United States ex rel. Shannon Martin, M.D. v. Darren Hathaway


RECOMMENDED FOR PUBLICATION Pursuant to Sixth Circuit I.O.P. 32.1(b) File Name: 23a0056p.06 UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT ┐ UNITED STATES OF AMERICA ex rel. SHANNON │ MARTIN, M.D.; UNITED STATES OF AMERICA ex rel. │ DOUGLAS MARTIN, │ Relators-Appellants, > No. 22-1463 │ │ v. │ │ DARREN HATHAWAY, M.D.; SOUTH MICHIGAN │ OPHTHALMOLOGY, P.C.; ELLA E. M. BROWN │ CHARITABLE CIRCLE, dba Oaklawn Hospital, │ Defendants-Appellees. │ ┘ Appeal from the United States District Court for the Western District of Michigan at Grand Rapids. No. 1:19-cv-00915—Jane M. Beckering, District Judge. Argued: March 8, 2023 Decided and Filed: March 28, 2023 Before: SUTTON, Chief Judge; SILER and MATHIS, Circuit Judges. _________________ COUNSEL ARGUED: Julie A. Gafkay, GAFKAY LAW PLC, Saginaw, Michigan, for Appellants. Mary Massaron, PLUNKETT COONEY, Bloomfield Hills, Michigan, for Appellees Darren Hathaway, M.D. and South Michigan Ophthalmology, P.C. Jonathan S. Feld, DYKEMA GOSSETT PLLC, Chicago, Illinois, for Appellee Ella E. M. Brown Charitable Circle. Daniel Winik, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C., for United States as Amicus Curiae. ON BRIEF: Julie A. Gafkay, GAFKAY LAW PLC, Saginaw, Michigan, Floyd E. Gates, Jr., Christopher J. Zdarsky, BODMAN PLC, Grand Rapids, Michigan, for Appellants. Mary Massaron, PLUNKETT COONEY, Bloomfield Hills, Michigan, for Appellees Darren Hathaway, M.D. and South Michigan Ophthalmology, P.C. Jonathan S. Feld, Mark J. Magyar, Andrew T. VanEgmond, DYKEMA GOSSETT PLLC, Chicago, Illinois, Lisa A. McNiff, SCHROEDER DEGRAW PLLC, Marshall, Michigan, for Appellee Ella E. M. Brown No. 22-1463 United States ex rel. Martin, et al. v. Hathaway, et al. Page 2 Charitable Circle. Daniel Winik, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C., Jessica L. Ellsworth, HOGAN LOVELLS US LLP, Washington, D.C., for Amici Curiae. SUTTON, C.J., delivered the opinion of the court in which SILER, J., joined in full, and MATHIS, J., joined in part and in the judgment. MATHIS, J. (pg. 17), delivered a separate opinion concurring in all but Section II.A. of the opinion. _________________ OPINION _________________ SUTTON, Chief Judge. The False Claims Act imposes civil liability for “knowingly present[ing], or caus[ing] to be presented, a false or fraudulent claim [to the government] for payment or approval.” 31 U.S.C. § 3729(a)(1)(A). The Act allows individuals with knowledge of false claims to bring private lawsuits, known as qui tam lawsuits, on behalf of the government. Id. § 3730(b). Among other types of false claims, the Act covers claims for “items or services resulting from a violation” of the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(g), which prohibits medical providers from making referrals “in return for” “remuneration,” id. § 1320a- 7b(b)(1)(A). At issue in this case is (1) whether a hospital’s decision not to hire an ophthalmologist in return for a general commitment of continued surgery referrals from another ophthalmologist for patients from the local community counts as the kind of “remuneration” covered by the Anti-Kickback Statute and (2) whether claims from such continued referrals “result[] from” violations of the statute. Id. § 1320a-7b(b)(1), (g). Because we agree with the district court that …

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