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United States District Court for the Middle District of Tennessee, Nashville Division
March 21, 2022, Filed
Case No. 3:13-cv-00672 (Lead); Case No. 3:20-cv-00168 (Member)
Three motions to dismiss are pending [*3] in this case. First, the defendants have filed a Renewed Motion to Dismiss the Consolidated Complaint in Intervention of the United States and Tennessee (Doc. No. 147), to which the United States and Tennessee have filed a Response (Doc. No. 153), and the defendants have filed a Reply (Doc. No. 163). Second, the defendants have filed a Renewed Motion to Dismiss the First Amended Complaint of Plaintiff-Relators [Robin Dillon] Teague, [Lisa] Pence, [Lisa] Adkins, and [Amy] Carnell (Doc. No. 148), to which those relator-plaintiffs have filed a Response (Doc. No. 154), and the defendants have filed a Reply (Doc. No. 164). Finally, the defendants have filed a Motion to Dismiss the Third Amended Complaint of Plaintiff-Relators Rachel Carol Anderson and Steven Troy Mathis (Doc. No. 165), to which those relator-plaintiffs have filed a Response (Doc. No. 168), and the defendants have filed a Reply (Doc. No. 170). For the reasons set out herein, the motion directed at the governments' claims will be denied, the motion directed at the claims of Teague et al. will be denied partially on the merits and partially as moot, and the motion regarding the claims of Anderson and Mathis will be granted [*4] in part and denied in part.
In order to address the unique difficulties facing patients with terminal illnesses and their loved ones, the medical profession has developed a model of care known as hospice, which is designed, not to cure or even halt the patient's disease, but to use medical technologies and methods, as well as other supports, to ease the patient's final days, months, or, in some cases, years of life. See 42 C.F.R. § 418.3. But hospice is expensive, and many dying people cannot afford it on their own. For certain qualifying patients, the costs of hospice are shouldered, at least in part, by government healthcare programs such as Medicare and Medicaid.
This case is about a group of Tennessee hospice providers that, the plaintiffs allege, helped themselves to a portion of the money available from those programs for hospice care by falsely certifying that patients' illnesses had reached a terminal stage, when, in fact, they had not. The defendants do not argue—at least at this point—that the fraud claims against them should be dismissed in their entirety. Rather, they ask the court to "narrow" the case in a number of ways, based on the law governing how such causes of action [*5] should be pleaded. The defendants also ask the court to dismiss a handful of additional claims, brought by former employees who helped bring this situation to light, alleging retaliatory discharge.
Full case includes Shepard's, Headnotes, Legal Analytics from Lex Machina, and more.
2022 U.S. Dist. LEXIS 49561 *; 2022 WL 842937
UNITED STATES OF AMERICA ex rel. RACHEL CAROL ANDERSON and STEVEN TROY MATHIS, STATE OF TENNESSEE ex rel. RACHEL CAROL ANDERSON and STEVEN TROY MATHIS, Plaintiffs, v. CURO HEALTH SERVICES HOLDINGS, INC., CURO HEALTH SERVICES LLC f/k/a CURO HEALTH SERVICES, INC., TNMO HEALTHCARE, LLC d/b/a AVALON HOSPICE, and REGENCY HEALTH CARE GROUP LLC, Defendants.
patients, hospice, allegations, terminal, overpayment, pleaded, false claim, defendants', clinical, fraudulent, hospice care, election, certification, intervene, eligibility, prognosis, facilities, cause of action, agencies, disease, terminal illness, documentation, discharged, Holdings, policies, records, notice, cases, protected activity, illegal activity