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WebMartin Flanagan. Menu and widgets. Instead, it alleges that FMCNA paid kickbacks for referrals on a widespread basis, and that therefore all claims for payment that it submitted to the government were false. Previously, Martin was a Direct or, Acute Maket Development Wbd at Fresenius Medical Care North America. Ex. According to the complaint, FMCNA offered physicians the opportunity to enter into free practice-management agreements, in return for which it obtained the practice's data from the prior three to five years. The government can intervene in a qui tam action and assume primary responsibility over it. . Chronic kidney disease refers to the progressive loss of a person's kidney function, which is normally irreversible. In response, relator filed an amended complaint. Relator here has not attempted to do so. 198-205). 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. 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. 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. 3730(e)(4)(A). Flanagan and his colleagues were allegedly instructed by their superiors to obtain hospital contracts at any cost to secure the referrals of discharged patients. . As its Western Division director of acute market development, he was FMCNA also inserted non-competition clauses into their JVAs in order to lock partners into referring patients to its facility. Make your practice more effective and efficient with Casetexts legal research suite. Judge Douglas P. Woodlock assigned to case. Flanagan v. Fresenius Medical Care Holdings, Inc. (#18) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #17 Motion for Leave to Appear Pro Hac Vice Added Noah M. Rich. Relator did comply with that requirement before filing his original complaint, which was 22 pages long and described an illegal scheme with two essential components. 28). It alleged that [t]hese problematic physician relationships generally break down into two areas. (Id.). It then provides a table of patients and patient treatments for the same facilities over the same time period. Corp. v. Twombly, 550 U.S. 544, 570 (2007). 15). (Id. As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. 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. . . for reimbursement were submitted to the government. 2021) case opinion from the District of Maryland US Federal District Court 4:05-cv-985 (E.D. Feb. 25, 2013), the mere publication of compensation information, without an allegation of fraud or misrepresentation, is not sufficient to trigger the bar. (Id. First, it added a second definition for original source. 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. See United States ex rel. 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. 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. 3730(e)(4)(B) (2006). Martin Flanagan It then used that data to identify physicians and practice groups to target for medical director positions and joint-venture agreements. les 5 doigts de la main gestion de classe; is the armed forces vacation club legitimate; biggest drug bust in the world guyana; martin flanagan fresenius. To be clear, the dispositive question is not whether FMCNA engaged in an illegal and pervasive scheme to pay kickbacks for referrals. 3729(a)(1)(C) (Count 3). The complaint alleges that FMCNA violated the Anti-Kickback Statute (AKS) and caused the submission of false claims for payment to Medicare, Medicaid, and other government health-care payors. Duxbury v. Ortho Biotech Prods., L.P., 579 F.3d 13, 26 (1st Cir. ESRD expenditures by Medicare exceed $40 billion annually. Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. That is not sufficient, under the case law, to state a false claim with particularity within the meaning of Rule 9(b). (Attachments: #1 Affidavit Certificate of Noah M. Rich in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#16) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #14 Motion for Leave to Appear Pro Hac Vice Added Jamie Bennett. 128). The government had an opportunity to intervene if it chose, and elected not to do so. Winkelman v. CVS Caremark Corp., 827 F.3d 201, 208 (1st Cir. 3729(a)(1)(A), (a)(1)(B). 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. Nor is the issue whether the scheme should, in some fashion, be redressed. 167-69). FMCNA generated reports to track which medical directors and their practice groups referred patients to outside clinics and the reasons why. See Wilson, 2011 WL 2462469, at *7. 2005)). 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). FMCNA is America's largest dialysis-services provider. 89). Marvel Studios Phenomenon 1320a-7b, and False Claims Act, 31 U.S.C. However, the First Circuit has rejected the holding in Poteet, explaining that earlier-filed complaints must provide only the essential facts to give the government sufficient notice to initiate an investigation into allegedly fraudulent practices and emphasizing that Section 3730(b)(5) contains no exceptions. United States ex rel. But this is not enough to satisfy Rule 9(b).). v. Fresenius Medical Care [$6,000,000.00] Gonzales et al. (Id. A variety of hospitals, nephrologists and nephrology group practices have been specifically identified in the Complaint. 343). (Id. (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. Id. To the extent the complaint here provides any factual or statistical evidence as to the actual false claims, it does so by alleging in a handful of instances that certain types of claims associated with patients at certain facilities were false. at 253. (Id. Save US$2.12. (Id. 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. 2016). It is insufficient to allege a scheme and then to make generalized allegations that the scheme must have, as a matter of logic, resulted in false claims. Martin Flanagan and United States of America: Defendant: FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North There is no contention that any dialysis services performed were medically unnecessary or excessive, or that those services were performed in a substandard manner. Quick View. Dist. The statute defines original source as an individual who, [1] prior to a public disclosure . 3/17/2023 8:35 PM. 308-20). (Id. 3730(b)(5). It might also be entirely rational to shift the burden to the defendant: that is, once a relator has established the existence of a kickback scheme, arguably the burden should be shifted to the defendant to prove that certain referrals were not caused by payment of kickbacks. Quick View. WebBrigid M. Flanagan, RN, MS, Sean Philpott, PhD, MS, and Martin A. Strosberg, MA, MPH, PhD. . 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. (Id. (Am. (Id. 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. Webmartin flanagan freseniusno credit check homes for rent in tucker, ga. at Edisto Beach. 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. Flanagan v. Fresenius Medical Care Holdings, Inc. Martin Flanagan and United States of America, FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North America, US District Court for the District of Massachusetts. By law, all outpatient dialysis clinics must have a qualified medical director to be responsible for the delivery of patient care and outcomes in the facility. 42 C.F.R. Complicating matters further is the nature of the alleged false claims. Documents and certified copy of docket sheet and order of transfer received from the Clerk in the transferor district via Email. The second question is whether there is an exception to the first-to-file bar that would allow relator's pre-2010 claims to survive. Currently, Mr. Flanagan is President, Chief Executive Officer & Director at Invesco Ltd. Mr. Flanagan is also Chairman at Metro Atlanta Chamber of Commerce and on the board of 19 other companies. Flanagan v. Fresenius Medical Care Holdings, Inc. 41 (The fact that medical director compensation is lower where the physician actually shares the cost of his or her compensation through his or her joint venture (ownership) agreement shows that where there are arms-length negotiations between two more or less equal parties, a lower compensation rate results.)). 299 (Washington state) (All such claims . Thus, the statute now defines original source as an individual who. 249 (NANI) (All . As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. Compl. 3.06 avg rating 31 ratings published 2005. 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. a. or recommend purchasing . (Id. There must be particularized allegations of claims for payment arising from that scheme. (Reuters) - A former top legal executive at Germany's Fresenius Medical Care AG & Co KGaA sued the dialysis clinic operator on Tuesday alleging he was The amended complaint in this case, which was the first time relator raised any allegations concerning joint ventures, was filed three years later, in 2021. #57) filed by Appellant Martin Flanagan. Michael P. Flanagan, MD | Penn State Health Flanagan As to Diablo Nephrology, the complaint alleges the following: As to Balboa Nephrology Medical Group, it alleges the following: As to NANI, the complaint provides a table of Medicare and Medicaid revenue for a period of five years at seventeen dialysis centers in the Chicago area. 2009). Add to basket. This is a qui tam action alleging violations of the Anti-Kickback Statute, 42 U.S.C. Certainly it would not be irrational to conclude that the presence of kickbacks taints the entire payment process, so that 100% of the claims may be deemed to have been caused by the violation. medical director agreements that compensated physicians in excess of fair market value and contained sticks and carrots, in the form of onerous non-competition covenants and medical directorship rights of first refusal to provide medical director services at other centers; non-fair market value joint venture arrangements that allegedly did not comply with applicable fraud and abuse safe harbors, both because physician referral sources often held more than a 40% equity interest in such centers and because they were offered equity in such centers at less than fair market value. (Id. Use the links below to access additional information about this case on the US Court's PACER system. 83). The complaint further alleges that FMCNA provided free or below-cost services to physicians to secure referrals. The amended complaint describes-in considerable detail-a multi-part scheme to compensate caregivers in return for referrals. [23-1305] (JAW) [Entered: 04/05/2023 Martin Flanagan is a journalist and author who writes on sport, Australian culture and the relationship between indigenous and non-indigenous Australia. 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. 293 (Washington state) (All such claims . (Id.). United States ex rel. Flanagan v. Fresenius Med. Care 359 (NANI); id. 39). A subscription to PACER is required. Wilson v. Bristol-Myers Squibb, Inc., 750 F.3d 111 (1st Cir. June 16, 2011). Here, despite its length, the amended complaint does not describe a single particular false claim. Again, however, no case, to the Court's knowledge, has ever established such a procedure. Martin L. Flanagan is a businessperson who has been at the helm of 13 different companies. Cancellation and Refund Policy, Privacy Policy, and A medical director's productivity was tracked, and contracts with medical directors who generated a large number of patients were renewed. Relator Martin Flanagan has brought suit against defendant Fresenius Medical Care Holdings, Inc., d/b/a Fresenius Medical Care North America (FMCNA), 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. Previously, Kelly was a Quality Assurance Analyst at S Read More Contact Kelly Flanagan's Phone Number and Email Last Update 3/15/2023 6:18 PM Email k***@fresenius-kabi.com Engage via Email Contact Number (708) ***-**** Engage via Finally, one place to get all the court documents we need. Instead, those services were provided free of charge. 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. In any event, as to those aspects of the alleged scheme, the allegations of the submission of false claims are similarly general. 284 (North Carolina) (All such claims . #57) filed by Appellant Martin Flanagan. Among other things, the complaint uses the passive voice throughout: claims were submitted, rather than FMCNA submitted claims.. According to the complaint, [f]or this reason, claims submitted to the state Medicaid agencies are presented to the federal government within the meaning of the [False Claims Act]. (Id.). 17). 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. Under the circumstances presented here, the Court concludes that he cannot. . 331). Stevens v. Vermont Agency of Nat. Ex. v. Fresenius Medical Care United States v. Cyberonics, Inc., 844 F.3d 26, 31 (1st Cir. were false .); id. 22-1305 | 2022-04-25, U.S. Courts Of Appeals | Other | Westmoreland v. Amgen, 707 F.Supp.2d 123, 130 (D. Mass. Chief Judge F. Dennis Saylor, IV assigned to case. Michael D. Flanagan, MD | Main Line Health After describing that scheme in some detail, the complaint alleges the following as to the submission of actual false claims: The complaint also provides a somewhat more complete description of the false claims for services allegedly provided to Scripps Health, a large health care system with five hospitals in San Diego, California. (Id. Compl. Internal spreadsheets from the Western Business Unit show that FMCNA recorded losses on its contracts with hospitals, often in excess of the budgeted losses. 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. L. No. Martin Flanagan worked for Fresenius Medical Care North America (FMCNA) for 29 years. MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS MEDICAL CARE HOLDINGS, INC., d/b/a FRESENIUS MEDICAL CARE NORTH AMERICA, Defendant. [23-1305] (JAW) [Entered: 04/05/2023 09:24 PM]. were false .); id. (McManus, Caetlin) (Entered: 11/22/2021), Docket(#17) MOTION for Leave to Appear Pro Hac Vice for admission of Noah M. Rich Filing fee: $ 100, receipt number AMADC-9065658 by Martin Flanagan. Martin Flanagan hasnt hidden himself from view in The Short Long Book but he says he wouldnt trust any journalist who did. In summary, the amended complaint fails to state allegations of fraud under the FCA with the particularity required by Rule 9(b). In 2010, Congress amended the AKS to clarify that any Medicare claim that includes items or services resulting from a violation of [the AKS] constitutes a false or fraudulent claim for the purposes of [the FCA]. 42 U.S.C. (McManus, Caetlin) (Entered: 11/22/2021), (#17) MOTION for Leave to Appear Pro Hac Vice for admission of Noah M. Rich Filing fee: $ 100, receipt number AMADC-9065658 by Martin Flanagan. According to ZoomInfo records, Sandra Martins professional experience began in 1986. Rather than spend time at this point disputing and, if necessary clarifying rule language, however, I have simply consulted with the Chief Judge and under L.R. Care Holdings, Inc., 906 F.Supp.2d 1264, 1274 (N.D.Ga. (Id.). 2016). Each step in that argument relies on an inference: first, the inference that the relevant financial arrangements were intended as kickbacks; second, the inference that every referral to an FMCNA clinic was made as a result of the kickbacks; and third, the inference that every claim for government reimbursement was tainted by the kickbacks. Defendant next contends that the remaining FCA claims in the amended complaint are barred by the public-disclosure bar of the statute, 31 U.S.C. The qui tam provisions of the FCA permit relators, in some instances, to reap huge financial windfalls. v. Balfour Beatty Infrastructure, Inc., 2014 WL 2611312, at *2 (N.D. Cal. (Id. (Id. 1320a-7b(b)(2). Family Medicine Call for an 360 (ENA); id. To strike a balance between encouraging whistle-blowing and discouraging opportunistic behavior, the FCA contains a public-disclosure bar. Id. The complaint must set forth with particularity the who, what, when, where, and how of the alleged fraud. U.S. ex rel. v. Fresenius Medical Care [$6,000,000.00] - San Diego Sexual Harassment Attorneys, Sexual Harassment Lawyers in San Diego, CA. Lutz v. United States, 853 F.3d 131, 135 (4th Cir. See Pub. (Entered: 10/05/2021), (#1) ELECTRONIC NOTICE of Case Assignment. 1999)). Poteet v. Medtronic, Inc., 552 F.3d 503, 516-17 (6th Cir. 3729(a)(1)(A) (Count 1); making or using false records material to a false or fraudulent claim in violation of the False Claims Act, 31 U.S.C. (Id. Free or Below-Cost Management Services. Moreover, the CKD complaint alleged that the scheme was nationwide. (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. 1320a-7b, states that whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person . Chief Judge F. Dennis Saylor, IV assigned to case. to purchase . . (Id. Currently, Sandra Martin works as a Clinical Application Specialist at Fresenius Medical Care North America. 45). Flanagan filed the original complaint on March 6, 2014, alleging presentation of false claims in violation of the False Claims Act, 31 U.S.C. Want to Read. In an FCA case, these may include details concerning the dates of the claims, the content of the forms or bills submitted, their identification numbers, the amount of money charged to the government, the particular goods or services for which the government was billed, the individuals involved in the billing, and the length of time between the alleged fraudulent practices and the submission of claims based on those practices. U.S. ex rel.