United States of America et al v. Davita Health Care Partners et al

COMPLAINT against All Defendants, filed by David Gonzalez, United States of America.

District of Massachusetts, mad-1:2016-cv-11840

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5 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF THE DISTRICT OF MASSACHUSETTS) UNITED STATES OF AMERICA, ex rei,) STATE OF CALIFORNIA, ex reI.,) STATE OF COLORADO, ex reI.,) STA TE OF CONNECTICUT, ex rei,) STATE OF DELAWARE, ex reI.,) CASE NO.: DISTRICT OF COLUMBIA, ex rei,) STATE OF GEORGIA, ex rei,) STATE OF HAWAII, ex rei,) STATE OF ILLINOIS, ex reI.,) COMPLAINT STATE OF INDIANA, ex reI.,) FILED UNDER SEAL STATE OF IOWA, ex reI.,) PURSUANT TO STATE OF LOUISIANA, ex reI.,) 3 i U.S.c. §3730(b)(2) STATE OF MARYLAND, ex reI.,) COMMONWEALTH OF MASSACHUSETTS, ex reI.,) JURYTRIAL STATE OF MICHIGAN, ex rei.,) DEMANDED STATE OF MINESOTA, ex rei,) STATE OF MONTANA, ex rei.,) STATE OF NEVADA, ex rei.,) STATE OF NEW JERSEY, ex rei.,) STATE OF NEW MEXICO, ex reI.,) STATE OF NEW YORK, ex rei,) STATE OF NORTH CAROLINA, ex reI.,) STATE OF OKLAHOMA, ex rei,) STATE OF RHODE ISLAND, ex rei.,) STATE OF TENNESSEE, ex rei,) STATE OF TEXAS, ex rei.,) STATE OF VERMONT ex rei.,) COMMONWEALTH OF VIRGINIA, ex rei., and) STATE OF WASHINGTON, ex rei.,) DAVID GONZALEZ) I 1700 Old Columbia Pike, #709)) Silver Spring, MD 20904)) Plaintiff- Relator,)) BRIGING THIS ACTION ON BEHALF) OF THE UNITED STATES OF AMERICA,) THE STATES OF CALIFORNIA, COLORAO,) CONNECTICUT, DELAWARE, GEORGIA,) HAWAII, ILLINOIS, INDIANA, IOWA,) LOUISIANA, MARYLAND, MICHIGAN,) I 5 MINESOTA, MONT ANA, NEVADA,) NEW JERSEY, NEW MEXICO, NEW YORK,) NORTH CAROLINA, OKLAHOMA,) WASHINGTON,) RHODE ISLAND, TENNESSEE, TEXAS, VERMONT) THE COMMONWEALTH OF MASSACHUSETTS,) THE COMMONWEALTH OF VIRGINIA, and) c/o) THE DISTRICT OF COLUMBIA) UNITED STATES ATTORNEY) JOHN JOSEPH MOAKLEY)) UNITED STATES COURTHOUSE) I COURTHOUSE WAY, SUITE 2300) BOSTON, MA,022IO)) ATTORNEY GENERAL OF) THE UNITED STATES) U.S. Deparent of Justice) 10th and Constitution Avenue, N.W.) Washington, DC 20530)) CALIFORNIA) ATTORNEY GENERAL FOR THE STATE OF) P.O. Box 944255) Sacramento, CA 94244-2250) COLORADO)) ATTORNEY GENERAL FOR THE STATE OF) 13 00 Broadway 9th Floor) Denver, CO 80203)) CONNECTICUT 55 Elm Street)) ATTORNEY GENERAL FOR THE STATE OF) Hartford, CT 06 i 06) DELAWARE)) ATTORNEY GENERAL FOR THE STATE OF) 820 N. French Street) Wilmington, DE 19801)) ATTORNEY GENERAL FOR THE) DISTRICT OF COLUMBIA) 44 i 4th Street NW, Suite 1060 N) Washington, DC 20001) 2 5 GEORGIA) ATTORNEY GENERA FOR THE STATE OF) 40 Capitol Square, SW)) Atlanta, GA 30334) HAWAII) A TTORNEY GENERAL FOR THE STATE OF) 425 Queen Street) Honolulu, HI 96813)) ILLINOIS) ATTORNEY GENERAL FOR THE STATE OF) i 00 West Randolph Street) Chicago, IL 6060 i)) INDIANA) ATTORNEY GENERAL FOR THE STATE OF) Indiana Governent Center South) 302 W. Washington St., 5th Floor)) Indianapolis, IN 46204) INDIANA) INSPECTOR GENERAL FOR THE STATE OF) 3 i 5 WEST OHIO STREET) Indianapolis, IN 46202)) IOWA) ATTORNEY GENERAL FOR THE STATE OF) 1305 E. Walnut Street, 2nd Floor) Des Moines, IA 503 i 9)) L~S~A) ATTORNEY GENERAL FOR THE STATE OF) i 885 North 3rd St) Baton Rouge, LA 70802))) MARYLAND) ATTORNEY GENERAL FOR THE STATE OF) 200 St. Paul Place) Baltimore, MD 212202)) ATTORNEY GENERA FOR THE) COMMONWEAL TH OF MASSACHUSETTS) One Ashburon Place) Boston, MA 02108-1518) 3 5 MICHIGAN)) ATTORNEY GENERA FOR THE STATE OF) G. Mennen Williams Building, 7th Floor) 525 W. Ottwa St.) P.O. BoxMI30212 Lansing, 48909))) MINNESOTA) ATTORNEY GENERAL FOR THE STATE OF) 1400 Bremer Tower) 445 Minnesota Street) St. Paul, MN 55101) MONTANA)) ATTORNEY GENERAL FOR THE STATE OF) Justice Building, Third Floor) 2 I 5 North Sanders P.O. Box 201401)) Helena, MT 59620-1401) NEVADA) ATTORNEY GENERAL FOR THE STATE OF) 100 Nort Carson Street) Carson City, NY 89701))) NEW JERSEY) ATTORNEY GENERAL FOR THE STATE OF) Richard 1. Hughes Justice Complex) 8th Floor, West Wing) 25 Market Street) Trenton, NJ 08625-0080) MEXICO NEW Box 1508)) ATTORNt:Y GENERAL FOR THE STATE OF) PO Santa Fe, NM 87504-1508)) NEW YORK) ATTORNEY GENERAL FOR THE STATE OF) i 20 Broadway, 24th Floor) New York, NY 10271))) ATTORNEY GENERAL FOR THE STATE OF) NORTH CAROLINA) 4 5 900 I Mail Service Center) Raleigh, NC 27699-9001)) OKLAHOMA 313 NW 21st St)) ATTORNEY GENERAL FOR THE STATE OF) Oklahoma City, OK 73 105)) ATTORNEY GENERAL FOR THE STATE OF) RHODE ISLAND) i 50 South Main Street) Providence, RI 02903)) A TTORNEY GENERAL AND REPORTER FOR THE) STATE OF TENNESSEE) 425 5TH TN Nashville, Avenue 37243)) TEXAS) ATTORNEY GENERAL FOR THE STATE OF) PO Box 12548) Austin, TX 787 i 1-2548))) ATTORNEY GENERAL FOR THE) iMontpelier, 09 State Street COMMONWEAL TH OF VERMONT)) Vermont 05609)) ATTORNEY GENERAL FOR THE) COMMONWEALTH OF VIRGINIA) Offce of the Attorney General) 900 East Main Street) Richmond, Virginia 23219)) WASHINGTON) ATTORNEY GENERAL FOR THE STATE OF) 1125 Washington Street, SE) P.O. Box 40100) v.) Olympia, W A 98504) DAVIT A HEALTH CARE PARTNERS))) DA VITA KIDNEY CARE) 2000 i 6th Street) Denver, Colorado 80202) 5 5) FRESENIUS MEDICAL CAR NORTH AMERICA) FRESENIUS KIDNEY CARE) 920 Winter Street) Waltham, MA 02451)) AMERICAN KIDNEY FUND) 11921 Rockville Pike #300,) Rockville, MD 20852) JOHN DOE 1-100)) DEFENDANTS.))) i. This is an action filed under the qui tam provisions of the Federal False Claims Act, 3 I U.S.c. Sec. 3729, et seq., by Plaintiff-Relator David Gonzlez, in the name of the United States and the governents of California, Colorado, Connecticut, Delaware, the Distrct of Columbia, Georgia Hawaii, Ilinois, Indiana, Iowa, Louisiana, Marland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Jersey, New Mexico, New York, Nort Carolina, Oklahoma, Rhode Island, Tennessee, Texas, Vermont, Virginia, Washington and himself to recover penalties and damages arising from the Defendants knowing direction of payments for End Stage Renal Services in a maner, which creates illegal remuneration and kickbacks and thereby false claims to the above listed governents. 2. Accordingly, Plaintiff-Relator files this action to recover penalties and damages on behalf of himself and the above-listed governments. I. JURISDICTION AND VENUE 3. This action arises under the Federal False Claims Act, 3 i U.S.C. §§ 3729, et seq. 6 5 4. This Cour maintains subject matter jurisdiction over this action pursuant to 3 I U.S.C. § 3732(a) and 28 U.S.c. § 1331, and supplemental and pendant jurisdiction. 5. Plaintiff-Relator also brings this action on behalf of the governents of Californa, Colorado, Connecticut, Delaware, the District of Columbia, Georgia, Hawaii, Ilinois, Indiana, Iowa, Louisiana, Marland, Massachusetts, Michigan, Minnesota, Montaa, Nevada, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Rhode Island, Tennessee, Texas, Vermont, Virginia and Washington, hercinafter referred to collectively as "the States." 6. Plaintiff- Relator brings this action on behalf of the States for the Defendant's violations of CaL. Gov't Code §§ 12650 et seq.; Colo. Rev. Stat. §§ 25.4-4-303.4 et seq.; Conn. Gen. Stat. §§i 7b-30Ia--1 7b-301p (2010 supplement); DeL. Code Ann. Tit.6. §§ 1201 et seq.; D.C. Code §§ 2-38i.01 et seq.; Ga. Code. Ann. §§ 49-4-168 et seq., Haw. Rev. Stat. An. §§ 661-21 et seq.; 740 Il Compo Stat. An. 175/1 et seq.; Ind. Code §§ 5-11-5.5 et seq.; Iowa Code § 685.1 et seq.; La. Rev. Stat. An. §§ 6:438.1 et seq.; Md. Code Ann. Health-Gen. §§ 2-601 et seq.; Md. Code Ann. Gen. ProVo §§ 8-101 et seq.; Mass. Ann. Laws ch.12, §§ 5 et seq., Mich. Compo Laws. Servo §§ 400.601 et seq.; Minn. Stat. §§ 15C.01 et seq., Mont. Code An. §§ 17-8-401 et seq.; Nev. Rev. Stat. Ann. §§ 357.010 et seq.; N.J. Stat. Ann. §§ 2A: 32C-I et seq.; N.M. Stat. An. §§ 27-14-1 et seq.; N.M. Stat. An. §§ 44-9-1 et seq. N.Y. State Fin. Law §§ 188 et seq.; N.C. Gen. Stat. §§ 1-605 et seq., Okla. Stat. tit. 63, §§ 5053 et seq.; R.I. Gen. Laws §§ 9-i.l-1 et seq.; Tenn. Codc An. §§ 4-18-101 et seq.; Tenn. Code Ann. §§ 71-5-181 et seq. 1993; Tex. Hum. Res. Code Ann. §§ 36.001 et seq.; Va. Code Ann. §§ 8.01-216.1 et seq, 32 VSA §§ 630 et seq.; RCW 74.66.005 et seq. 7 5 7. These laws hereinafter are collectively referred to as the "State False Claims Acts" 8. Jurisdiction over claims arising under the State False Claims Acts is also conferred by 3 I U.S.c. § 3732(b) in that the transactions and or occurences described, which violate the State False Claims Acts involve a common nucleus of facts as, and are related to, those that violate the Federal False Claims Act. 9. Venue is proper in this jurisdiction pursuant to 31 U.S.C. § 3732(a) because at least one Defendant maintains an offce in this district, and regularly transacts business in this district and did so at all times relevant to this Complaint. The False Claims Act confers nationwide jursdiction and at lcast one of the Defendants resides or regularly transacts business in this district. II. PARTIES 10. Plaintiff-Relator David Gonzalez, of 11700 Old Columbia Pike, #709, Silver Spring, MD 20904, worked for the American Kidney Fund for twelve years, until October 20, 2015, when he was forced out of the organization for questioning the practices detailed herein. He scrved as an "HIPP" or Health Insurance Premium Program, Patient Services Coordinator. 1 i. There have been no prior public disclosures of allegations or transactions that are the subject of this Complaint as defined by thc term "publicly disclosed" under 3 i U.S.c. § 3730(e)(4)(A). 12. Mr. Gonzalez is an original source of all the allegations contained in this Complaint within the meaning of 31 U.S.c. § 3730(e)(4)(B). Mr. Gonzalez has independent knowledge of all the information contained herein, and voluntarily provided such 8 5 information to the United States and the above listed States prior to fiing an action in Court. 13. Defendant Da Vita Health Care Parters is a forte 500 health care company traded on the New York Stock Exchange and the parent company of DaVita Kidney Care (hereinafter collectively "Da Vita"). The company maintains headquarers at 2000 I 6th Street Denver, Colorado 80202. DaVita provides End Stage Renal Services including dialysis treatment. Its website includes a service whereby a patient seeking dialysis treatment can search by zip code and find a Da Vita provider in any state in the United States as well as in Washington, DC. DaVita claims to operate or provide administrative services at more than two thousand outpatient dialysis centers in the United States and Da Vita regularly conducts business and has caused to be submitted some of the false claims at issue in this case in this district. 14. Defendant Fresenius Medical Care provides Dialysis to almost three hundred thousand patients worldwide. International Headquarers are at 61346 Bad Homburg v.d. H. Germany, with subsidiaries including Fresenius Medical Care North America and Fresenius Kidney Care (hereinafter all referred to as "Fresenius") headquartered at 920 Winter Street Waltham, MA 02451. Fresenius also operates in all 50 states and the District of Columbia. Fresenius regularly conducts business and has caused to be submitted some of the false claims at issue in this case in this district. i 5. Defendant, American Kidney Fund CAKF") of 11921 Rockville Pike #300, Rockville, MD, 20852 is a non-profit "501(c)(3)" corporation. The AKF raises money and provides public serviccs including providing free screenings for kidney disease, education and advocacy on kidney related issues. The majority of funds raised by the AKF, however, go 9 5 to provide payment assistance for patients who need dialysis treatment for kidney conditions. The AKF's latest IRS Form 900 disclosure shows it obtained gross receipts of more than $275,000,000 in 2015. The AKF caused to be submitted some of the false claims at issue in this case in this distrct. i 6. In addition, the Plaintiff-Relator brings these claims against John Doe Defendants 1-100 which include, but are not limited to, six companies listed anonymously as Company A, Company B, Company C, Company D, Company E and Company F