United States v. RCHP-Florence, LLC

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UNITED STATES OF AMERICA ex rel. ANDREW D. WILKERSON, M.D. and RAMNARINE BOODOO, M.D, Plaintiffs, v. RCHP-FLORENCE, LLC, d/b/a SHOALS HOSPITAL; PRIME HEALTHCARE SERVICES- GADSDEN, LLC; RIVER REGION PSYCHIATRY ASSOCIATES, LLC; ALABAMA PSYCHIATRY, LLC; AND SHANKAR B. YALAMNCHILI, Defendants.

No. 2:21-cv-00569-ACA

United States District Court, N.D. Alabama, Southern Division

April 11, 2023

MEMORANDUM OPINION

ANNEMARIE CARNEY AXON, UNITED STATES DISTRICT JUDGE

Plaintiffs/Relators Dr. Andrew D. Wilkerson and Dr. Ramnarine Boodoo filed this qui tam action alleging that two separate hospitals operating two different inpatient psychiatric facilities fraudulently billed Medicare and conspired at different times with Defendant Shankar B. Yalamanchili and at least one of two limited liability companies Dr. Yalamanchili owns. Dr Wilkerson and Dr. Boodoo's amended complaint asserts claims under the federal False Claims Act, 31 U.S.C. § 3729 et seq. and the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b.

This is the second federal lawsuit involving similar factual allegations and claims. Dr. Boodoo previously voluntarily dismissed claims against two of the defendants in this case after those defendants moved to dismiss the first lawsuit. Dr. Boodoo, along with Dr. Wilkerson, then filed this case, adding a number of defendants and claims.

Currently before the court are Defendants' motions to dismiss Dr. Boodoo and Dr. Wilkerson's amended complaint. (Docs. 49, 51, 52). For the reasons explained below, the court WILL GRANT IN PART and WILL DENY IN PART the motions to dismiss.

I. BACKGROUND

A. The Parties

There are two relators in this case, Dr. Wilkerson and Dr. Boodoo. (Doc. 4 at 5-6 ¶¶ 15-16, 6 ¶ 19). There are five defendants, Defendant RCHP-Florence, LLC (“Shoals Hospital”); Prime Healthcare Services-Gadsden, LLC (“Prime”); River Region Psychiatry Associates, LLC; Alabama Psychiatry, LLC; and Dr. Shankar Yalamanchili. (Id. at 4 ¶¶ 10-14). How these relators and defendants are connected to each other is vital to understanding this case.

Shoals Hospital and Prime are unrelated hospitals, both of which run inpatient psychiatric facilities that independently contracted with either Dr. Yalamanchili^[1]or one of his two companies, River Region and Alabama Psychiatry. (See doc. 40 at 5 ¶¶ 13-14, 34 ¶ 121, 43 ¶ 142). Dr. Yalamanchili is the president and founder of River Region, a group medical practice providing inpatient psychiatric services, and he is the sole member of Alabama Psychiatry, which also contracts with inpatient psychiatric facilities. (Id. at 4 ¶¶ 10-12). The complaint alleges that River Region is a division of Alabama Psychiatry (id. at 4 ¶ 12), but the two LLCs are in fact separate entities (see doc. 68-1; doc. 68-21).

In 2017, Shoals Hospital's inpatient psychiatric facility (the “Shoals IPF”) hired Relator Dr. Wilkerson, a psychiatrist, to serve as its medical director. (Doc. 40 at 22 ¶ 78). Dr. Wilkerson served in that role until May 2020. (Id. at 6 ¶ 20). Shoals Hospital then hired Dr. Yalamanchili “and his physician practices (River Region Psychiatry and Alabama Psychiatry)” to serve medical director at the Shoals IPF. (Id. at 4 ¶ 10, 5 ¶ 13, 34 ¶ 121).

Unrelatedly, Prime's inpatient psychiatric unit (the “Riverview IPF”) hired Alabama Psychiatry to provide medical director services at an undisclosed date.

(Doc. 40 at 5 ¶ 14, 43 ¶ 142). Relator Dr. Boodoo worked for Alabama Psychiatry in 2018 and 2019 and provided inpatient psychiatric services at the Riverview IPF under the direction of Dr. Yalamanchili. (Id. at 5-6 ¶ 15, 43 ¶ 142).

B. Procedural History

In December 2019, Dr. Boodoo filed a complaint against several defendants, including Prime^[2]and Dr. Yalamachili. United States ex rel. Ramnarine Boodoo v. Prime Healthcare Services, Inc., et al., Case No. 2:19-cv-1952-RDP, Doc. 2 (“2019 Complaint”). The allegations against Prime and Dr. Yalamanchili in that case are substantially similar to the allegations against Prime and Dr. Yalamanchili in this case. (Compare 2019 Complaint at doc. 2 at 3-6 ¶¶ 7-16 with Doc. 40 at 42 ¶ 141, 45 ¶¶ 148-150, 46 ¶¶ 151-153, 47 ¶ 157, 48 ¶¶ 160, 163-164, 49 ¶¶ 164166, 62 ¶ 202). The defendants moved to dismiss Dr. Boodoo's 2019 Complaint. (Case 2:19-cv-1952-RDP, docs. 23, 27). They argued, among other things, that the 2019 Complaint failed to plead violations of the False Claims Act with requisite specificity as required by Federal Rule of Civil Procedure 9(b). (Id.). In December 2020, in advance of the court ruling on the motions, Dr. Boodoo voluntarily dismissed the 2019 Complaint pursuant to Federal Rule of Civil Procedure 41(a)(1)(A)(i). (Case 2:19-cv-1952-RDP, doc. 31).

In April 2021, Dr. Boodoo joined forces with Dr. Wilkerson and filed in this case an eighty-five page, thirteen count complaint containing 240 separate allegations. (Doc. 1). Five months later, the government declined to intervene. (Doc. 5). In February 2022, each defendant filed motions to dismiss, and the court entered a briefing schedule placing the motion under submission on March 16, 2021. (Docs. 22, 26, 29, 30, 32, 37). As one of its grounds for their dismissal, each defendant argued that the complaint failed to meet the heightened pleading standard set out in Federal Rule of Civil Procedure 9(b). (Docs. 22, 29, 32).

On March 9, 2022, the plaintiffs filed an amended complaint that is eighty pages long and contains fourteen counts and 276 allegations. (Doc. 40). They also filed a response in opposition to the motions to dismiss, arguing that the court should deny the motions as moot in light of their amended complaint. (Doc. 41). After unrelated motion practice (docs. 42, 56, 57), the defendants refiled motions to dismiss (docs. 49, 51, 52) and those motions were fully briefed (docs. 50, 51-2, 52-2, 59, 60, 61, 62, 63, 64). The motions to dismiss the operative complaint came under submission in April 2022.

C. The Claims

The amended complaint asserts fourteen claims in various combinations of relators and defendants. For ease of the reference, the court will describe the claims brought by the two relators together, followed by the claims each relator brings individually.

Both Dr. Boodoo and Dr. Wilkerson assert:

(1) all defendants presented false claims by billing in violation of Medicare rules and laws, in violation of the False Claims Act, 31 U.S.C. § 3729(a)(1)(A) (“Counts One, Two, Three”);

(2) River Region, Alabama Psychiatry, and Dr. Yalamanchili presented false claims by upcoding professional fee services, in violation of § 3729(a)(1)(A) (“Count Four”);

(3) Shoals Hospital, Prime, River Region, Alabama Psychiatry, and Dr. Yalamanchili violated the False Claims Act, § 3729(a)(1)(A), by violating the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b) (“Counts Five(a) and Five(b)^[3]”);

(4) Shoals Hospital, Prime, River Region, Alabama Psychiatry, and Dr. Yalamanchili made or used false statements in connection with false claims, in violation of the False Claims Act, § 3729(a)(1)(B) (“Counts Six and Seven”);

(5) Shoals Hospital, Prime, River Region, Alabama Psychiatry, and Dr. Yalamanchili violated the False Claims Act, § 3729(a)(1)(G), by avoiding payment of money due to the government (“Counts Eight and Nine”);

(6) Shoals Hospital, River Region, Alabama Psychiatry, and Dr. Yalamanchili conspired to violate the False Claims Act, § 3729(a)(1)(C) (“Count Ten”); and

(7) Prime, River Region, Alabama Psychiatry, and Dr. Yalamanchili conspired to violate the False Claims Act, § 3729(a)(1)(C) (“Count Eleven”).

(Doc. 40 at 63-79). In addition to their joint claims, Dr. Wilkerson asserts that Shoals Hospital retaliated against him, in violation of the False Claims Act, 31 U.S.C. § 3130(h) (“Count Twelve”), and Dr. Boodoo asserts that River Region, Alabama Psychiatry, and Dr. Yalamanchili retaliated against him, in violation of § 3130(h) (“Count Thirteen”). (Id. at 79-81).

D. The Facts

The court accepts as true the factual allegations in the amended complaint and construes them in the light most favorable to Dr. Wilkerson and Dr. Boodoo. See Butler v. Sheriff of Palm Beach Cnty., 685 F.3d 1261, 1265 (11th Cir. 2012). But the court need not consider “conclusory allegations, unwarranted deductions of facts or legal conclusions masquerading as facts.” Aldana v. Del Monte Fresh Produce, N.A., Inc., 416 F.3d 1242, 1246 (11th Cir. 2005).

Before describing the allegations, the court must address the elephant in the room, an issue that must be clear to anyone reading this opinion closely: the fact that this complaint is a shotgun pleading. Shotgun pleadings are those that violate Federal Rules of Civil Procedure 8(a)(2) and 10(b). Weiland v. Palm Beach Cnty. Sheriff's Office, 792 F.3d 1313, 1320 (11th Cir. 2015). One type of shotgun pleading is a complaint that “assert[s] multiple claims against multiple defendants without specifying which of the defendants are responsible for which acts or omissions.” Id. at 1323. The amended complaint does just that. It attempts to ignore the legal truth that Dr. Yalamanchili, Alabama Psychiatry, and River Region are separate entities by grouping these defendants together and referring to the group as the “Yalamanchili Defendants.” (Doc. 40 at 2 ¶ 1). This attempt to “confuse the ‘enemy[]'” and the court failed. See Barmapov v. Amuial, 986 F.3d 1321, 1324 (11th Cir. 2021). For the most part, the term “Yalamanchili Defendants” is used in the context of conclusory allegations. (See, e.g., id. at 6 ¶ 18, 36 ¶ 129, 44 ¶ 145, 45 ¶ 147, 53 ¶ 181). So, the court has, in compliance with the Supreme Court's instructions, ignored those allegations. See Ashcroft v. Iqbal, 556 U.S. 662, 678-80 (2009).

In the few places where the grouping led to confusion, the court was...