Physicians who wanted to terminate the non-competition agreements were forced to negotiate onerous buyouts. The original complaint referred to joint-venture agreements between FMCNA and physicians, but only in order to contrast such agreements (which it referred to as a product of arms-length negotiations) with the higher compensation paid to medical directors in the absence of such agreements. Martin Flanagan hasnt hidden himself from view in The Short Long Book but he says he wouldnt trust any journalist who did. 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. One problem lies in the phrase results in-that is, the requirement of causation. Why is this public record being published online? Because the complaint does not state allegations of fraud under the FCA with the particularity required by Rule 9(b), the conspiracy claim under the FCA must fail as well. Flanagan v. Fresenius Medical Care Holdings, Inc. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a Fresenius Medical Care North America, CIVIL CASE docketed. Dec. 2, 2022). 4.9 out of 5 from 219 Patient Satisfaction Ratings. Martin Flanagan Roughly 90% of all dialysis patients undergo hemodialysis at a dialysis clinic three times per week. (Attachments: #1 Affidavit Certificate of Jamie Bennett in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#13) MOTION for Leave to Appear Pro Hac Vice for admission of W Scott Simmer Filing fee: $ 100, receipt number AMADC-9065559 by Martin Flanagan. It alleges that Flanagan and colleagues were directed by their superiors to pursue contracts even when they resulted in losses. #57) filed by Appellant Martin Flanagan. (Id. 332-36). The complaint further alleges that FMCNA would typically pay high-performing physicians 10 to 12% of the clinic's topline revenue, whereas it would pay lower-performing physicians up to 6% of topline revenue. . 256-69 (IMN and other practices in Indiana); id. (Id. In 2014, a qui tam action was filed in the Eastern District of New York alleging that on FMCNA acquired controlling interests in dialysis clinics and paid physician owners above market value for their clinics and that this excess constituted payment to induce the doctors to refer patients back to these clinics. U.S. ex rel. 22-1304 | 2022-04-25, U.S. Courts Of Appeals | Other | The first issue is whether relator complied with the requirements of the False Claims Act to notify the government of his claims prior to filing suit. 40). (Id. Fresenius fired lawyer for reporting embezzlement, misconduct The following is a relevant excerpt from an SEC filing cited by the court in CKD: That excerpt discloses that the joint ventures do not qualify for safe-harbor protection and identifies the penalties that might be imposed should the company be found to be in violation of the relevant statutes. 14-cv-6646 (E.D.N.Y. In any event, as noted, the complaint does not include a single allegation concerning a single specific false claim. There is, of course, considerable logic to relator's arguments: if 100% of the business of FMCNA is tainted by kickbacks, and if 80% or more of the business of FMCNA involves government payors, it follows that FMCNA must have submitted many false claims. On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended (Am. . It did not allege that FMCNA improperly provided free services to hospitals and patients in the form of free discharge-planning services, free in-service training to staff, free training to patients, and free quality assessment and improvement program data analysis, nor did it mention the Bridge Program. 22). Defendant correctly contends that the initial complaint did not contain any allegations concerning unlawful joint-venture agreements, or the provision of free services to hospitals, physicians, and patients. As set forth above, the complaint alleges that FMCNA provided dialysis services to hospitals at prices well below cost in order to capture referrals of discharged patients to its dialysis clinics. 19). they [therefore] violated the FCA's filing and service requirements. Wilson, 750 F.3d at 120. To begin, it appears-although the complaint is ambiguous at times-that the Medicare claims at issue were submitted to the federal government by FMCNA itself, and that the Medicaid claims were submitted by various state government agencies based on claims that FMCNA submitted to those agencies.As to the Medicare claims, therefore, the complaint must be evaluated according to the ordinary standard applicable in False Claims Act cases, not the more flexible standard applicable where the defendant allegedly caused a third party to submit false claims. While it is true that CMS data are reports for the purposes of the public disclosure bar, see U.S. ex rel. martin flanagan fresenius . 353, 357 (Balboa); id. Unless otherwise noted, the following facts are alleged in the amended complaint. plaintiff the benefit of all reasonable inferences therefrom. Ruiz v. Bally Total Fitness Holding Corp., 496 F.3d 1, 5 (1st Cir. President, National Cardiovascular Partners; President, Spectra Laboratories. (Id. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. 17). Martin Flanagan | Book Depository 361 (Dallas Nephrology Associates)). June 11, 2014). WebA division of Fresenius Medical Care North America, Azura Vascular Care partners with dedicated, highly skilled physicians and surgeons, providing opportunities for practice Id. If the trial Judge issues an Order of Reference of any matter in this case to a Magistrate Judge, the matter will be transmitted to Magistrate Judge Judith G. Dein. Webmartin flanagan freseniusno credit check homes for rent in tucker, ga. at Edisto Beach. Martin Flanagan L. No. 285-91 (practices in Texas); id. Hardback. Learn more about the survey. If relator is correct, that means that the entire government-payor business of FMCNA-which appears to amount to more than $10 billion in revenue per year-is based on fraud. . As to Medicaid, the complaint alleges in general terms that state administrators of the program obtain reimbursement from the federal government by submitting a quarterly Form 64 to the Centers for Medicare and Medicaid Services at Department of Health and Human Services. (Am. 1). US$14.87 US$16.99. This is a qui tam action alleging violations of the Anti-Kickback Statute, 42 U.S.C. 9(b). Add to basket. Furthermore, they do not directly disclose the existence of any of the alleged schemes, or any other form of fraud, nor do they describe facts from which the existence of a fraudulent scheme might be inferred. Under the circumstances presented here, the Court concludes that he cannot. Those arguments, however, are unavailing. A more recent docket listing 3729(b)(2). Under the FCA, a relator must comply with the following requirements: Those notification requirements were enacted to allow the Government an adequate opportunity to fully evaluate the private enforcement suit and determine both if that suit involves matters the Government is already investigating and whether it is in the Government's interest to intervene and take over the civil action. United States ex rel. (CKD Compl. Ex. 1:19-OP-45655 | 2019-07-22, U.S. Courts Of Appeals | Property | However, even assuming compliance with those requirements, the claims concerning joint-venture agreements would be barred in any event. claims . 1320a-7b, and False Claims Act, 31 U.S.C. Martin Flanagan According to the United States Renal Data System, there were approximately 746,557 ESRD patients in the United States at the end of 2017. Paperback. Relator here has not attempted to do so. [23-1305] (JAW) [Entered: 04/05/2023 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 Suppose, for example, that in a world free from kickbacks, 25% of the dialysis services business of FMCNA would have been captured by competitors. Duxbury v. Ortho Biotech Prods., L.P., 719 F.3d 31, 33 (1st Cir. While it is true that it did not use the term medical director agreements, its allegations concerning improper remuneration to physicians in the form of compensation above fair-market value and favorable leases are nonetheless substantially similar to those in the amended complaint. 299 (Washington state) (All such claims . As to Scripps, it alleges the following: The complaint further alleges, at considerable length, a scheme to pay medical directors compensation above fair market value in order to induce referrals. . MEMORANDUM AND ORDER: This case was erroneously assigned to my docket as a result of a failure by docketing personnel in the Clerks Office to recognize that it is not related to the MDL proceeding assigned to me. (Id. Again, those claims will be dismissed on other grounds; however, even if those claims survived those challenges, they are duplicative of the allegations in CKD and therefore would be barred by the first-to-file rule. (Id. Family Medicine Call for an 89). 3730(b)(5); (4) the complaint has not pleaded fraud with particularity as required by Rule 9(b); and (5) the complaint fails to state a claim for FCA conspiracy. 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. Web1 of 5 stars 2 of 5 stars 3 of 5 stars 4 of 5 stars 5 of 5 stars. 3730(b)(2), (b)(4), (c)(1). (Id. (McManus, Caetlin) (Entered: 11/02/2021), (#9) ELECTRONIC NOTICE of Case Reassignment. Search Google Scholar for this author This is the same scheme with the same methodology as alleged here. 167-69). 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. b. Fifth, it alleges that FMCNA entered into favorable joint-venture agreements (JVAs) with physician groups to induce them to make referrals. . Michael D. Flanagan, MD | Main Line Health (McManus, Caetlin) (Entered: 11/22/2021), (#14) MOTION for Leave to Appear Pro Hac Vice for admission of Jamie Bennett Filing fee: $ 100, receipt number AMADC-9065597 by Martin Flanagan. The Anti-Kickback Statute, 42 U.S.C. 91, 93). . Previously, Martin was a Direct or, Acute Maket Development Wbd at Fresenius Medical Care North America. 128). Evidence of an actual false claim is the sine qua non of a False Claims Act violation. Karvelas, 360 F.3d at 225. (Id. (Id. (Attachments: #1 Affidavit Certificate of Noah M. Rich in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), Docket(#16) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #14 Motion for Leave to Appear Pro Hac Vice Added Jamie Bennett. (Id. To do so, the complaint must both allege the existence of a scheme to defraud and identify particularized false claims. The plausibility standard is not akin to a probability requirement,' but it asks for more than a sheer possibility that a defendant has acted unlawfully. Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 556). Westmoreland v. Amgen, 707 F.Supp.2d 123, 130 (D. Mass. at 555 (citations omitted). Accordingly, and for the following reasons, the motion to dismiss will be granted. To the extent that the amended complaint addresses those remuneration relationships, therefore, the claims will not be dismissed. Notice of appeal (doc. Ge v. Takeda Pharm. It employs more than 40,000 employees and treats nearly 190,000 patients at approximately 2,400 outpatient clinics in the United States, including 39 in Massachusetts. 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. . 11). Another six described a scheme involving improper remuneration relationships with physicians who serve as medical directors at Fresenius clinics. (Id. . The Clerks Office nevertheless takes the position that the matter may not reassigned by their corrective action alone but requires some action of a judicial officer under the Local Rules. (Id. Contact. were false.); id. or recommend purchasing . It alleged that [t]hese problematic physician relationships generally break down into two areas. (Id.). The fact that the CKD complaint was dismissed on jurisdictional grounds is therefore irrelevant. FMCNA has moved to dismiss the complaint for failure to state a claim upon which relief can be granted pursuant to Fed.R.Civ.P. 2:22-CV-01807 | 2022-10-21, U.S. District Courts | Personal Injury | See Wilson, 2011 WL 2462469, at *7. 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. 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. 14). Compl. (Entered: 10/05/2021), (#1) ELECTRONIC NOTICE of Case Assignment. The government had an opportunity to intervene if it chose, and elected not to do so. Martin Flanagan 44). WebSenior Vice President of Strategic Business Integrations Fresenius Medical Care. See 31 U.S.C. Marvel Studios Phenomenon For the sake of simplicity, the Court will focus first on the Medicare claims. Martin Flanagan is a resident of Texas. 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. 3729(a)(1)(C) (Count 3). Attorneys admitted Pro Hac Vice must have an individual PACER account, not a shared firm account, to electronically file in the District of Massachusetts. Relator relies on the Sixth Circuit's holding in United States ex rel. Want to Read. The complaint goes on to identify four specific sets of joint-venture arrangements (Balboa, NANI, ENA, and Dallas Nephrology Associates) and again alleges that all claims submitted in connection with patients treated by those physicians or facilities were tainted by kickbacks and therefore false. By continuing to use this website, you agree to UniCourts General Disclaimer, Terms of Service, (Attachments: #1 Affidavit Certificate of W. Scott Simmer in Support of Motion for Admission Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#11) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #6 Motion for Leave to Appear Pro Hac Vice Added James F. Bennett. Email. Free or Below-Cost Management Services. The third, and perhaps most difficult, issue is whether the amended complaint pleads fraud with sufficient particularity to meet the requirements of Fed.R.Civ.P. 01 Jun 2022. Nor is the issue whether the scheme should, in some fashion, be redressed. 23-7001 | 2023-01-06, U.S. District Courts | Personal Injury | 247-48). (Danieli, Chris) (Entered: 11/02/2021), (#8) Judge Douglas P. Woodlock: ELECTRONIC ORDER FOR TRANSFER entered. This docket was last retrieved on April 5, 2023. Co., Ltd., 842 F.3d 125, 130 (1st Cir. Martin Flanagan has been a director and President and Chief Executive Officer of Invesco since 2005. Stevens v. Vermont Agency of Nat. were false.) (emphasis added)). If you do not agree with these terms, then do not use our website and/or services. L. No. 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. Dismissal is appropriate if the complaint fails to set forth factual allegations, either direct or inferential, respecting each material element necessary to sustain recovery under some actionable legal theory. Gagliardi v. Sullivan, 513 F.3d 301, 305 (1st Cir. Read More . (Id. The first-to-file bar provides that [w]hen a person brings an action . Again, however, no case, to the Court's knowledge, has ever established such a procedure. FMCNA also inserted non-competition clauses into their JVAs in order to lock partners into referring patients to its facility. Save US$2.12. The statute defines original source as an individual who, [1] prior to a public disclosure . Martin Flanagan (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. The government can intervene in a qui tam action and assume primary responsibility over it. of Cunningham v. Millennium Lab'ys of Cal., Inc., 713 F.3d 662, 669-70 (1st Cir. The qui tam action at issue was United States ex rel. Previo usly, Mem. FMCNA then moved to dismiss the complaint. (g), I respectfully disagree with that interpretation. The False Claims Act, 31 U.S.C. 750 F.3d at 120. Of those, thirteen described a scheme to offer dialysis services to hospitals well below cost in order to capture referrals. (Compl. 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. 170. 30-31). (Entered: 10/05/2021), Docket(#1) ELECTRONIC NOTICE of Case Assignment. 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 228). Connect via Twitter or email . Martin Flanagan is a Director, National of Acute Dialysis Services at Fresenius Medical Care North America based in Waltham, Massachusetts. 321-31). The Line: A Man's Experience; A Son's Quest to Understand. has voluntarily disclosed to the Government the information on which allegations or transactions in a claim are based, or (2) who has knowledge that is independent of and materially adds to the publicly disclosed allegations or transactions . 31 U.S.C. (Finn, Mary) (Entered: 10/05/2021), Nineteenth Circuit Courts - Martin County | Personal Injury | Flanagan v. Fresenius Medical Care Holdings, Inc. - Law360 MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. Dist. Scott Downing at 312.624.6326 or sdowning@beneschlaw.com, Mark Silberman at 312.212.4952 or msilberman@beneschlaw.com, Juan Morado Jr. at 312.212.4967 or jmorado@beneschlaw.com, Whistleblower Lawsuit Against Fresenius Alleges Unlawful Arrangements with Hospitals and Nephrologists Intended to Induce Dialysis Referrals. 2004), abrogated on other grounds by Allison Engine Co. v. United States ex rel. Currently, Sandra Martin works as a Clinical Application Specialist at Fresenius Medical Care North America. 232-35 (Diablo Nephrology in California); id. (Id. Gagne v. City of Worcester, 565 F.3d 40, 45 (1st Cir. In that role, he was responsible for, among other duties, negotiating contracts under which FMCNA provided dialysis treatment to hospital inpatients. Flanagan v. Fresenius Med. 1998) (rev'd on other grounds, 529 U.S. 765 (2000)). (Id. 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. Third, it alleges that FMCNA provided physicians free or below-cost practice-management services. 110-11). (Attachments: #1 Affidavit Certificate of Jamie Bennett in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), Docket(#13) MOTION for Leave to Appear Pro Hac Vice for admission of W Scott Simmer Filing fee: $ 100, receipt number AMADC-9065559 by Martin Flanagan. . Medicaid is a state-administered program where each state sets its own guidelines concerning eligibility and services, with funding coming jointly from the states and the federal government. 12% off. no person other than the Government may intervene or bring a related action based on the facts underlying the pending action. 31 U.S.C. POLEN and STEVENSON, JJ., concur. 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. Martin Flanagan is a Director, National of Acute Dialysis Services at Fresenius Medical Care North America based in Waltham, Massachusetts. Beneschs healthcare+ attorneys have significant experience representing nephrology group practices and dialysis organization in governmental fraud and abuse investigations. It further alleges that defendant is required to submit on an annual basis a Form 265 cost report to Medicare that certifies, among other things, that the services identified in the report (that is, the dialysis services) were provided in compliance with federal law, including the Anti-Kickback Statute. Vascular Access Care - Fresenius Medical Care 3. 2008) (quoting Centro Medico del Turabo, Inc. v. Feliciano de Melecio, 406 F.3d 1, 6 (1st Cir. 111-148, 10104(j)(2), 124 Stat. 368-74). . Feb. 25, 2013), the mere publication of compensation information, without an allegation of fraud or misrepresentation, is not sufficient to trigger the bar. 2007) (citing Rogan v. Menino, 175 F.3d 75, 77 (1st Cir. By contrast, here the statements in defendant's securities filings concerning medical-director agreements do not even convey the possibility that those agreements might violate the law. See Pub. The Call. Martin Flanagan In response, relator filed an amended complaint. The relator is eligible to collect a portion of any damages awarded in a qui tam action, whether or not the government intervenes. FMCNA also established the Bridge Program, allegedly to help hospitals save money by streamlining the process for patient discharge from the hospital and admission to a chronic facility for dialysis. (Id. Pilon v. Martin Marietta Corp., 60 F.3d 995, 998-99 (2d Cir. Courts have therefore required relators to abide by those requirements when filing an amended complaint that is not substantially similar to the original complaint. occurred; (2) said disclosure . In substance, the complaint alleges the FMCNA created a nationwide scheme to pay unlawful kickbacks for referrals at all of its outpatient dialysis facilities; that all claims submitted for all dialysis services are therefore tainted by kickbacks; and that therefore every claim submitted by FMCNA during the relevant period was false. First, the complaint alleges in general terms that all claims for reimbursement made to Medicare require the submission of a Form UB-40 (or a substantially similar form) that contains various data, including the patient's identifying information and line items for each claim sought to be reimbursed. (Am. Dialysis refers to a treatment regimen aimed at artificially replacing some of the functions performed by a healthy kidney. The 2005 complaint alleged improper conduct dating from a decade before the conduct alleged here. 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. were false .); id. Martin To be clear, the dispositive question is not whether FMCNA engaged in an illegal and pervasive scheme to pay kickbacks for referrals. The complaint alleges that FMCNA engaged in improper remunerative relationships with medical directors in its outpatient clinics to capture their referrals. (Id.). MEMORANDUM AND ORDER: This case was erroneously assigned to my docket as a result of a failure by docketing personnel in the Clerks Office to recognize that it is not related to the MDL proceeding assigned to me. 2021), the court found that SEC filings disclosing the nature of the joint-venture relationships and the regulatory risks associated with them were sufficient to qualify as public disclosures. . Winkelman v. CVS Caremark Corp., 827 F.3d 201, 208 (1st Cir. (Id. A variety of hospitals, nephrologists and nephrology group practices have been specifically identified in the Complaint. Michael P. Flanagan, MD | Penn State Health US$184.67 US$190.00. 223). 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.
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