Chattanooga-Hamilton County Hospital Authority (doing business as Erlanger Medical Center and Erlanger Health System) and UT-Erlanger Medical Group, Inc. (collectively “Erlanger”) have filed a motion to dismiss in a whistleblower lawsuit brought by two Chattanooga, Tennessee-based orthopedic surgeons and a former chief information officer (collectively the “relators”).
The motion to dismiss lists six arguments in support of the motion. Erlanger asserts that “False Claims Act (“FCA”) allegations be supported with specific facts and particularized details about how Erlanger executed the alleged fraud and how the fraud led to specific claims for payment.” Erlanger argues that the relators have failed to meet this burden. Notably, Erlanger asserts that “despite 151 pages and 457 paragraphs of allegations, the complaint is devoid of necessary details that, even if taken as true, could support a viable FCA claim.”
In the complaint the relators assert that the defendants allowed overlapping surgeries where a teaching physician was not present for the “key portion of [the] service or procedure.” However, in the motion to dismiss Erlanger argues that “relators fail to plead facts suggesting that any surgeries were concurrent or otherwise non-billable.” Essentially, Erlanger is saying that the relators have failed to provide details regarding the surgeries that support the fraud claim and that overlapping surgeries on their own are not fraudulent.
In the motion to dismiss Erlanger also asserts that relators “fail to plead a plausible FCA retaliation claim.” The relators claim they were “punished” for bringing their complaints about the alleged violations. Erlanger argues that the relators’ claims fail because “they have not pleaded that they engaged in activity protected by the FCA.” Notably, Erlanger asserts that the relators’ claims “center on patient safety, not ‘fraud committed against the federal government’” which is required for their type of action.
If Erlanger succeeds in its motion to dismiss, the court would dismiss the case against Erlanger. For OTW’s original coverage of the case, see “Ortho Surgeon Whistleblowers Sue Erlanger Health System.”
