Another six described a scheme involving improper remuneration relationships with physicians who serve as medical directors at Fresenius clinics. (Id. In substance, it is a dressed-up version of a generalized allegation: it essentially alleges that if a practice benefited financially from a relationship with FMCNA, and if it administered 104,000 treatments, and 93% of those were to patients who were beneficiaries of government-sponsored healthcare programs, then it submitted 96,720 false claims. Lutz v. United States, 853 F.3d 131, 135 (4th Cir. 270-84 (ENA and other practices in North Carolina); id. And under Rule 9(b), those claims must be described with some level of specificity. 119 (2010). (Id. Martin Flanagan and United States of America: Defendant: FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North 308-14). (Attachments: #1 Affidavit Certificate of Jamie Bennett in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#13) MOTION for Leave to Appear Pro Hac Vice for admission of W Scott Simmer Filing fee: $ 100, receipt number AMADC-9065559 by Martin Flanagan. First, the complaint alleges in general terms that all claims for reimbursement made to Medicare require the submission of a Form UB-40 (or a substantially similar form) that contains various data, including the patient's identifying information and line items for each claim sought to be reimbursed. (Am. Here, the original complaint was 22 pages long and contained 54 numbered paragraphs. It alleged that [t]hese problematic physician relationships generally break down into two areas. (Id.). 83). The description of the alleged scheme consisted of 25 paragraphs. Private persons, known as relators, can file civil qui tam actions on behalf of the United States against persons or entities who violate the act. 2014), the First Circuit affirmed the denial of a motion to amend the complaint a third time. Est. And, presumably, it has other weapons in its arsenal for dealing with fraudulent conduct. 217). (Id. Flanagan v. Fresenius Med. Employed by Penn State Health. 170. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS, Court:United States District Court, D. Massachusetts. The complaint alleges that FMCNA engaged in improper remunerative relationships with medical directors in its outpatient clinics to capture their referrals. Karvelas v. Melrose-Wakefield Hosp., 360 F.3d 220, 233 (1st Cir. 2016) (citing Duxbury I, 579 F.3d at 29). Judge Douglas P. Woodlock assigned to case. On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended 99-345, 1986 U.S.C.C.A.N. 1998) (rev'd on other grounds, 529 U.S. 765 (2000)). (Id. Why is this public record being published online? Compl. Bonuses and performance evaluations for mid-level managers were tied, in part, to patient growth and the increase in number of treatments at individual clinics. Add to [23-1305] (JAW) [Entered: 04/05/2023 Compl. 14). As to the alleged scheme to provide other services to hospitals, the complaint alleges the following: As to the scheme to provide free or below-cost practice-management services, the complaint alleges the following: As noted, despite its length and detail, the description of the fraudulent scheme set out in the complaint, without more, is insufficient to state a claim under the False Claims Act. . Id. at 233. 162). Pilon v. Martin Marietta Corp., 60 F.3d 995, 998-99 (2d Cir. (Id. Add to basket. Flanagan v. Fresenius Medical Care Holdings, Inc. :: Justia Dockets & Filings Notice of appeal (doc. Complicating matters further is the nature of the alleged false claims. Mo. (Id.). . United States ex rel. 308, 321). they [therefore] violated the FCA's filing and service requirements. Wilson, 750 F.3d at 120. Web1 of 5 stars 2 of 5 stars 3 of 5 stars 4 of 5 stars 5 of 5 stars. . Res., 162 F.3d 195, 200 (2d Cir. A subscription to PACER is required. no person other than the Government may intervene or bring a related action based on the facts underlying the pending action. 31 U.S.C. 29). 1995) (quoting S. Rep. No. The amended complaint in this case, which was the first time relator raised any allegations concerning joint ventures, was filed three years later, in 2021. To register for a PACER account, go the Pacer website at # https://pacer.uscourts.gov/register-account.Pro Hac Vice Admission Request Instructions # https://www.mad.uscourts.gov/caseinfo/nextgen-pro-hac-vice.htm.A Notice of Appearance must be entered on the docket by the newly admitted attorney. (Id.). Relator first alleged fraud concerning joint ventures in the amended complaint, which was filed in 2021. (Attachments: #1 Affidavit Certificate of Noah M. Rich in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), Docket(#16) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #14 Motion for Leave to Appear Pro Hac Vice Added Jamie Bennett. Second, the requirement for direct knowledge was replaced with the requirement that a relator's knowledge must materially add[ ] to the publicly disclosed allegations or transactions. Id. The 2010 Patient Protection and Affordable Care Act amendment to the public-disclosure bar made two notable changes to that definition. WebMartin Flanagan. A variety of hospitals, nephrologists and nephrology group practices have been specifically identified in the Complaint. 13). It did not allege that FMCNA improperly provided free services to hospitals and patients in the form of free discharge-planning services, free in-service training to staff, free training to patients, and free quality assessment and improvement program data analysis, nor did it mention the Bridge Program. Martin Flanagan. As to joint-venture agreements, the complaint again alleges in general terms that all claims submitted by facilities with joint-venture partners are false claims. 39). By contrast, here the statements in defendant's securities filings concerning medical-director agreements do not even convey the possibility that those agreements might violate the law. 111-148, 124 Stat. (McManus, Caetlin) (Entered: 11/02/2021), (#10) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #5 Motion for Leave to Appear Pro Hac Vice Added Megan S. Heinz. (Id. Id. WebA division of Fresenius Medical Care North America, Azura Vascular Care partners with dedicated, highly skilled physicians and surgeons, providing opportunities for practice occurred in the manner which is specified in the FCA; and (3) the relator's suit [is] based upon' those publicly disclosed allegations or transactions. U.S. ex rel. Free Services to Hospitals and Patients. 83). The U.S. Justice Department said on Tuesday it joined a whistle-blower lawsuit against Fresenius Medical Care AG, the world's biggest dialysis care company, on claims that it defrauded Medicare. Wilson v. Bristol-Myers Squibb, Inc., 2011 WL 2462469, at *6-7 (D. Mass. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. It then used that data to identify physicians and practice groups to target for medical director positions and joint-venture agreements. In many states, Medicaid pays for treatment costs for ESRD patients who do not qualify for Medicare and/or pays for the 20% of treatment costs not covered by Medicare. In substance, the complaint alleged that FMCNA engaged in a scheme to pay kickbacks to physicians with whom it had entered into joint-venture agreements. Accordingly, and for the following reasons, the motion to dismiss will be granted. This action is taken to insure the parties receive timely notice of the properly assigned presiding judge and is without prejudice to consideration by the Court as a whole whether Local Rule 40.1 should be amended in some fashion to eliminate any further misunderstanding by the Clerks Office. 22-1138 | 2022-03-02, U.S. District Courts | Property | 256-69 (IMN and other practices in Indiana); id. FMCNA generated reports to track which medical directors and their practice groups referred patients to outside clinics and the reasons why. Phone: 1.619.238.4720 Email: inquiries@hoguebelonglaw.com Home Home Gonzales et al. occurred; (2) said disclosure . 15). 331). Accordingly, the motion to dismiss will be granted. See East Bay Mun. (Id. Add to basket. Id. WebFlanagan v. Fresenius Medical Care Holdings, Inc. View recent docket activity Reflects complaints, answers, motions, orders and trial notes entered from Jan. 1, 2011. Martin Flanagan's Phone Number and Email Last Update. WebMartin Flanagan is a Director, National of Acute Dialysis Services at Liberty Dialysis based in Anchorage, Alaska. (Id. Bell Atl. (Id. Relator relies on the Sixth Circuit's holding in United States ex rel. Menu and widgets. 359 (NANI); id. Previously, Kelly was a Quality Assurance Analyst at S Read More Contact Kelly Flanagan's Phone Number and Email Last Update 3/15/2023 6:18 PM Email k***@fresenius-kabi.com Engage via Email Contact Number (708) ***-**** Engage via 293 (Washington state) (All such claims . In United States ex rel. The complaint alleges that FMCNA made a calculated business decision to offer inpatient dialysis services to hospitals at prices well below cost in order to capture referrals of discharged patients to its dialysis clinics. Under the FCA, a relator must comply with the following requirements: Those notification requirements were enacted to allow the Government an adequate opportunity to fully evaluate the private enforcement suit and determine both if that suit involves matters the Government is already investigating and whether it is in the Government's interest to intervene and take over the civil action. United States ex rel. The second issue is whether the public-disclosure bar of the statute precludes all or any of the claims-that is, whether relator is filing suit concerning matters that had been previously disclosed to the public. 29 at 10); (2) compensation is negotiated individually [based on] local factors . We believe that the compensation of our medical directors is in line with the market (Id. Contact. (Id. (Id.). Documents and certified copy of docket sheet and order of transfer received from the Clerk in the transferor district via Email. If relator is correct, that means that the entire government-payor business of FMCNA-which appears to amount to more than $10 billion in revenue per year-is based on fraud. 1320a-7b, states that whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person . The objective of the essential facts test is to determine whether the statutorily required threshold for notifying the government of the fraud alleged in the later-filed suit has been met. According to the complaint, FMCNA pitched medical-director positions to nephrologists as a way to earn a considerable income for little or no investment of time. (Id. 4.9 out of 5 from 219 Patient Satisfaction Ratings. Conrad v. Abbott Lab'ys, Inc., No. Scott Downing at 312.624.6326 or sdowning@beneschlaw.com, Mark Silberman at 312.212.4952 or msilberman@beneschlaw.com, Juan Morado Jr. at 312.212.4967 or jmorado@beneschlaw.com, Whistleblower Lawsuit Against Fresenius Alleges Unlawful Arrangements with Hospitals and Nephrologists Intended to Induce Dialysis Referrals. 2017)). (McManus, Caetlin) (Entered: 11/22/2021), (#15) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #13 Motion for Leave to Appear Pro Hac Vice Added W. Scott Simmer. . . Mem. . on the assumption that all the allegations in the complaint are true (even if doubtful in fact). Id. It is sufficient to conclude that judgmental immunity is not applicable where, as here, there is evidence, if believed, that the attorneys fell below the standard of reasonable care in representing their client. 28). The False Claims Act, 31 U.S.C. And it further alleges that Flanagan was instructed not to enforce escalator clauses, which called for annual fee increases of up to 4.0%. Moreover, the CKD complaint alleged that the scheme was nationwide. 181). 167-69). . 31 U.S.C. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. 90). . Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. FMCNA has moved to dismiss the amended complaint on the grounds that (1) the amended complaint is essentially a new complaint and should therefore have been filed under seal as required by 31 U.S.C. Flanagan and his colleagues were allegedly instructed by their superiors to obtain hospital contracts at any cost to secure the referrals of discharged patients. The complaint further alleges that FMCNA provided free or below-cost services to physicians to secure referrals. 172, 206-13). The complaint further alleges that FMCNA paid its medical directors far above fair market value. Martin Flanagan is a Senior National Account Manager at Quick International Courier based in Jamaica, New York. The plaintiff further recounts various instances where Fresenius leadership was questioned about the fair market value of such relationships and the companys alleged failure to enforce annual contractual rate increases. (Id. (Id. Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. 44). Co., Ltd., 842 F.3d 125, 130 (1st Cir. (Attachments: #1 Affidavit Certificate of W. Scott Simmer in Support of Motion for Admission Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#11) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #6 Motion for Leave to Appear Pro Hac Vice Added James F. Bennett. The Anti-Kickback Statute, 42 U.S.C. Duxbury v. Ortho Biotech Prods., L.P., 719 F.3d 31, 33 (1st Cir. . End-Stage Renal Disease (ESRD) is the stage of advanced kidney impairment that requires either continued dialysis treatments or a kidney transplant to sustain life. 28, 38-40, 60-65). 249 (NANI) (All . Id. Again, the complaint does not identify a single specific false claim-by Form UB-40, by patient name, by date, by location, by dollar amount, by billing code, by type of service, or otherwise. 93). Moreover, referral sources were routinely permitted to own more than 40% of the joint venture investment, contrary to HHS OIG guidance. 233 (Diablo Nephrology) (Every claim for reimbursement [FMCNA] submitted to [f]ederal health care programs associated with the treatment of these patients was tainted by kickbacks and therefore false within the meaning of the FCA.); id. Finally, the complaint alleges that medical directors were required to sign agreements containing non-competition provisions in order to preclude any medical director and those in the same practice group from engaging in any remunerative relationship with another dialysis company. This docket was last retrieved on December 5, 2022. His last title was Director of Acute Market Development for the Fresenius Western Business Unit. Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. free or discounted physician practice alignment services, including providing dedicated chronic kidney disease educator services, financial coordination services for patients beginning dialysis, vascular access development services and assistance with physician recruiting through Fresenius online recruiting platform. In 2010, Congress amended the AKS to clarify that any Medicare claim that includes items or services resulting from a violation of [the AKS] constitutes a false or fraudulent claim for the purposes of [the FCA]. 42 U.S.C. Unless otherwise noted, the following facts are alleged in the amended complaint. As to Scripps, it alleges the following: The complaint further alleges, at considerable length, a scheme to pay medical directors compensation above fair market value in order to induce referrals. He is also a trustee and vice-Chair of the Inv Martin Flanagan's Phone Number and Email Last Update 4/3/2023 2:19 PM Contact Number (***) ***-**** Engage via Phone Mobile Number (***) ***-**** Engage via Mobile Test Drive Defendant also contends that the claims concerning joint-venture agreements are barred by the first-to-file rule. at 555 (citations omitted). The portions of the claims based on those allegations will therefore be dismissed for failing to comply with the FCA's pre-suit requirements. It then alleges: Similarly, for North Carolina, the complaint provides a table of Medicaid (but not Medicare) revenue for a period of six years at fourteen dialysis centers. CEO Martin Flanagan still sees a growth opportunity in Chinaand a big risk in Bitcoin. The complaint also alleges that Fresenius regularly entered into a variety of problematic arrangements with nephrologists and nephrology group practices intended to secure patient referrals for Fresenius wholly-owned and joint venture outpatient dialysis centers, including: Many of the allegations contained in the Complaint of inappropriate physician arrangements are similar, in many regards, to the allegations contained in whistleblower David Barbettas complaint filed against DaVita in federal district court in 2009. Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. It alleges that although FMCNA directed that all services provided under the Bridge Program must be provided at FMV, Flanagan was never required to obtain an FMV analysis for any hospital contract or for Bridge Program services during his tenure with the company. UniCourt uses cookies to improve your online experience, for more information please see our Privacy Policy. 132, 140). Nov. 12, 2014) (ECF No. (Id. (Reuters) - A former top legal executive at Germany's Fresenius Medical Care AG & Co KGaA sued the dialysis clinic operator on Tuesday alleging he was 2013) (Duxbury II) (internal quotation marks and citations omitted). Compl. Here, the complaint describes in general terms how claims are submitted to Medicare and Medicaid; it describes the various ways in which FMCNA allegedly paid kickbacks for referrals; and as to each such aspect of the scheme, it alleges that every claim or all claims were fraudulent. The complaint alleges that FMCNA violated the Anti-Kickback Statute (AKS) and caused the submission of false claims for payment to Medicare, Medicaid, and other government health-care payors. Duxbury v. Ortho Biotech Prods., L.P., 579 F.3d 13, 26 (1st Cir. 3.06 avg rating 31 ratings published 2005. 3729(a)(1)(A), (a)(1)(B). of Cunningham v. Millennium Lab'ys of Cal., Inc., 713 F.3d 662, 669-70 (1st Cir. In addition to Medicare and Medicaid, CHAMPUS/TRICARE, which is administered by the United States Department of Defense, provides ESRD benefits to health-care programs for individuals and dependents affiliated with the armed forces and to covered beneficiaries. at 999. Plaintiff-Relator Martin Flanagan (Relator) worked for Fresenius for twenty-nine years, most recently as Director of Acute Market Development for the
