Guerrero v. Total Renal Care, Inc. (Summary)

FALSE CLAIMS ACT/WRONGFUL TERMINATION

Guerrero v. Total Renal Care, Inc., No. EP-11-CV-449-KC (W.D. Tex. Mar. 18, 2013)

In a wrongful termination case brought under the False Claims Act, the United States District Court for the Western District of Texas denied competing requests for summary judgment made by the defendant dialysis treatment center as well as the plaintiff nurse who had been terminated by the center.  The nurse had sued the dialysis center, claiming that he was terminated in retaliation for an internal report that he made to a senior staff member concerning Medicare and Medicaid fraud that he alleged had been committed by another nurse.  The center claimed that no such report was ever made and that the nurse’s termination was due to a patient complaint following multiple disciplinary actions that had been taken during the nurse’s six-year employment. 

With regard to the nurse’s motion, the court stated that there was a factual controversy over whether or not the nurse had actually made the internal report regarding the false record of treatments. The nurse did not have any support of his claims that he made explicit statements to his supervisors regarding the fraud; no transcript existed and the supervisors denied discussing the potentially false Medicare submissions with the nurse. Since it was possible that a reasonable jury would believe the supervisors over the nurse, it would be improper to grant summary judgment.

The district court also denied the dialysis center’s motion for summary judgment, citing the factual dispute over whether the nurse engaged in “protected activity” under the FCA by making the internal report. It was irrelevant that the center did not bill Medicare or Medicaid directly; if the center knowingly caused a fraudulent payment to be submitted then it could be held liable. The district court also stated that the basic requirements of notice and adverse action were met – within a week of the nurse’s alleged internal report to his supervisors he was terminated by those same supervisors with little explanation.  The court was also wary of the lack of documentation that the center maintained in connection with the disciplinary actions taken against the nurse, with particular emphasis on the center’s review of the patient complaint that they claimed triggered the nurse’s termination.