Articles Posted in U.S. Court of Appeals for the Eighth Circuit

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The Eighth Circuit affirmed the dismissal of relator's False Claims Act (FCA), 31 U.S.C. 3729 et seq., suit based on the public disclosure bar. Relator alleged that defendants sought reimbursement from Medicare and Medicaid for ineligible drugs. The Eighth Circuit concluded that the amended public disclosure bar was appropriately resolved on a motion to dismiss, even assuming that it no longer poses a jurisdictional question; relator's complaint was insufficient to plausibly state that she qualified as an original source; the district court did not abuse its discretion in denying leave to amend; and the district court did not abuse its discretion by allowing Paddock and Perrigo to jointly file a motion to dismiss the second amended complaint. View "United States ex rel. Ambrosecchia v. Paddock Laboratories" on Justia Law

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Relator filed a qui tam action under the False Claims Act (FCA), 31 U.S.C. 3729-33, alleging that his former employer, AAKC, violated the FCA by submitting claims for Medicare reimbursement of anesthesia services at the “Medical Direction” rate. Relator alleged that, because AAKC anesthesiologists were not present in the operating room during patients’ “emergence” from anesthesia, and therefore AAKC did not comply with the Medicare conditions of payment for submitting such claims. The district court granted AAKC summary judgment. The court granted the United States leave to appear as amicus curiae supporting neither party. The court concluded that, because the agency had not clarified an obvious ambiguity in its Step Three regulation for decades, AAKC’s failure to obtain a legal opinion or prior CMS approval cannot support a finding of recklessness. The court also concluded that the district court did not abuse its discretion in refusing to consider a new theory first articulated in relator's summary judgment papers. Finally, the court rejected relator's claim that AAKC violated 42 C.F.R. 415.110(b). Accordingly, the court affirmed the judgment. View "Donegan v. Anesthesia Assoc." on Justia Law

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Plaintiff filed a qui tam suit under the Minnesota False Claims Act (MFCA), Minnesota Statutes Annotated 15C.01 et seq., and the federal False Claims Acts (FCA), 31 U.S.C. 3729 et seq., against UMMC, alleging that UMMC fraudulently induced MDHS to overreimburse it for services provided to Medical Assistance (MA) patients. The district court granted UMMC's motion to dismiss and denied plaintiff's motion for leave to amend the complaint for a third time. Plaintiff alleges that UMMC's false or fraudulent claim is that it's children's unit was a "children's hospital." The court concluded that, in the absence of a statutory definition of "children's hospital," it was reasonable for UMMC to inquire about the proper classification of its children's unit. A reasonable interpretation of ambiguous statutory language does not give rise to a FCA claim. The court also concluded that the district court did not incorrectly hold plaintiff to Rule 9(b)'s heightened pleading standard; plaintiff's second amended complaint fails to demonstrate that UMMC violated section 3729(a)(1)(G); and the court found no violation of section 3729(a)(1)(C). Finally, the court concluded that plaintiff's proposed amendments would be futile. Accordingly, the court affirmed the judgment. View "Olson v. Fairview Health Serv." on Justia Law

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Relator filed a qui tam action alleging that Bi-State and Eager Road made false claims to receive federal public-transit funds through the Department of Transportation and the Federal Transit Administration. The district court denied Bi-State’s motion for summary judgment. The court dismissed the appeal for lack of jurisdiction. The court concluded that the issue of Bi-State's immunity is not properly before the court. At no point during the proceedings before the district court did Bi-State claim that it was entitled to sovereign immunity. Bi-State’s motion for summary judgment argued only that it is not a “person” under the False Claims Act (FCA), 31 U.S.C. 3729-3733, and the district court’s denial of summary judgement addressed only that question. View "United States ex rel Fields v. Bi-State Dev. Agency" on Justia Law