U.S. ex rel. v. Health Mgmt. Assocs., Inc. (Summary)

FALSE CLAIMS ACT/QUI TAM LAWSUIT

U.S. ex rel. v. Health Mgmt. Assocs., Inc., No. 2:11-cv-89-FtM-29DNF (M.D. Fla. Mar. 19, 2013)

In this false claims case, the United States District Court for the Middle District of Florida granted a motion to dismiss filed by a hospital operator and its subsidiary hospital. The federal government brought suit against the hospital after an employee raised concerns about Medicare and Medicaid fraud. The employee claimed that the hospital engaged in various kickback schemes, including overpayment for call coverage and using the corporate jet to fly physicians to a high profile golf tournament, in order to entice physicians to refer patients to its facilities.

The district court dismissed all of the employee’s claims, stating that none of the claims were specific enough to survive a motion to dismiss. The employee failed to demonstrate a link between the golf tournament and any false claims that the government may have paid. The employee’s complaint also failed to identify specific patients who were referred by the surgeons who allegedly were overpaid for call, thus failing the heightened pleading standards required to bring such a claim.