. Perhaps most significantly, the Government doubted, reasonably, Zediker’s credibility and usefulness, given, initially, the pending criminal charges and, ultimately, her guilty plea to 50 counts of theft and forgery. Id. at 3, 7. Unquestionably, and pretermitting whether Zediker’s qui tam complaint was in whole or in part a tactic employed in Zediker’s criminal defense,3 Zediker’s crimes have loomed large

throughout this litigation. In her guilty plea colloquy, the presiding judge told Zediker that “[r]egardless of what OrthoGeorgia or the other entity may have been doing . . . [t]wo wrongs don’t make a right. . . .” Doc. 47-2 at 33:13-15. Zediker’s wrongs were certainly significant. In a nutshell, through a multifaceted series of fraudulent schemes involving company credit cards, misuse of social security numbers, and forged loan applications, Zediker stole $711,881, or at least that’s what she agreed to pay in restitution. Id. at 5-16, 35. According to the prosecution, the evidence would have showed that Zediker stole more. Doc. 47-2 at 8.

3 If it was, it seems to have failed. The Government only learned of Zediker’s guilty plea the day after it was entered, and only then from news coverage and counsel for OrthoGeorgia. Doc. 47 at 7. Up until then, Zediker’s counsel had assured the Government that the criminal charges were “trumped up.” Id. at 17. Clearly, this was not true. Id.

As the Government came to the realization that almost all of Zediker’s claims lacked merit, it engaged in settlement discussions with OrthoGeorgia. Persistently and aggressively, Zediker attempted to inject her rejected allegations into those discussions. The Government, convinced her allegations were unfounded, again and again rebuffed Zediker, sticking to its decision to narrow the case and dismiss USG as a defendant. Id. at 8. In December 2018, the Government and OrthoGeorgia reached an agreement in principle, which Zediker strongly opposed. Id. Then, days before the Government’s deadline to intervene, Zediker “abruptly changed position, reserving only disputes concerning Relator’s share and attorney’s fees.” Id. at 9. Zediker agreed “that [the]

Agreement is fair, adequate, and reasonable under all the circumstances.” Doc. 47-1 at 5. On February 19, 2019, with the final settlement pending, the Government filed its scaled-down intervenor complaint and dismissed USG as a defendant. Docs. 35; 36. The complaint raised only three relatively minor claims. See generally Doc. 35. They were: (1) the E/M-Injection claim, (2) the Arthrex claim, and (3) the Veritas claim.4

4 The E/M-Injection claim involved OrthoGeorgia submitting claims for payment for established patient office visits with “-25” modifiers affixed on the same date of service, beneficiaries receiving an injection, and OrthoGeorgia falsely claiming that those office visits were separately significant from the injections received by beneficiaries on that date of service; the Arthrex claim involved OrthoGeorgia submitting claims for payment for shoulder surgery procedures that utilized implants that were provided for free by vendors in violation of the Anti-Kickback Statute, which caused false claims to be submitted to Medicare and Medicaid; and the Veritas claim involved OrthoGeorgia referring urine drug screens to Veritas Significantly, of Zediker’s 158-page complaint, only a small fraction of the allegations are specifically related to these claims. Docs. 47 at 4; 47-1 at 2; see generally Doc. 2.

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Bluebook (online)
ZEDIKER v. ORTHOGEORGIA, Counsel Stack Legal Research, https://law.counselstack.com/opinion/zediker-v-orthogeorgia-gamd-2019.