Justia U.S. 8th Circuit Court of Appeals Opinion Summaries

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

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

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

Relators filed related qui tam actions, alleging that government contractors, including Cisco, committed fraud against the government by means of a kickback and defective pricing schemes in violation of the False Claims Act (FCA), 31 U.S.C. 3729-3733 and the Anti-Kickback Act, 41 U.S.C. 51-52. The government intervened against Cisco, adopted the complaint, and settled the action. The government objected to relators’ claim to a percentage of the settlement on the ground that the relators’ complaint did not plead the conduct that formed the basis of the claims that the government ultimately settled; that the relators’ claims based on an alleged kickback scheme lacked merit; and that the settlement covered a separate defective pricing scheme. The district court awarded relators over eight million dollars. The Eighth Circuit initially affirmed. On rehearing, en banc, the Eighth Circuit vacated and remanded, concluding that the relator may recover only from the proceeds of the settlement of the claim that he brought. The district court’s order did not clearly apply that legal standard or make factual findings necessary to resolve the case under that standard. View "Rille v. United States" on Justia Law

Duit, an Oklahoma highway contractor, contracted with the Arkansas State Highway and Transportation Department (ASHTD) to reconstruct I-30 between Little Rock and Benton. Duit encountered soil conditions that, it alleges, differed materially from information provided by the ASHTD during bidding. Duit’s claims for compensation were denied by the ASHTD, the Arkansas State Claims Commission, and the General Assembly. Duit sued under 42 U.S.C. 1983, citing the “in re Young” exception to Eleventh Amendment immunity. Duit alleged violations of the Federal Aid Highway Act, 23 U.S.C. 101, and the Due Process and Equal Protection clauses and sought to “enjoin Defendants from accepting federal aid … until . . . they fully comply with the federally mandated differing site clause.” The court dismissed the FAHA claim because that statute is enforced exclusively by an executive agency, dismissed the due process claim because Duit’s interest in future highway contracts is not a protected property interest and because the state appeals process for claim denials satisfies procedural due process requirements. The court declined to dismiss the equal protection claim, concluding Duit sufficiently alleged that the Commission treated out-of-state-contractor Duit differently from similarly situated in-state contractors without a rational reason. The Eighth Circuit held that Duit lacks standing to bring its equal protection claim and that the court erred in not dismissing that claim. View "Duit Constr. Co. Inc. v. Bennett" on Justia Law

Schell filed a qui tam suit under the False Claims Act, 31 U.S.C. 3729-3733, alleging Bluebird made false statements to the government to secure a three-year grant from the National Telecommunications and Information Administration of the U.S. Department of Commerce for increasing broadband accessibility in northern Missouri and retaliated against Schell, a former Bluebird employee, for reporting fraudulent or illegal conduct. The alleged fraud concerned a requirement for matching funds, changing the purpose of the grant, and disclosure of management. The Eighth Circuit affirmed the district court’s entry of summary judgment in Bluebird’s favor. Schell did not show that Bluebird knew that changes would be necessary and obscured the true information or otherwise presented their grant application with the mens rea the FCA requires. View "Schell v. Bluebird Media, LLC" on Justia Law

Former employees filed a qui tam False Claims suit against Heritage College, a for-profit school, alleging it fraudulently induced the Department of Education (DOE) to provide funds by falsely promising to keep accurate student records as required by 20 U.S.C. 1094(a)(3). They claimed that Heritage altered grade and attendance records from 2006 to 2012 to ensure students made satisfactory progress and to avoid refunds, thereby maximizing Title IV funds. Around 97% of Heritage students receive Title IV aid, accounting for about 90% of gross tuition. From 2009 to 2012, the DOE disbursed $32,817,727 to Heritage. Each relator also alleged retaliation under the FCA and wrongful discharge under state law. For purposes of summary judgment, Heritage did not dispute that it altered records. The district court granted summary judgment to Heritage, finding that any false statements were not material to government funding decisions. The Eighth Circuit reversed and remanded the FCA claim, but affirmed the employment claims. Heritage could not have executed the participation agreement without stating it would maintain adequate records and without the agreement Heritage could not have received any Title IV funds. Heritage's actions with respect to the plaintiffs were not retaliatory. View "Miller v. Weston Educ., Inc." on Justia Law

In 2006, Robinson opened Paideia Academy, a non-profit charter St. Louis charter school. State and federal monies, disbursed through the Missouri Department of Elementary and Secondary Education, exclusively funded the school, and were restricted to operating kindergarten through eighth grade. Robinson directed $242,533 from Paideia to develop a pre-kindergarten child care center. Robinson also worked, beginning in 1990, purporting to inspect parking meters. On weekly timesheets, he always recorded 40 hours, regardless of holidays, and even after parking meter services were outsourced. In 2009, the FBI investigated his “employment,” interviewing former Parking Division employees and watching Robinson’s car. They reasonably suspected that Robinson did not inspect meters. The agents installed, without a warrant, a GPS device on his car while parked on a public street. Tracking confirmed that Robinson did not inspect meters. The government charged Robinson with Paideia-related wire fraud, 18 U.S.C. 1343; two Paideia-related counts of federal program theft, 18 U.S.C. 666(a)(1)(A); and five parking-related counts of federal program theft. The district court denied Robinson’s motion to suppress the GPS evidence, motion to sever counts 1-3 from counts 4-8, and Batson objection to the jury’s composition. At trial, the court rejected his challenges to certain testimony and parking-related jury instructions. The court sentenced him to 24 months’ imprisonment and awarded $419,333 in restitution. The Eighth Circuit affirmed View "United States v. Robinson" on Justia Law

The Arkansas DHS regulates child care facility licensing and administers the USDA Child Care Food Program. Sparkman day care facility provided disability services funded by DHS and participated in the Program through DHS. The Program prohibits placement of disqualified individuals in a position of authority, 7 C.F.R. 226.6(c)(3)(ii)(B). DHS Policy states that violations can result in exclusion of a provider from further funding. DHS alleged that Sparkman placed a disqualified individual, Whitaker, in a position of authority. Sparkman believed that racial animus motivated DHS to place Whitaker on the disqualification list, but did not raise an equal protection claim at the hearing. Before the hearing was complete, the ALJ resigned, stating "as an African American male I cannot continue to work in a[n] office where racism and harassment continue to exist." Another ALJ, a Caucasian present as an observer, upheld DHS's termination of funding. With state appeals pending, Sparkman filed a federal complaint. The district court stayed proceedings. Following state court remand, DHS appointed a private attorney to serve as hearing officer; Sparkman agreed to the selection. Sparkman again made no equal protection or due process claims. The hearing officer decided in DHS's favor. Sparkman’s state court appeal alleged ex parte communications between DHS and the hearing officer. The state courts upheld the decision. The federal court concluded that claim preclusion barred Sparkman's due process and equal protection claims. The Eight Circuit affirmed, holding that the claims could have been brought during the state administrative proceeding and judicial review. View "Sparkman Learning Ctr. v. Ark. Dep't. Human Servs." on Justia Law

Bailey was convicted of federal prostitution charges in 2004. Minneapolis police officers took trial exhibits to a locked police storage facility, including $2,036 in cash, a wallet, and a cell phone. Years later Bailey moved for return of the property, but the government could not locate it. Bailey sought damages. The government agreed to pay Bailey $2,500 "by a check . . . made payable to Robert Bailey" to be mailed to the address of his lawyer. The Illinois Department of Healthcare and Family Services notified Bailey that he owed past due support of $45,956.48 and announced the state's "intent to collect this amount through the federal administrative offset process and by withholding . . . [tax refunds] or other federal or state payment(s)." The notice cited 31 U.S.C. 3716, indicating that "certain federal payments which might otherwise be paid to you will be intercepted for payment of current and past due support." It advised Bailey of his rights, such as having the debt redetermined. Bailey unsuccessfully moved to vacate his settlement agreement. He was advised that the $2,500 had been administratively offset against his child support obligation. The Eighth Circuit affirmed; the government did not breach Bailey's settlement agreement View "United States v. Bailey" on Justia Law