The U.S. Court of Appeals for the Eighth Circuit upheld the District Court of Minnesota's previous dismissal of a False Claims Act complaint in Dunn vs. North Memorial Health Care in December 2012, saying the case did not sufficiently identify an exact instance of an alleged submitted false claim, according to a Mondaq report.
Michael Dunn, former administrator for Cardiovascular Consultants, an independent physician group providing services at North Memorial Health Care in Robbinsville, Minn., initiated the whistleblower suit, alleging the hospital failed to provide adequate physician supervision for its cardiac and pulmonary rehabilitation units required by Medicaid since February 1997. Mr. Dunn said this lack of supervision rendered North Memorial's reimbursement claims as false and in violation of the FCA. He filed the lawsuit in November 2010.
The Minnesota District Court dismissed the claim under Rule 12(b)(6) of the Federal Rules of Civil Procedure that allows a party to dismiss a claim if they believe the plaintiff has not stated a sufficient claim.
The appeals court reaffirmed the district court's dismissal, but it cited Rule 9(b) which requires plaintiffs to identify the specific time, place and content of the alleged violation, which Mr. Dunn did not do. According to the report, Mr. Dunn did not identify "even one example of an actual false claim submitted to [Medicare] for reimbursement."
Additionally, the appeals court said FCA violations are based on fraudulent payment claims violations, not "regulatory violations," according to the report.
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