On Thursday in the Middle District of Florida, Judge Charlene Edwards Honeywell granted defendant Biotronik Inc.’s motion to dismiss a complaint by an individual who alleged Biotronik was operating a scheme involving kickbacks paid to physicians and fraudulent billing practices in violation of the False Claims Act.
Christina Paul, the relator in the suit and a former employee of Biotronik, a medical device company, alleged that at the time she was employed, between 2014 and 2019, Biotronik employee Paul McLoughlin “provided incentives” to 11 physicians in exchange for using Biotronik products and services; such incentives included vacations, trips, meals, bill payments, parties, and other gifts, the court explains.
Further, the relator alleged, the defendant increased its market share and profits through this purported scheme by overcharging government-funded health care programs “an additional $500-1,000” per medical device “under the guise of a home monitoring program that was not ordered by the physicians, was not consented to by the patients, and never occurred” for 85 patients Paul identified. She argued that McLoughlin was authorized by Biotronik to operate this alleged fraudulent billing procedure “without the approval of the attending physicians,” according to the court.
The defendant moved to dismiss these claims, arguing Paul failed to properly plead a kickback scheme, failed to offer specific facts about the alleged fraudulent submissions to the government, and failed to allege causation between Biotronik’s conduct and submission of false claims, among other reasons.
The court agreed with the defendant on the relator’s failures, deciding that Paul’s allegations are conclusory. The judge explains that Paul’s provision of the 85 patients allegedly improperly given certain medical devices and placed on the home-monitoring program in question is not sufficient enough to have properly alleged the misconduct of fraudulent submissions: “She has provided the ‘who,’ ‘what,’ ‘where,’ ‘when,’ and ‘how’ of improper practices, but has failed to allege the “who,” “what,” “where,” “when,” and “how” of fraudulent submissions to the government,” the judge states. In the same vein, Paul failed to identify specific statements or records that reveal the “dummy accounts” that she originally alleged existed for the purpose of fraudulent billing, the judge explained, and lacked specificity in her allegations that fraudulent claims were in fact being sent to government-funded entities like Medicare and Medicaid.
Although the judge dismissed this complaint for the aforementioned reasons, she offered Paul leave to amend.
The relator is represented by Campbell, Trohn, Tamayo, & Aranda. The defendant is represented by King & Spalding and Trombley & Hanes.
