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United States ex rel. Clausen v. Lab. Corp. of Am.

United States ex rel. Clausen v. Lab. Corp. of Am.

United States Court of Appeals for the Eleventh Circuit

May 9, 2002, Decided

No. 01-13312

Opinion

 [*1302]  HULL, Circuit Judge:

In this qui tam action, the plaintiff-relator seeks to recover damages under the False Claims Act, 31 U.S.C. § 3729 et seq., as a result of alleged overbilling of the United States Government by the defendant medical testing company. The district court, however, twice dismissed the plaintiff's complaint for failing to provide the specificity required under Federal Rule of Civil Procedure 9(b). We affirm.

I. BACKGROUND

A. The Parties

This case revolves around the billing practices of the defendant, Laboratory Corporation of America, Inc., ("LabCorp"). LabCorp is an Atlanta-based company that performs medical testing services nationwide and specializes in providing testing on a contract basis to long-term care facilities ("LTCFs"). 1

 [**2]  LTCFs, which include nursing homes, furnish skilled and unskilled care in a residential setting to patients that are often old or disabled. Many LTCF patients participate in medical insurance programs receiving funds from the United States Government ("Government"), such as Medicaid, Medicare and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Between the late 1980s and 1998, LabCorp provided laboratory testing services on a contract basis to at least 100 LTCFs in Georgia and at least three regional or national LTCF chains - Golden Age, Beverly, and Capital Care Management.

Plaintiff Jeffrey Scott Clausen ("Clausen") works in the medical testing industry. A resident of Georgia, he is a former employee of SmithKline Beecham Clinical Laboratories and identifies himself as a current competitor of LabCorp. He does  [*1303]  not claim to have ever worked for LabCorp. He filed this action on behalf of the United States as a relator under the False Claims Act, entitling him to a percentage of any recoveries through judgment or settlement.

B. The Allegations

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290 F.3d 1301 *; 2002 U.S. App. LEXIS 8899 **; 52 Fed. R. Serv. 3d (Callaghan) 793; 15 Fla. L. Weekly Fed. C 560

UNITED STATES OF AMERICA, ex rel., JEFFREY SCOTT CLAUSEN, Plaintiff-Appellant, versus LABORATORY CORPORATION OF AMERICA, INC., Defendant-Appellee.

Subsequent History:  [**1]  Writ of certiorari denied: United States ex rel Clausen v. Lab. Corp. of Am., Inc., 2003 U.S. LEXIS 601 (U.S. Jan. 13, 2003).

Writ of certiorari denied United States ex rel. Clausen v. Lab. Corp. of Am., Inc., 537 U.S. 1105, 123 S. Ct. 870, 154 L. Ed. 2d 774, 2003 U.S. LEXIS 601 (2003)

Prior History: Appeal from the United States District Court for the Northern District of Georgia. D. C. Docket No. 97-02200-CV-TWT-1. Judge: Thomas W. Thrash.

United States ex rel. Clausen v. Laboratory Corp. of Am., 198 F.R.D. 560, 2000 U.S. Dist. LEXIS 17162 (N.D. Ga. 2000).

United States v. Lab. Corp. of Am., 2001 U.S. Dist. LEXIS 27340 (N.D. Ga., May 16, 2001)United States ex rel. Clausen v. Laboratory Corp. of Am., 198 F.R.D. 560, 2000 U.S. Dist. LEXIS 17162 (N.D. Ga., 2000)

Disposition: AFFIRMED.

CORE TERMS

tests, false claim, schemes, billing, allegations, patients, amended complaint, district court, fraudulent, charges, particularity, medical test, codes, lawsuits, duplicative, amounts, misconduct, circumstances, complaints, conclusory, electronic, knowingly, pleadings, blank, alerting, manually, lists, conclusory allegation, billing practices, claim for payment

Civil Procedure, Dismissal, Involuntary Dismissals, Failure to State Claims, Defenses, Demurrers & Objections, Motions to Dismiss, Failure to State Claim, Appeals, Dismissal of Appeals, General Overview, Involuntary Dismissals, Standards of Review, Governments, Federal Government, Claims By & Against, De Novo Review, Labor & Employment Law, False Claims Act, Scope & Definitions, Qui Tam Actions, Employer Liability, Legislation, Statutory Remedies & Rights, Jurisdictional Bar, Business & Corporate Compliance, Remedies, Civil Penalties, Costs & Attorney Fees, Treble Damages, Pleadings, Complaints, Requirements for Complaint, Pleading & Practice, Rule Application & Interpretation, Heightened Pleading Requirements, Fraud Claims, Environmental Law, Hazardous Wastes & Toxic Substances, Toxic Torts, Public Health & Welfare Law, Healthcare