United States ex rel. Benaissa v. Trinity Health, No. 19-1207 (8th Cir. 2020)Annotate this Case
Relator filed a qui tam action against Trinity, alleging that Trinity violated the False Claims Act (FCA) by knowingly presenting a false or fraudulent claim to the government, making a false statement material to a false or fraudulent claim, and retaliating against him.
The Eighth Circuit affirmed the district court's grant of Trinity's motion to dismiss for failure to state a claim, holding that the complaint failed to allege with particularity that defendant presented a false or fraudulent claim to the government or that it had made, used or caused to be used a false record or statement. In this case, relator's general allegations that Trinity's compensation scheme most likely resulted in the presentment of claims for payment or approval are insufficient; while there is no "presentment" requirement for a 31 U.S.C. 3729(a)(1)(B) claim, the plaintiff must plead a connection between the alleged fraud and the actual claim made payable to the government; because relator failed to allege with particularity that Trinity submitted a claim for payment to the government, he cannot establish that Trinity's allegedly false statements were "material" to any claim that was actually submitted; and relator's allegations are insufficient to establish that Trinity knew he was engaged in a protected activity.