Baklid-Kunz v. Halifax Hosp. Med. Ctr. (Summary)

FALSE CLAIMS ACT

Baklid-Kunz v. Halifax Hosp. Med. Ctr.,
No. 6:09-cv-1002-Orl-31TBS (M.D. Fla. July 1, 2014)

The U.S. District Court for the Middle District of Florida granted in part and denied in part a motion for summary judgment filed by Halifax Hospital (“Hospital”) in a False Claims Act suit brought by the Relator. The Relator had accused the hospital of unnecessarily admitting patients in order to inflate its charges for Medicare claims.

The claims at issue spanned a period from 2002 to 2013. Less than a month before trial, the Hospital argued, for the first time, that claims prior to 2007 were barred by the statute of limitations. The court denied the Hospital’s request, holding that the Hospital had been given notice of this issue and should have raised it sooner.

The Relator alleged that the Hospital violated the Medicare Conditions of Participation (CoP) by admitting patients without a physician’s order. In defense, the Hospital argued that failing to abide by a CoP was irrelevant with respect to whether a claim was false for purposes of the False Claims Act. The court agreed, concluding that a claim is not false solely because of the lack of an admission order.

The court granted the Hospital’s motion for summary judgment with respect to the Relator’s attempt to recover damages, concluding that the Relator had failed to produce adequate evidence from which a reasonable jury could determine the appropriate amount of damages. Furthermore, the court held that even if the Relator could prove that patients had been improperly admitted, the proper measure of damages would be the difference between what the Hospital billed for its inpatient services and what the Hospital could have billed for outpatient services. The Hospital could still be found liable for civil penalties under the False Claims Act.