at 999. The description of the alleged scheme consisted of 25 paragraphs. The qui tam provisions of the FCA permit relators, in some instances, to reap huge financial windfalls. Id. I understand that the relevant personnel have since received training to avoid such errors in the future. Michael D. Flanagan, MD | Main Line Health Please contact one of the below authors if you have questions about the lawsuit and its implications for the nephrology and dialysis industry. Fourth, it alleges that FMCNA entered into favorable leases with medical directors that paid them above-market rates. 9(b). (Am. Marvel Studios Phenomenon 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. We remand for further proceedings. 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. Martin Why is this public record being published online? 332-36). Fresenius fired lawyer for reporting embezzlement, misconduct 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. . 3730(b)(2). Now, a relator may also qualify as an original source if prior to a public disclosure under subsection (e)(4)(a), [he] voluntarily disclosed to the Government the information on which allegations or transactions in a claim are based. Id. Since 1972, Medicare has been the primary payor for more than 80% of the cost of dialysis treatment for nearly 800,000 ESRD patients in the United States. Ex. Protecting Participants of Clinical Trials Conducted in the Co., 827 F.3d 5, 13 (1st Cir. 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 a. Of those, thirteen described a scheme to offer dialysis services to hospitals well below cost in order to capture referrals. (Compl. 2016) (citing Duxbury I, 579 F.3d at 29). As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. 3730(b)(2), (b)(4), (c)(1). . 83). The public-disclosure bar seeks to prevent parasitic qui tam actions in which relators, rather than bringing to light independently discovered information of fraud, simply feed off of previous disclosures of public fraud. United States ex rel. Martin Flanagan United States of America Defendant FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North America Dist. This is a qui tam action alleging violations of the Anti-Kickback Statute, 42 U.S.C. 22-1304 | 2022-04-25, U.S. Courts Of Appeals | Other | The complaint describes a culture of doing whatever it takes to enter into hospital contracts to secure patient referrals for Fresenius outpatient dialysis centers. Lutz v. United States, 853 F.3d 131, 135 (4th Cir. Rather than spend time at this point disputing and, if necessary clarifying rule language, however, I have simply consulted with the Chief Judge and under L.R. Access this case on the Massachusetts District Court's Electronic Court Filings (ECF) System. . Among other things, the complaint uses the passive voice throughout: claims were submitted, rather than FMCNA submitted claims.. Plaintiff-Relator Martin Flanagan (Relator) worked for Fresenius for twenty-nine years, most recently as Director of Acute Market Development for the (Id.). DOJ files False Claims Act case against dialysis giant Fresenius 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 (Id. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. 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. According to the complaint, FMCNA clinics and other providers treating ESRD submit to the government one reimbursement claim bill per month for each patient, including the charges for several dialysis treatments, any separately billable laboratory services, and separately billable drugs. WebMartin Flanagan. were false.); id. Util. Although this financial incentive encourages would-be relators to expose fraud, it also attracts parasitic relators who bring FCA damages claims based on information within the public domain or that the relator did not otherwise discover. United States ex rel. (Id. Duxbury v. Ortho Biotech Prods., L.P., 579 F.3d 13, 26 (1st Cir. to purchase . And it means that relator stands to reap a reward of 15%-30% of any recovery-an amount that might well be measured in tens of billions of dollars. United States ex rel. . See Kelly, 827 F.3d at 15 (It may not be irrational to infer that, given [the allegations of the fraudulent scheme], some false claims . 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. United States v. Cyberonics, Inc., 844 F.3d 26, 31 (1st Cir. Flanagan Free Services to Hospitals and Patients. martin flanagan fresenius 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. 4:05-cv-985 (E.D. 41 (The fact that medical director compensation is lower where the physician actually shares the cost of his or her compensation through his or her joint venture (ownership) agreement shows that where there are arms-length negotiations between two more or less equal parties, a lower compensation rate results.)). 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. Rather, the complaint must allege both the existence of a scheme and the making of particular false claims resulting from the scheme. Chief Judge F. Dennis Saylor, IV assigned to case. While it is true that CMS data are reports for the purposes of the public disclosure bar, see U.S. ex rel. Paperback. (Id.). 321-31). Relator relies on the Sixth Circuit's holding in United States ex rel. 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. 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. FMCNA is headquartered in Waltham, Massachusetts. Public Records Policy. 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. However, even assuming compliance with those requirements, the claims concerning joint-venture agreements would be barred in any event. b. The complaint provides a detailed account of Fresenius acute care dialysis management business and alleges that it systematically used acute care dialysis management contracts with hospitals as loss leaders to secure patient referrals for Fresenius outpatient dialysis centers in violation of the FCA and AKS. Finally, one place to get all the court documents we need. 12% off. Connect via Twitter or email . 01 Oct 2018. It also provides a very limited amount of statistical evidence to attempt to bolster those allegations. Compl. DaVita settled that case in October 2014 by entering into a Corporate Integrity Agreement ("CIA") with the Office of Counsel to the Inspector General of the Department of Health and Human Services. 13). Martin Flanagan On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended Ex. Flanagan Care Holdings, Inc., 906 F.Supp.2d 1264, 1274 (N.D.Ga. . of Cunningham v. Millennium Lab'ys of Cal., Inc., 713 F.3d 662, 669-70 (1st Cir. Judge Douglas P. Woodlock assigned to case. 172, 206-13). Poteet v. Medtronic, Inc., 552 F.3d 503, 516-17 (6th Cir. Martin Flanagan - Director, Natio.. - Liberty Dialysis A subscription to PACER is required. For example, in United States ex rel. It then used that data to identify physicians and practice groups to target for medical director positions and joint-venture agreements. (Id. Dialysis refers to a treatment regimen aimed at artificially replacing some of the functions performed by a healthy kidney. The initial complaint has since been amended to add 125 pages of allegations, including multiple new claims. Accordingly, the motion to dismiss will be granted. Martin Flanagan Id. . Martin Flanagan (Id. The first question, for the purpose of applying the first-to-file bar, is whether the first-filed complaint contained all the essential facts of the fraud later alleged. United States v. Millenium Lab'ys, Inc., 923 F.3d 240, 252 (1st Cir. (McManus, Caetlin) (Entered: 11/02/2021), (#9) ELECTRONIC NOTICE of Case Reassignment. . (g), I respectfully disagree with that interpretation. 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. 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. 132, 140). If the government declines to intervene and the qui tam case is unsealed, further proceedings are governed by 31 U.S.C. Winkelman v. CVS Caremark Corp., 827 F.3d 201, 213 (1st Cir. Defendant also contends that the claims concerning joint-venture agreements are barred by the first-to-file rule. (Id.). Defendant contends that the amended complaint should be dismissed for failure to comply with the pre-suit requirements of the FCA, 31 U.S.C. 44). (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. Duxbury I, 579 F.3d at 33; United States ex rel. In assessing whether a given later-filed suit is based upon' publicly disclosed allegations, [courts] look to whether those allegations are substantially similar' to said allegations. Cunningham, 713 F.3d at 670. Courts have therefore required relators to abide by those requirements when filing an amended complaint that is not substantially similar to the original complaint. 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. On a motion to dismiss, the court must assume the truth of all well-plead[ed] facts and give . 274 (North Carolina) ([E]ach of these claims was false .); id. Here, the allegations are substantially similar to those in CKD and are thus based upon the public disclosures. 2019) (quoting U.S. ex rel. As is often the case with qui tam actions, the issue is not whether the complaint alleges an unlawful scheme-it does, in considerable detail-but whether it actually pleads a violation of the False Claims Act. Flanagan v. Fresenius Medical Care Holdings, Inc. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a Fresenius Medical Care North America, CIVIL CASE docketed. 304 (Washington state) (All such claims . (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 Here, the motion to dismiss presents three sets of issues, all arising from the strict requirements for pleading such claims. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. 13). It might also be entirely rational to shift the burden to the defendant: that is, once a relator has established the existence of a kickback scheme, arguably the burden should be shifted to the defendant to prove that certain referrals were not caused by payment of kickbacks. Medicare is a federally-funded health-insurance program that primarily provides benefits to the elderly, but also provides coverage to patients with ESRD, regardless of age. FMCNA decided that one of the keys to capturing new patients for its dialysis clinics was through its relationships with hospitals providing inpatient acute care. See U.S. ex rel. 3. And it further alleges that Flanagan was instructed not to enforce escalator clauses, which called for annual fee increases of up to 4.0%. 38). (Id. Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. (Id. 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. (Id. 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. for money or property presented to an officer, employee, or agent of the United States. . (Woodlock, Douglas) (Entered: 11/02/2021), Docket(#7) NOTICE of Appearance by Abraham R. George on behalf of United States of America (George, Abraham) (Entered: 10/18/2021), Docket(#6) MOTION for Leave to Appear Pro Hac Vice for admission of James F. Bennett Filing fee: $ 100, receipt number AMADC-9005666 by Fresenius Medical Care Holdings, Inc.. (Attachments: #1 Affidavit Certification of James F. Bennett)(Durant, Maria) (Entered: 10/13/2021), Docket(#5) MOTION for Leave to Appear Pro Hac Vice for admission of Megan S. Heinsz Filing fee: $ 100, receipt number AMADC-9005610 by Fresenius Medical Care Holdings, Inc.. (Attachments: #1 Affidavit Certification of Megan S. Heinsz)(Durant, Maria) (Entered: 10/13/2021), Docket(#4) NOTICE of Appearance by Maria R. Durant on behalf of Fresenius Medical Care Holdings, Inc. (Durant, Maria) (Entered: 10/07/2021), Docket(#3) NOTICE of Appearance by William H. Kettlewell on behalf of Fresenius Medical Care Holdings, Inc. (Kettlewell, William) (Entered: 10/07/2021), Docket(#2) Case transferred in from District of Maryland; Case Number 14-cv-00665-GLR. Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. The complaint alleges that certain medical practices, such as Diablo and Balboa, benefited financially from medical-director agreements and joint-venture agreements with FMCNA, that in return they referred patients to FMCNA facilities, and as a result all of their claims for government reimbursement were false. It appears, therefore, that the government may have suffered little or no actual financial loss. In an FCA case, these may include details concerning the dates of the claims, the content of the forms or bills submitted, their identification numbers, the amount of money charged to the government, the particular goods or services for which the government was billed, the individuals involved in the billing, and the length of time between the alleged fraudulent practices and the submission of claims based on those practices. U.S. ex rel. 85). 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. 2013) (internal quotation marks and citations omitted). 494.150; Am. occurred; (2) said disclosure . Wilson v. Bristol-Myers Squibb, Inc., 2011 WL 2462469, at *6-7 (D. Mass. Employed by Penn State Health. The Call. 97-106). [ ]. FMCNA generated reports to track which medical directors and their practice groups referred patients to outside clinics and the reasons why. Ex. Appearance form, Docketing Statement, and Transcript Report/Order form due 04/19/2023. 232-35 (Diablo Nephrology in California); id. (Id. Documents and certified copy of docket sheet and order of transfer received from the Clerk in the transferor district via Email. Relator first alleged fraud concerning joint ventures in the amended complaint, which was filed in 2021. Accordingly, even if relator had complied with the pre-suit requirements of the False Claims Act, the public-disclosure bar would preclude the claims concerning joint-venture agreements. In other words, an AKS violation that results in a federal health care payment is a per se false claim under the FCA. Guilfoile v. Shields, 913 F.3d 178, 190 (1st Cir. claims . Martin Flanagan | Book Depository Martin Flanagan. 3730(e)(4)(B) (2006). MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. constitutes a false claim.); id. Nov. 12, 2014) (ECF No. 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. 360 (ENA); id. A variety of hospitals, nephrologists and nephrology group practices have been specifically identified in the Complaint. Martin Flanagan is a journalist and author who writes on sport, Australian culture and the relationship between indigenous and non-indigenous Australia. 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. les 5 doigts de la main gestion de classe; is the armed forces vacation club legitimate; biggest drug bust in the world guyana; martin flanagan fresenius. Compl. 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. As to each, it provides some specifics as to the scheme (such as referral trends and medical-director compensation levels). Id. . 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. v. Fresenius Medical Care [$6,000,000.00] Gonzales et al. (McDonagh, Christina). 25). 18). 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. 17). The district court had found that the relators had violated the filing and service requirements of the FCA because the new allegations were not substantially similar to those in the original complaint. 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. See Wilson, 2011 WL 2462469, at *7. Pilon v. Martin Marietta Corp., 60 F.3d 995, 998-99 (2d Cir. 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. It also contracts with hospitals to provide dialysis services on an outpatient basis. 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 . A more recent docket listing 273). 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. POLEN and STEVENSON, JJ., concur. In response, relator filed an amended complaint. The complaint alleges that the Bridge Program was actually designed to capture all of a hospital's referrals, as about half of the company's patients came into [FMCNA] clinics via [the discharge planning process]. (Id. WebMichael D. Flanagan, MD, specializes in Obstetrics / Gynecology and Maternity Care, Geriatrics and sees patients in Bryn Mawr.
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