Latest Case: Druding v. Care Alternatives (Government Contracts)

Another Attempt to Find Optimism in American Politics

NEIL H. BUCHANAN

UF Levin College of Law professor Neil H. Buchanan continues his series of columns attempting to find optimism in what he describes as “post-constitutional life in America.” In this installment, Buchanan notes that President Trump’s reactions to COVID-19 are a reason for optimism because they reflect a fear that a pandemic (and market responses to a pandemic) could threaten his hold on the White House.

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Druding v. Care Alternatives

Docket: 18-3298

Opinion Date: March 4, 2020

Judge: Greenaway

Areas of Law: Government Contracts, Health Law, Public Benefits

Care Alternatives provides hospice care to New Jersey patients, employing “interdisciplinary teams” of registered nurses, chaplains, social workers, home health aides, and therapists working alongside independent physicians who serve as hospice medical directors. Former Alternatives employees filed suit under the False Claims Act, 31 U.S.C. 3729–3733 alleging that Alternatives admitted patients who were ineligible for hospice care and directed its employees to improperly alter those patients’ Medicare certifications to reflect eligibility. They retained an expert, who opined in his report that, based on the records of the 47 patients he examined, the patients were inappropriately certified for hospice care 35 percent of the time. Alternatives’ expert testified that a reasonable physician would have found all of those patients hospice-eligible. The district court determined that a mere difference of opinion between experts regarding the accuracy of the prognosis was insufficient to create a triable dispute of fact as to the element of falsity and required that the plaintiffs provide evidence of an objective falsehood. Upon finding they had not adduced such evidence, the court granted Alternatives summary judgment. The Third Circuit vacated, rejecting the objective falsehood requirement for FCA falsity. The plaintiffs’ expert testimony created a genuine dispute of material fact as to falsity.