Duval v. Physicians Med. Ctr.
Duval v. Physicians Med. Ctr.
2024 WL 3463366 (E.D. La. 2024)
February 21, 2024
Roby, Karen W., United States Magistrate Judge
Summary
The defendants filed a motion to quash subpoenas and/or for a protective order regarding ESI issued by the plaintiff, Megan Duval, in her whistleblower and discrimination lawsuit against her former employer, Physicians Medical Center. The defendants argued that the subpoenas were not relevant and overbroad, but the court found that they may have some relevancy to Duval's claims and were not limited to her period of employment.
MEGAN DUVAL
v.
PHYSICIANS MEDICAL CENTER, LLC Et. Al
v.
PHYSICIANS MEDICAL CENTER, LLC Et. Al
CIVIL ACTION NO: 22-2286
United States District Court, E.D. Louisiana
Signed
February 20, 2024
Filed February 21, 2024
Counsel
David Winston Ardoin, Amo Trial Lawyers, LLC, Thibodaux, LA, Charles Clarence Bourque Jr., St. Martin & Bourque, Houma, LA, Preston Lee Hayes, Amo Trial Lawyers, LLC, Metairie, LA, for Megan Duval.Duris Lee Holmes, Deutsch Kerrigan & Stiles LLP, New Orleans, LA, for Physicians Medical Center, LLC.
Kim M. Boyle, Mark David Fijman, Stephanie Michelle Poucher, Phelps Dunbar, LLP, New Orleans, LA, John Barrick Bollman, Pro Hac Vice, Rachel B. Cowen, Pro Hac Vice, McDermott Will & Emery LLP, Chicago, IL, for Surgery Partners, Inc., SP Management Services, Inc., SP Louisiana, LLC.
Kim M. Boyle, Stephanie Michelle Poucher, Phelps Dunbar, LLP, New Orleans, LA, for Jeanne Olivier, Brittney Sonnier, Tara Pellegrin, Scott Chapman, Sandra Vincent.
Franklin J. Foil, Franklin J. Foil, Attorney at Law, Baton Rouge, LA, Douglas A. Grimm, Pro Hac Vice, Michael L. Stevens, Pro Hac Vice, ArentFox Schiff LLP, Washington, DC, for Andrew Knizely.
Roby, Karen W., United States Magistrate Judge
ORDER
*1 Before the Court is Before is a Motion to Quash Subpoena and/or for Protective Order (R. Doc. 123) filed by Defendants, Surgery Partners, Inc. (“SP”), SP Management Services, Inc. (“SP Management”), and SP Louisiana, LLC (“SP Louisiana”) (collectively, the “SP Defendants”) and Physicians Medical Center, LLC (“PMC”), seeking an Order quashing the outstanding subpoenas issued by Plaintiffs and/or for the entry of an appropriate protective order. The motion is opposed. R. Doc. 126. The motion was heard on October 25, 2023.
I Background
A. Factual Summary
Megan Duval was hired by PMC in 2012 and was terminated in June 2022 for alleged insubordination while she was on FMLA leave for long haul COVID-symptoms. R. Doc. 1, ¶125. Duval subsequently filed suit against Defendants, alleging that she discovered billing discrepancies while working as the Chief Nursing Officer at the Physicians Medical Center of Houma, a hospital specializing in surgical implants. R. Doc. 1. Duval further contends that in some cases, the hospital was overcharging Medicare for procedures or billing Medicare for medications that were never administered. Id. at 1. Duval contends that she reported this to her superiors, and that it resulted in broad changes to the hospital's billing practices and a shareholder lawsuit against the owners of the hospital. Id.
Duval alleges that in 2020, the hospital hired a new CEO, Andrew Knizely (“Knizely”). R. Doc. 1. Duval contends that when Knizely learned that she had been a whistleblower, he began a campaign of harassment to force her out based on her gender and whistleblower activities. Id. at 2. Specifically, Duval alleges that Knizely began telling employees that Ms. Duval had “slept her way to the top” and that she was using sexual relations with doctors as “blackmail.” Id. Duval contends that Knizely even falsely said she had made sexual advances on him. Id.
Duval alleges that when she was on FMLA leave due to COVID-19, Defendants replaced her, removed her from her position as Chief Nursing Officer, and offered her a demoted replacement position. R. Doc. 1. Duval further contends that the hospital also refused to accommodate – or even respond to – her requests for accommodation as she recovered from long COVID symptoms. Id.
B. The Motion
The Defendants contend that Duval did not assert any cause of action alleging that the Defendants had engaged in any improper billing practices, and yet she issued four subpoenas to vendors seeking PMC and the SP defendant's financial report documents. R. Doc. 123. The Defendants further contend that Duval's fifth subpoena sought the production of plainly privileged information from the law firm that the SP Defendants had engaged to investigate Duval's complaints. Id. The Defendants allege that these requests go well beyond what the Rules of Civil Procedure allow and should be quashed and/or limited by a protective order Id.
Plaintiff alleges that her discrimination claims stem from her discovery of the fraudulent billing practices, the report of those fraudulent billing practices, and the alleged coordinated efforts of the Defendants. R. Doc. 126. Plaintiff also alleges that due to the coordinated discriminatory efforts of the Defendants, she would “never recover professionally or personally.” Id.
*2 Defendants contend that Duval's subpoenas to the health care providers should be quashed because they are neither relevant nor proportional to the needs of the case. R. Doc. 123. Defendants contend that because Duval did not bring a qui tam action, the subpoenas to the four health care providers are irrelevant. Id. The Defendants contend that the key issues are whether Duval was discriminated against because of her gender and retaliated against because she reported billing issues. Id.
The five subpoenas deuces tecum at issue were issued to Health Information Associates, LLC (“HIA”)[1] Harmony Health Care (“Harmony’), Kholer Health Care Consulting, Inc. (‘Kohler”), Surgical Information Systems, LLC (“SIS”) and Proskauer Rose, LLP (“Proskauer Rose”). R. Doc. 126.
HIA is a medical coding support provider who SP engaged to consult on coding issues and perform coding audits. R. Doc. 123-1. The subpoena to HIA seeks (1) criteria for audits, (2) 10 years of audits, (3) coding sheets and correct claims (4) all correspondence between HIA and any employee of SP entities, and (5) HIA's complete file with SP entities and PMC, including meeting minutes, zoom recordings and draft documents. Id. This subpoena has no limitation. Id.
Harmony is a SP defendant vendor retained to provide revenue cycle and coding support. R. Doc. 111. The subpoena to Harmony seeks (1) audit results and criteria for the audits of the SP Defendants and PMC; (2) SP and PMC audits for the past 10 years; (3) coding sheets, original and corrected claims, billing errors identified from 2018-present; and (4) Harmony's work file for worked performed on behalf of PMC. Id. Records requests one and four do not have any temporal limitation. Id.
Kohler is a healthcare providers consultant with a focus on clinical revenue management services. R. Doc. 113. The subpoena to Kohler seeks (1) Kohler's complete file on the defendants; (2) all correspondence, draft contract, coding sheets, charts, or any other work done for PMC; and (3) all correspondence with Megan Duval of PMC. Id. The subpoena to Kohler has no limitation in scope. Id.
SIS is a software vender that licenses its AdvantX administrative software to the Defendants. R. Doc. 115. The subpoena to SIS seeks (1) AdvantX audit trails and reports for its in-house counsel and outsourced billing staff from January 2018-present; (2) correct claims for diagnostic imaging at PMC, including nuclear medicine, ultrasound, CT, Mammography and x-ray from 2018-present; (3) the subpoena seeks all Advantix workorders, payment reports, and write offs from 2018-present; (4) all supply usage reports from Advantix for Drs. Cenac and Poutahari from 2018-present; and (5) all original and corrected claims Drs. Cenac and Poutahari from 2018-present. Id.
Proskauer Rose is a law firm retained to investigate Duval's complaint of discrimination. R. Doc. 114. Attorney Nicole Eichberger led the investigation. R. Doc. 123-1. Duval's subpoena seeks the law firm's entire file, including all reports, notes, drafts, and correspondence, including letters and text messages, regarding its investigation of the harassment and discrimination claims against the Defendants. Id.
II Standard of Review
*3 Federal Rule of Civil Procedure 26(b)(1) sets the scope of discovery to include “any non-privileged matter that is relevant to any party's claim or defense.” FED. R. CIV. P. 26(b)(1). Rule 26(b)(1) further specifies that “[i]nformation within the scope of discovery need not be admissible in evidence to be discovered.” Rule 26(b)(1) also specifies that discovery must be “proportional to the needs of the case, considering the important of the issues at stake in the action, the amount in controversy, the parties' relative access to relevant information, the parties' resources, the importance of the discovery in resolving the issues, and whether the burden or expense of the proposed discovery outweighs its likely benefit.” Id.
Under Rule 26(b)(2)(C), discovery may be limited if: (1) the discovery sought is unreasonably cumulative or duplicative, or is obtainable from another, more convenient, less burdensome, or less expensive source; (2) the party seeking discovery has had ample opportunity to obtain the discovery sought; or (3) the proposed discovery is outside of the scope permitted under Rule 26(b)(1).
“A party or attorney responsible for issuing and serving a subpoena must take reasonable steps to avoid imposing undue burden or expense on a person subject to the subpoena.” FED. R. CIV. P. 45(d)(1). However, if a subpoena subjects a person to undue burden, Rule 45(d)(3)(A)(iv) requires a district court to quash or modify the subpoena. A court considers factors from Wiwa v. Royal Dutch Petroleum Co., 392 F.3d 812, 817-18 (5th Cir. 2004) to determine whether a subpoena presents an undue burden. The factors include the relevance of the information requested; the party's need for the documents; the breadth of the documents requested; the time period covered by the request; the particularity with which the party describes the requested documents; and the burden imposed. Id. at 818. Further, if the person to whom the document request is made is a non-party, the court may also consider the expense and inconvenience to the non-party. Id. A subpoena that is facially overbroad may present an undue burden. Id.
III Analysis
A. HIA, Harmony, Kohler, and SIS subpoenas
Defendants move to quash the subpoenas Plaintiff issued to vendors HIA, Harmony Healthcare, and Kohler Healthcare. R. Docs. 112, 113, 115. In anticipation of Duval's response, the Defendants contend that they have standing to challenge the subpoena because the subpoenas seek to obtain their documentation that is in the possession of third parties. Id.
The Defendants contend that the subject subpoenas should be quashed because the information sought by the four provider subpoenas is not relevant to Duval's False Claims Act claim. R. Doc. 123-1. More specifically, Defendants allege that whether Duval engaged in protected activity and the reasonableness of her belief that overbilling occurred are not elements of her FCA retaliation claim. Id. The Defendants further contend that even if their billing practices are relevant, the documents sought are not proportional to the needs of the case because the information sought is overbroad. Id. Defendants also contend that Duval's provider subpoenas lack any relation to the alleged period of her reporting, seeks information beyond her term of employment, and is a thinly vailed attempt to investigate the Defendants' business practices for the past decade which has no relation to the claims that she has lodged against them. Id.
In response, Duval asserts that the information she seeks is relevant because she has also asserted a Louisiana Whistleblower claim and must prove that the Defendants violated state law. R. Doc. 126. Duval contends that the information sought in the subpoenas propounded will help her in proving that the Defendants violated state law. Id. Duval next directs the Court to the answers filed by the Defendants, in which they affirmatively plead that Duval had unclean hands and that her complaint is barred or may limited due to after-acquired evidence of her employment misconduct. Id.
*4 Duval contends that the documents sought are relevant to support the fact that she uncovered the billing issues which led to physician owners of PMC filing suit against Surgery Partners. R. Doc. 126. Duval further contends that Surgery Partners then retaliated against her for years and investigated her relentlessly even though she was on disability, which heightened the scrutiny and is retaliatory in and of itself. Id.
A review of the pleadings in this case show that Duval asserts various claims of relief. She claims retaliation, False Claims Act violations, Gender Discrimination, and violation of the Family Medical Leave Act. R. Doc. 1 ¶198-245. Duval also alleges Whistleblower Retaliation pursuant to R.S. 23:967. Id. ¶ 178-180. She also alleges claims for Disability Discrimination under the ADA and state law Human Rights Act. Id. ¶246-272. Duval also asserts a claim for violation of the Equal Pay Act, ERISA, Intentional Infliction of Emotional Distress, and breach of Implied Covenant of Good Faith and Fair Dealing. Id. ¶ 273-300.
Under Louisiana's Whistleblower Statute, an employer may not retaliate against its employees who advise an employer of violations of law. La. R.S. 23:967. The prerequisite for filing a claim under 23:967 is that an “employer must have committed a ‘violation of state law’ for an employee to be protected from reprisal.” Puig v. Greater New Orleans Expressway Comm'n, No. 00–924 (La. App. 5th Cir.10/31/00) 772 So.2d 842, 845, writ denied, 2000–3531 (La.3/9/01) 786 So.2d 731 (distinguishing between 23:967, which deals with conduct which does violate state law as opposed to 42:1169 on governmental ethics).
The Defendants do not appear to challenge the relevancy of the subject matter to Duval's whistleblower claim.[2] R. Doc. 123-1. Likewise, Duval contends that the documents are relevant and necessary to prove the alleged violations under the Louisiana Whistleblower Statute.[3] R. Doc. 126. Consequently, the documents may have some relevancy to Duval's whistleblower state law claim, which requires proof of the violation of state law, but not Duval's FCA claim. See Dr. Maria Williams v. The Hospital Service District of West Feliciana Parish, No. 15-95, 250 F. Supp.3d 90 (M.D. La. 2017). To establish Medicaid fraud, Plaintiff must demonstrate that Defendants actually submitted or caused to be submitted a fraudulent claim to Medicaid or a medical assistance program. See Caldwell v. Janssen Pharm., Inc., No. 12-2447 (La. 1/28/14); 144 So.3d 898. See also State v. Griffon, 82-2186, 448 So.2d 1287, 1290 (La. 1984). The Defendants' relevancy objection is overruled. However, this does not end the Court's inquiry as to the appropriateness of Duval's subpoenas.
*5 The Defendants further contend that the subpoenas are overbroad because they are not temporally limited to Duval's period of employment. R. Doc. 123-1. According to the complaint, such employment was from 2012-June 2022. R. Doc. 1. Defendants further contend that the subpoenas are overbroad because they seek information beyond the scope of Duval's claims, such as all communications with the Defendants and documents beyond June 2022 when her employment ended. R. Doc. 123-1. Defendant alleges that such documents and communications beyond the duration of Duval's employment could not make up her whistleblower claim. Id.
In response, Duval contends that the information she seeks from HIA falls within the scope of her claims because HIA was engaged to perform coding after she brought the billing discrepancy to the attention of several people. R. Doc. 126. However, she fails to indicate exactly when they were retained or when she reported the billing problems. Id.
As to Harmony and Kohler, Duval contends that because Harmony and Kohler were hired to do coding audits, their information is relevant. R. Doc. 126. She alleges that she submitted claims to Kohler for review to substantiate the need for coding audits, which validated her findings. Id.
As to SIS, Duval further contends that the information sought from SIS is needed to show that she did nothing with billing and the AdvantX system, and that she did not submit bills or enter diagnostic or procedure codes. Id. Duval also contends she needs these documents to show fraud committed by the Defendants and substantiate the continued harassment by Ms. Olivier. Id.
In her complaint, Duval alleges that she discovered alleged underbilling of insurance, and improper coding or billing of implant codes on spine, hip and shoulder and hernia meshes in 2019. R. Doc. 1. She alleges that as a result of the discrepancies she observed in 2019, a group of minority shareholder doctors filed a lawsuit in 2020. Id. Therefore, the period in which the alleged discrepancies occurred was in 2019, not 2018 or 2020 and beyond. After 2019, Duval's claim shifts to retaliation, alleged discrimination, pay violations and state law claims.
Therefore, the Court sustains the Defendants' overbroad objection and Quash the subpoenas to HIA, Harmony, Kohler, and SIS.
B. Proskauer Rose Subpoena
The Defendants seek to quash the subpoena to Proskauer Rose because it requests privileged information, namely the documentation of Proskauer Rose investigation. R. Doc. 123. The Defendants contend that the PR investigation was in anticipation of litigation and that the documents sought are the results of the attorneys' work-product. R. Doc. 123-1.
Duval contends that the Defendants put the work of Proskauer Rose at issue when it filed an affirmative defense asserting that Duval's unclean hands or her own behavior defeats her defense. R. Doc. 126.
The Court finds that documents regarding the SP Defendants' and PMC's coding and billing practices and audits do not bear on any element of Plaintiff's retaliation claim. To the extent that the requested information may be relevant to Plaintiff's state law claim, Proskauer Rose was engaged to investigate her claims. Nicole Eichbeger, a partner at Proskauer Rose, led that investigation. Duval now seeks all documents regarding that investigation. Defendants assert that these documents are protected by the work product doctrine and attorney-client privilege.
The Defendants rely on Green v. Kroger Co., No. 4:20-cv-01328, 2022 WL 1078024 (S.D. Tex. Apr. 2022) for the application of the work product doctrine. In Green, Kroger's human resources manager conducted an internal investigation in conjunction with and at the direction of Kroger's in-house counsel following an EEOC charge. Id. at 1. During that manager's deposition, the plaintiff asked for details regarding that investigation, including the documents reviewed, who was interviewed, and what was said during those interviews. Id.
*6 Kroger objected, relying on the work-product and attorney-client privileges. Id. The court held that both privileges applied. Id. at *1-2. First, the court explained that the investigation was not done in the normal course of business but was in response to the complaint the employee made and was thus “clearly in anticipation for litigation.” Id. Therefore, the work product doctrine applied to protect from disclosure information regarding the investigation. Id.
The Court finds that this case is distinguishable from the case at hand. In Green, the HR Manager conducted the investigation at the direction of counsel following an EEOC charge. In this case, at the time the investigation was made Duval had complained of discrimination but there is no suggestion that the EEOC charge had been filed.
Duval cites to Wartell v. Purdue University, 2014 WL 3687233 (N.D. Ind. July 24, 2014) for the proposition that an investigation report of an outside attorney investigator is discoverable. In Wartell, the Vice President for Ethics and Compliance who reported to the university president was appointed to investigate the plaintiff's complaint that he was denied a request for an extension of the university's mandatory retirement age. The plaintiff expressed concern about the vice president of Ethics and Compliance conducting the investigation and as a result, she proposed a process in which an independent investigator would be agreed upon by both parties to conduct the investigation.
An attorney, John Trimble, was selected without objection by the plaintiff or his attorney. Id. The university paid for the investigators fees and Trimble prepared a report with his determinations and recommendations for the Trustee Panel. Id. No one besides the panel was designated as an intended recipient of the report and no one else received a copy. Id. After a decision of no discrimination was reached, plaintiff requested a copy of Trimble's report and any other documents he prepared regarding his complaint which was denied. Id. After the matter proceeded to litigation the plaintiff propounded discovery seeking this report by the investigator as well as any documentation or communications related to the investigation of Wartell's complaint. Id.
The university, like in this case, objected based upon the work product doctrine. Id. The university acknowledged that its ordinary course of action to respond to an employee's complaint was to investigate. Id. The court found that the report was not prepared solely because litigation was imminent, and the record contained no evidence that it was. Id. The Court noted that a non-attorney employee usually conducted the investigation, which would not be privileged, but in this instance due to a potential conflict a lawyer was retained. Id. Therefore, the documents were not made in anticipation of litigation. Id.
Turning to the facts in this case, the Defendants contend that they retained Proskauer Rose to conduct the investigation. They do not state that they routinely retain an attorney to investigate upon a complaint of discrimination. The Defendants just blanketly asserts the application of the work product doctrine.
In addressing the application of the attorney client privilege, the Defendants do not provide support for the proposition that while Eichbeger is an attorney that she was providing legal advice to them rather than investigating the complaint of discrimination. Interviewing witnesses and preparing a report are consistent with the role of an investigatory. Illiana Surgery and Medical Center v. Hartford, 2010 WL 4582459 (N.D. Ind. Nov. 18, 2010).
*7 “For a communication to be protected under the [attorney-client] privilege, the proponent ‘must prove: (1) that he made a confidential communication; (2) to a lawyer or his subordinate; (3) for the primary purpose of securing either a legal opinion or legal services, or assistance in some legal proceeding.’ ” Id. (quoting United States v. Robinson, 121 F.3d 971, 974 (5th Cir. 1997)). The Fifth Circuit has explained that “[t]here is no presumption that a company's communications with counsel are privileged”; that “[i]t is vital to a claim of [attorney-client] privilege that the communication have been made and maintained in confidence”; that a “confidential communication between client and counsel is privileged only if it is generated for the purpose of obtaining or providing legal assistance”; that “communications by a corporation with its attorney, who at the time is acting solely in his capacity as a business advisor, [are not] privileged,” “nor are documents sent from one corporate officer to another merely because a copy is also sent to counsel”; and that “courts have stated that simply describing a lawyer's advice as ‘legal,’ without more, is conclusory and insufficient to carry out the proponent's burden of establishing attorney-client privilege.” Id. at 696 (cleaned up).
In reviewing the pleadings of record, Duval alleges that her attorneys contacted PMC and Surgery Partners on February 18, 2022 to put them on notice that she believed she had facts to support her assertion of various legal claims against them. R. Doc. 1 ¶ 159. The Defendants responded that they were investigating her complaints. Id. ¶ 161. On April 18, 2022, Duval filed a charge of discrimination, and her lawsuit was filed on July 22, 2022. Id. at ¶164.
On May 10, 2022, Roxanne Womack of surgery partners advised Duval by email of the results of the Proskauer investigation. R. Doc. 126-1. Duval was told that (1) she was not the person who actually uncovered or reported the billing issues; (2) she was removed from her role because she refused to enroll in the required educational courses; and (3) there was no witness who credibly substantiated that Mr. Knizley or Ms. Olivier stated that she “slept her way” to a promotion. Id. Duval was further advised that according to Proskauer (1) she behaved inappropriately towards coworkers, (2) she interfered with a subordinates FMLA leave, and (3) she falsely accused another employee of faking a pregnancy. Id. Duval was also told that Proskauer found that she made another employee read all of Surgery Partners' bylaws as a punishment. Id.
Ms. Womack referred to findings presumably in Proskauer's report when she emailed Duval advising her that there was no finding substantiating her claim. Womack went into specific detail as indicated above as to the particular findings of Proskauer.
Duval contends that this reference constitutes a waiver of the of the work product doctrine and the attorney client privilege because they are relying on the unclean hands defense in reliance on information provided by Proskauer. In their answer, the Defendants assert the unclean hands defense which would bar or reduce Duval's recovery for which she may be entitled. R. Doc. 5, p.23. Additionally, the Defendants assert that after-acquired evidence of Duval's on-the-job and employment-related misconduct would serve to bar or reduce any relief she may be entitled. Id. at 6.
The after-acquired evidence upon which the Defendants rely and the evidence of unclean hands must have been obtained as a result of the Proskauer investigation which is supported by the email from Womack. When a defendant affirmatively raises a defense that is premised at least in part on an internal investigation, the defendant waives the attorney-client privilege and work-product doctrine for all documents created as a part of that investigation. See Ambrose-Fraizer v. Herzing Inc. No. 15-1324, 2016 WL 890406 (E.D. La. 2016) (Morgan, J); See Williams v. United States Envtl. Servs., LLC, No. 15-168, 2016 WL 617447, at *5 (M.D. La. Feb. 16, 2016) (“Defendant has raised the Faragher/Ellerth affirmative defense....Defendant has cited to the investigation ...to show that it exercised reasonable care to promptly correct any harassing behavior....By relying on its investigation to defend against Plaintiff's allegations, Defendant has waived any applicable privilege with respect to not only the investigative report, but any underlying documents.” ); See also Angelone v. Xerox Corp., No. 09-6019, 2011 WL 4473534, at *2 (W.D.N.Y. Sept. 26, 2011) (“[T]he clear majority view is that when a Title VII defendant affirmatively invokes a Faragher–Ellerth defense that is premised, in whole in or part, on the results of an internal investigation, the defendant waives the attorney-client privilege and work product protections for not only the report itself, but for all documents, witness interviews, notes and memoranda created as part of and in furtherance of the investigation.”).
*8 Therefore, the Court finds that the SP Defendants' motion to quash the subpoena to Proskauer Rose and Nicole Eichberger is Denied.
IV CONCLUSION
Accordingly,
IT IS ORDERED THAT the Motion to Quash Subpoena and/or for Protective Order (R. Doc. 123) be GRANTED IN PART AND DENIED IN PART.
IT IS GRANTED to the extent the subpoenas issued to HIA, Harmony, Kohler, and SIS are QUASHED.
IT IS DENIED to the extent that Defendants' request to Quash the subpoenas issued to Proskauer Rose and Nicole Eichberger is DENIED.
IT IS FURTHER ORDERED that Proskauer Rose and Nicole Eichberger shall respond to the subpoena no later than fourteen (14) days from the signing of this order.
New Orleans, Louisiana, this 20th day of February 2024
Footnotes
HIA is a leading provider of medical coding support who was engaged by SP defendants to consult on coding issues and perform coding audits. R. Doc. 123-1.
A person commits “Medicaid fraud” pursuant to Louisiana Revised Statutes section 14:70.1 when he, “with intent to defraud the state or any person or entity through any medical assistance program[,] [p]resents for allowance or payment any false or fraudulent claim for furnishing services or merchandise [or] [k]nowingly submits false information for the purpose of obtaining greater compensation than that to which he is legally entitled for furnishing services or merchandise.”
In a retaliation claim under the False Claims Act, a plaintiff must establish: (1) she was engaging in conduct protected under the False Claims Act; (2) the employer knew that the employee was engaging in such conduct; and (3) the employer discriminated against the employee because of her protected conduct. Scott v. E.I. Du Pont de Nemours & Co., No. CV 13-741-SDD-SCR, 2015 WL 5194632, at *2 (M.D. La. Sept. 4, 2015).