The complaint does not allege, even in general terms, how claims are submitted under the CHAMPUS/TRICARE or CHAMPVA programs. (Id. To the extent that the amended complaint addresses those remuneration relationships, therefore, the claims will not be dismissed. . . Here, the motion to dismiss presents three sets of issues, all arising from the strict requirements for pleading such claims. To be clear, the dispositive question is not whether FMCNA engaged in an illegal and pervasive scheme to pay kickbacks for referrals. Martin Flanagan is a Director, National of Acute Dialysis Services at Fresenius Medical Care North America based in Waltham, Massachusetts. A former employee filed an amended whistleblower complaint against Fresenius Medical Care North America, alleging the dialysis company had unlawful Certainly it would not be irrational to conclude that the presence of kickbacks taints the entire payment process, so that 100% of the claims may be deemed to have been caused by the violation. Under the circumstances presented here, the Court concludes that he cannot. The qui tam action at issue was United States ex rel. occurred; (2) said disclosure . Plaintiff-Relator Martin Flanagan (Relator) worked for Fresenius for twenty-nine years, most recently as Director of Acute Market Development for the The Line: A Man's Experience; A Son's Quest to Understand. And the best part of all, documents in their CrowdSourced Library are FREE! 99-345, 1986 U.S.C.C.A.N. 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. United States ex rel. 142-43). According to ZoomInfo records, Sandra Martins professional experience began in 1986. Again, however, no case, to the Court's knowledge, has ever established such a procedure. Heineman-Guta v. Guidant Corp., 718 F.3d 28, 35-37 (1st Cir. (Id. It alleges that Flanagan and colleagues were directed by their superiors to pursue contracts even when they resulted in losses. . 249 (NANI) (All . As to Diablo Nephrology, the complaint alleges the following: As to Balboa Nephrology Medical Group, it alleges the following: As to NANI, the complaint provides a table of Medicare and Medicaid revenue for a period of five years at seventeen dialysis centers in the Chicago area. 3730(b)(2); (2) the claims are barred by the FCA publicdisclosure bar, 31 U.S.C. Save US$2.12. (g), I respectfully disagree with that interpretation. 198-205). And even though the regulatory guidance defines the medicaldirector position as occupying 0.25 FTE, the complaint alleges that FMCNA neither tracked nor enforced medical directors' hours spent on duties to their clinics. 11). 2016). Patients who were referred to non-FMCNA clinics were categorized as leakage. (Id. To survive a motion to dismiss, the complaint must state a claim that is plausible on its face. I understand that the relevant personnel have since received training to avoid such errors in the future. As set forth above, the complaint alleges that FMCNA provided dialysis services to hospitals at prices well below cost in order to capture referrals of discharged patients to its dialysis clinics. On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended Second, defendant contends that a complaint alleging medical-director fraud filed in Missouri in 2005 against two different companies-both of which were later acquired by FMCNA-qualified as a public disclosure barring the current allegations. Under the circumstances, the Court concludes that the bar does not apply. . . Full title:UNITED STATES ex rel. 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. (Am. Mo. A more recent docket listing Allegations concerning pre-merger conduct cannot be said to have disclosed post-merger conduct. UniCourt uses cookies to improve your online experience, for more information please see our Privacy Policy. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. The complaint describes a culture of doing whatever it takes to enter into hospital contracts to secure patient referrals for Fresenius outpatient dialysis centers. Third, it alleges that FMCNA provided physicians free or below-cost practice-management services. were false.) (emphasis added)). (Id. 3729(a)(1)(A) (Count 1); making or using false records material to a false or fraudulent claim in violation of the False Claims Act, 31 U.S.C. Here, the original complaint was 22 pages long and contained 54 numbered paragraphs. (Id. at 253. 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. 2016) (citing Duxbury I, 579 F.3d at 29). Webmartin flanagan freseniusno credit check homes for rent in tucker, ga. at Edisto Beach. 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 . a. (Id. The amended complaint describes-in considerable detail-a multi-part scheme to compensate caregivers in return for referrals. See 31 U.S.C. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS, Court:United States District Court, D. Massachusetts. 18). Id. Ex. . Flanagan v. Fresenius Medical Care Holdings, Inc. 23-1305 | U.S. Court of Appeals, First Circuit | Justia Justia Dockets & Filings First Circuit U.S. Court of Appeals, 331). The central issue is whether relator can sidestep the requirement to plead false claims with particularity by alleging that every single claim is necessarily false. Previously, Martin was a Direct or, Acute Maket Development Wbd at Fresenius Medical Care North America. June 11, 2014). Martin Flanagan. 83). (Id. 247-48). Id. 3730(b). 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. 2:22-CV-01807 | 2022-10-21, U.S. District Courts | Personal Injury | WebDr. WebLiked by Martin Flanagan Join now to see all activity Experience National Director of Acute Dialysis Services Liberty Dialysis LLC Jul 2011 - Jun 20121 year Director Acute Maket Saldivar v. Fresenius Med. 88). (Attachments: #1 Docket Sheet from District of Maryland, #2 Docket Entries 1-30, #3 Docket Entries 31-50, #4 Docket Entries 51-56, #5 Docket Entries 58-74) (Jones, Sherry) Modified on 10/7/2021 to correct docket text. may be available from PACER. The Marvel Studios Phenomenon. To strike a balance between encouraging whistle-blowing and discouraging opportunistic behavior, the FCA contains a public-disclosure bar. Id. Third, defendant contends that relevant public disclosures occurred in multiple SEC filings by FMCNA. (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. 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. . Flanagan v. Fresenius Medical Care Holdings, Inc. Martin Flanagan and United States of America, FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North America, US District Court for the District of Massachusetts. 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 181). . 3729(a)(1)(A), (a)(1)(B). 3729-33, provides for civil liability for anyone who knowingly presents, or causes to be presented, a false or fraudulent claim for payment or approval or knowingly makes, uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim. 31 U.S.C. v. Fresenius Medical Care [$6,000,000.00] Gonzales et al. #57) filed by Appellant Martin Flanagan. WebView the profiles of people named Martin Flanagan. 1320a-7b(b), and the resulting claims to Medicare were tainted by illegal kickbacks in violation of the False Claims Act. WebMichael P. Flanagan, MD. 3. 299 (Washington state) (All such claims . 256-69 (IMN and other practices in Indiana); id. 1:19-OP-45655 | 2019-07-22, U.S. Courts Of Appeals | Property | Family Medicine Call for an (Entered: 10/05/2021), Docket(#1) ELECTRONIC NOTICE of Case Assignment. (Id. On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended complaint (Complaint) against Fresenius alleging that the company had entered into arrangements with hospitals and physicians in order to secure dialysis patient referrals for Fresenius outpatient dialysis clinics, and that such arrangements violated the Federal False Claims Act (FCA) and the Federal Anti-Kickback Statute (AKS). 292-307 (practices in Washington state)). Moreover, the CKD complaint alleged that the scheme was nationwide. The original complaint referred to joint-venture agreements between FMCNA and physicians, but only in order to contrast such agreements (which it referred to as a product of arms-length negotiations) with the higher compensation paid to medical directors in the absence of such agreements. Physicians who wanted to terminate the non-competition agreements were forced to negotiate onerous buyouts. I understand that the relevant personnel have since received training to avoid such errors in the future. (Id. 2009). Where the defendant allegedly caused a third party to submit a false claim to the government, rather than submitting the false claim itself, a more flexible standard applies, under which Rule 9(b) is satisfied by providing factual or statistical evidence to strengthen the inference of fraud beyond possibility without necessarily providing details as to each false claim submitted. U.S. ex rel. Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. 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. See Pub. Phone: 1.619.238.4720 Email: inquiries@hoguebelonglaw.com Home Home Gonzales et al. FMCNA is headquartered in Waltham, Massachusetts. Please contact one of the below authors if you have questions about the lawsuit and its implications for the nephrology and dialysis industry. Internal spreadsheets from the Western Business Unit show that FMCNA recorded losses on its contracts with hospitals, often in excess of the budgeted losses. And it further alleges that Flanagan was instructed not to enforce escalator clauses, which called for annual fee increases of up to 4.0%. On a motion to dismiss, the court must assume the truth of all well-plead[ed] facts and give . 273). Martin Flanagan is a resident of Texas. His last title was Director of Acute Market Development for the Fresenius Western Business Unit. (Id.). Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. President, National Cardiovascular Partners; President, Spectra Laboratories. . 2007) (citing Rogan v. Menino, 175 F.3d 75, 77 (1st Cir. Add to There is no contention that any dialysis services performed were medically unnecessary or excessive, or that those services were performed in a substandard manner. WebA division of Fresenius Medical Care North America, Azura Vascular Care partners with dedicated, highly skilled physicians and surgeons, providing opportunities for practice The Clerks Office nevertheless takes the position that the matter may not reassigned by their corrective action alone but requires some action of a judicial officer under the Local Rules. Accordingly, the motion to dismiss will be granted. 274 (North Carolina) ([E]ach of these claims was false .); id. United States District Court, D. Massachusetts. any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program shall be guilty of a felony. WebMartin Flanagan (Author), Andrew Livingstone (Author), Mike McKenny (Author) Paperback $46.95 $42.25 Hardback $190.00 $171.00 Ebook (PDF) $42.25 $33.80 Ebook (Epub & Mobi) $42.25 $33.80 Quantity In stock $171.00 RRP $190.00 Website price saving $19.00 (10%) Add to basket Add to wishlist This product is usually dispatched within 1 week . Rule 9(b) may be satisfied where, although some questions remain unanswered, the complaint as a whole is sufficiently particular to pass muster under the FCA. U.S. ex rel. (Id. The complaint alleges that FMCNA provided free discharge-planning services to hospitals, free in-service training to staff, free training to patients, and free quality assessment and improvement program data analysis. Defendant next contends that the remaining FCA claims in the amended complaint are barred by the public-disclosure bar of the statute, 31 U.S.C. Wilson v. Bristol-Myers Squibb, Inc., 2011 WL 2462469, at *6-7 (D. Mass. MEMORANDUM AND ORDER: This case was erroneously assigned to my docket as a result of a failure by docketing personnel in the Clerks Office to recognize that it is not related to the MDL proceeding assigned to me. (Id. 238 (Balboa Nephrology Medical Group) (Every claim . After describing that scheme in some detail, the complaint alleges the following as to the submission of actual false claims: The complaint also provides a somewhat more complete description of the false claims for services allegedly provided to Scripps Health, a large health care system with five hospitals in San Diego, California. (Id. 81-166). Defendant further contends that the original complaint did not contain any allegations concerning medical-director agreements, and that all claims based on such agreements should likewise be dismissed. According to the United States Renal Data System, there were approximately 746,557 ESRD patients in the United States at the end of 2017. Care Holdings, Civil Action 21-11627-FDS (D. Mass. In summary, because the new allegations concerning (1) joint-venture agreements, (2) free services to hospitals and patients, and (3) free practice-management services to physicians are not substantially similar to the allegations in the initial complaint, that portion of the complaint will be dismissed for failure to comply with the filing and service requirements of the FCA. The first issue is whether relator complied with the requirements of the False Claims Act to notify the government of his claims prior to filing suit. 3730(b)(5); (4) the complaint has not pleaded fraud with particularity as required by Rule 9(b); and (5) the complaint fails to state a claim for FCA conspiracy. 308-20). According to the complaint, FMCNA offered physicians the opportunity to enter into free practice-management agreements, in return for which it obtained the practice's data from the prior three to five years. He did not do so, however, before filing his amended complaint, which is 147 pages long and contains a number of substantially new allegations of different components of the scheme. 45-49). 4.9 out of 5 from 219 Patient Satisfaction Ratings. Medicaid is a state-administered program where each state sets its own guidelines concerning eligibility and services, with funding coming jointly from the states and the federal government. Dist. Relator Martin Flanagan has brought suit against defendant Fresenius Medical Care Holdings, Inc., d/b/a Fresenius Medical Care North America (FMCNA), alleging that FMCNA improperly provided free or below-cost services to hospitals and physicians, and made various types of improper payments to physicians, in exchange for referrals to its dialysis clinics. . However, the First Circuit has rejected the holding in Poteet, explaining that earlier-filed complaints must provide only the essential facts to give the government sufficient notice to initiate an investigation into allegedly fraudulent practices and emphasizing that Section 3730(b)(5) contains no exceptions. United States ex rel. (Id. Ge v. Takeda Pharm. 42 U.S.C. Cases involving fraud against the government, False Claims Act (FCA) - 31 USC 3729-3733. As noted, there are no allegations at all concerning the payments of claims under the CHAMPUS/TRICARE or CHAMPVA programs. at *3 (collecting cases). As to the claims arising from that scheme, the complaint alleges the following: As set forth above, the allegations of the complaint concerning joint-venture agreements, free services to hospitals and patients, and free practice-management services to physicians will be dismissed for failure to comply with the notification and other requirements of the False Claims Act. 28). UNITED STATES ex rel. Hardback. That is not sufficient, under the case law, to state a false claim with particularity within the meaning of Rule 9(b). Id. 2016); Fed.R.Civ.P. MEMORANDUM AND ORDER: This case was erroneously assigned to my docket as a result of a failure by docketing personnel in the Clerks Office to recognize that it is not related to the MDL proceeding assigned to me. Learn more about the survey. #57) filed by Appellant Martin Flanagan. The False Claims Act permits relators to reap substantial awards for reporting false claims to the government-in this case, the relator could conceivably recover billions of dollars if his allegations are proved. . (Id. Because the complaint does not state allegations of fraud under the FCA with the particularity required by Rule 9(b), the conspiracy claim under the FCA must fail as well. The second was that these same doctors are often provided with opportunities to rent office space that they own to Fresenius at above or at the very top of fair market value, with guaranteed long-term leases that are not commercially reasonable. (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. (Id. Conrad v. Abbott Lab'ys, Inc., No. It employs more than 40,000 employees and treats nearly 190,000 patients at approximately 2,400 outpatient clinics in the United States, including 39 in Massachusetts. 1995) (quoting S. Rep. No. 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. Please contact one of the authors below or a member of theBenesch Healthcare+ Practice Groupif you have questions regarding information contained in this Client Alert. et al, County of Lycoming v. Purdue Pharma, L.P. et al, Lazy S Ranch Properties v. Valero Terminaling and Distribution, et al, Lester E. Cox Medical Centers d/b/a Cox Medical Centers et al v. Amneal Pharmaceuticals, LLC et al. The qui tam provisions of the FCA permit relators, in some instances, to reap huge financial windfalls.
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