Ruckh v. Salus Rehabilitation, LLC, No. 18-10500 (11th Cir. 2020)Annotate this Case
Relator filed a qui tam action under the False Claims Act (FCA) and the Florida False Claims Act (Florida FCA), against two skilled nursing home facilities, two related entities that provided management services at those and 51 other facilities in the state, and an affiliated company that provided rehabilitation services.
The Eleventh Circuit denied the motion to dismiss, holding that relator has sufficiently demonstrated she has constitutional standing and thus the case or controversy requirement is satisfied. Furthermore, relator's entry into the litigation funding agreement does not violate the FCA. Drawing all inferences in favor of relator, the court held that the evidence at trial permitted a reasonable jury to find that defendants committed Medicare-related fraud. In this case, relator alleged that defendants defrauded Medicare through the use of two improper practices: upcoding and ramping. Furthermore, relator introduced sufficient evidence to permit a jury to reasonably conclude that La Vie Management caused the submission of false claims. Therefore, the court reversed the district court's grant of summary judgment as a matter of law to defendants as to the Medicare-related fraud claims. However, the court held that the district court correctly granted defendants' motion for judgment as a matter of law as to the alleged false Medicaid claims where, based on the evidence presented at trial, no jury could have reasonably concluded that defendants defrauded Medicaid. The court remanded with instructions for the district court to reinstate the jury's verdict in favor of relator, the United States, and the State of Florida and against defendants on the Medicare claims in the amount of $85,137,095, and to enter judgment on those claims after applying trebling and statutory penalties. The court also reversed and vacated the district court's grant of a conditional new trial.