Thayer v. Planned Parenthood, No. 13-1654 (8th Cir. 2014)
Annotate this CaseRelator filed a qui tam action against Planned Parenthood, alleging that it violated the False Claims Act (FCA), 31 U.S.C. 3729-3733, and the Iowa False Claims Act (IFCA), Iowa Code Ann. 685.1-.7, by submitting false or fraudulent claims for Medicaid reimbursement. The district court dismissed the complaint under Rule 9(b). The court concluded that relator has pled sufficiently particularized facts to support her allegations that Planned Parenthood violated the FCA by filing claims for (1) unnecessary quantities of birth control pills, (2) birth control pills dispensed without examinations or without or prior to a physician's order, (3) abortion-related services, and (4) the full amount of services that had already been paid, in whole or in part. The court affirmed the dismissal of relator's claim that Planned Parenthood violated the FCA by instructing patients who experienced abortion-related complications to give false information to medical professionals at other hospitals, causing those medical professionals to unknowingly file claims for services performed in connection with abortions. Because relator failed to provide a factual basis for her knowledge of these alleged false claims, the court was unable to infer that false claims were submitted. Further, the court affirmed the dismissal of relator's upcoding claim. The court's holding with respect to the Rule 9(b) issue, however, should not be read as in any way expressing a view on Planned Parenthood's Rule 12(b)(6) arguments.
Court Description: Civil case - False Claims Act. In qui tam action alleging Planned Parenthood submitted false or fraudulent claims for Medicaid reimbursement, the district court erred in dismissing certain of plaintiff's claims as she had pled sufficiently particularized facts to support her allegations that defendant violated the False Claims Act by filing claims for (1) unnecessary quantities of birth control pills, (2) birth control bills dispensed without a prescription, (3) abortion-related services, and (4) the full amount of services where a portion or all of the charges had been paid by "'donations' Planned Parenthood coerced from patients;" however, plaintiff's allegations that Planned Parenthood violated the Act by causing other hospitals to unknowingly submit claims for abortion-related services and by upcoding were not sufficiently pled to satisfy Rule 9(b) and were properly dismissed; the courts' decision that certain claims were sufficiently pled to meet Rule 9(b)'s requirements should not be read as in any way expressing a view as to whether they survive Planned Parenthood's Rule 12(b)(6) arguments, which the district court did not address in light of its ruling that the complaint was insufficient under Rule 9(b).
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