Opinion

Slagh v. Joseph House, Inc.

Court
District Court, S.D. Ohio
Filed
Apr 10, 2023
Cited by
0 cases
Authority
More cited than 28.4%

The opinion

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF OHIO

WESTERN DIVISION

Darla Slagh, Ph.D., :

: Case No. 1:22-cv-691

Plaintiff, :

: Judge Susan J. Dlott

v. :

: Order Denying Motion to Dismiss

Joseph House, Inc., :

:

Defendant. :

Plaintiff Darla Slagh, Ph.D., filed this suit against her former employer, Defendant

Joseph House, Inc., asserting a False Claims Act retaliation claim pursuant to 31 U.S.C.

§ 3730(h)(1). Pending before the Court is Joseph House’s Motion to Dismiss Plaintiff’s

Complaint for failure to state a claim upon which relief can be granted. (Doc. 5.) Dr. Slagh has

filed a Memorandum in Opposition, to which Joseph House filed a Reply. (Docs. 6, 7.) For the

reasons that follow, the Court will DENY the Motion to Dismiss.

I. BACKGROUND

A. Factual Allegations

The facts alleged in the Complaint are taken as true for purposes of this dismissal motion.

In May 2022, Dr. Slagh began employment as the clinical director of Joseph House, a company

that provides services to male homeless veterans. (Doc. 1 at PageID 2.) As part of her duties,

she oversaw the work of the company’s mental health counselors. (Id.) The counselors lacked

sufficient licensure to directly bill Medicaid for their services, so they operated under Dr. Slagh’s

direction and her license. (Id.) The law requires that the counselors meet weekly with Dr. Slagh

in order for her to bill Medicaid for their services. (Id.) Dr. Slagh asserts that she uncovered

three instances of fraudulent billing occurring at Joseph House. (Id. at PageID 3.)

First, Dr. Slagh asserts that counselor Jim Engelhardt billed for counseling services he

did not provide. She reported to Katie Waits, the program director at Joseph House, that “she

believed . . . [Engelhardt] was committing Medicaid fraud.” (Id.) She reported that he

“appeared to be billing Medicaid for sessions that never occurred and/or billing for sessions in

greater intervals of time than the actual length of the sessions.” (Id.) Waits responded that

Engelhardt would not engage in Medicaid fraud, so Dr. Slagh must be incorrect or misunderstand

the billing system. (Id.) Subsequently, Dr. Slagh reported to Waits that she had heard

complaints from at least two patients who were billed for meetings with Engelhardt that did not

occur. (Id. at PageID 4.) Waits accused one patient of lying to obtain a new counselor. (Id.)

In July 2022, Joseph House confirmed that Engelhardt was fraudulently billing for

services he did not provide, and it terminated Engelhardt’s employment. (Id.) On August 10,

2022, Dr. Slagh reported Engelhardt’s fraudulent billing to the State of Ohio’s Board of

Counselors. (Id.) On August 21, 2022, Dr. Slagh told Alicia Patterson, the executive director at

Joseph House, that she had reported concerns about Engelhardt’s fraudulent billing to Waits, but

Waits had done nothing in response. (Id.) Patterson “became agitated” and cautioned “against

making such an accusation against Ms. Waits.” (Id.)

In the second instance, Dr. Slagh asserts that she discovered that Joseph House was

double-billing Medicaid for urinalysis services, perhaps inadvertently. (Id.) Specifically, she

discovered that providers were entering urinalysis services into the billing system when the

services were performed, but their supervisor, Brandon Cooper, also was billing for the

urinalysis services one time monthly. (Id. at PageID 4–5.) Cooper told Dr. Slagh that the

providers should not be billing for the urinalysis services at all. (Id. at PageID 5.) In August

2022, Dr. Slagh reported the issue to Patterson, the executive director, who agreed that Joseph

House had been double billing. (Id.) When Dr. Slagh followed up with the providers to make

sure that the double-billing did not happen again, they told her that they were instructed to tell

her that they had never billed for a urinalysis. (Id.)

In the third instance, Dr. Slagh alleges that she reported to Patterson in August 2022 that

Waits, who provided counseling services in addition to her managerial duties, was not meeting

with Dr. Slagh weekly as required for Joseph House to bill Medicaid for Waits’s services. (Id.)

Patterson falsely responded that Waits was attending weekly clinical meetings that satisfied the

requirement and that Joseph House had a waiver exempting Waits from such meetings. (Id.)

The weekly clinical meetings were attended by more participants than permitted under the law

for clinical meetings. (Id.) Additionally, Joseph House never presented Dr. Slagh with a waiver.

(Id. at PageID 5–6.)

On August 31, 2022, Joseph House terminated Dr. Slagh’s employment for purportedly

(1) failing to report suspicions that Engelhardt, the counselor, had been drinking on the job and

(2) disclosing information about Engelhardt’s fraudulent activity to other counselors at Joseph

House. (Id. at PageID 6.) Contrary to those assertions, Dr. Slagh states that she did not suspect

Engelhardt had been drinking on the job and that she did not disclose any information about

Engelhardt to other counselors. (Id.) She alleges that Joseph House terminated her employment

because she “objected to Joseph House’s apparent fraudulent billing to the Ohio Department of

Medicaid.” (Id. at 7.)

B. Procedural Posture

On November 23, 2022, Dr. Slagh filed this action against Joseph House asserting one

claim of retaliation in violation of the False Claims Act, 31 U.S.C. § 3730(h)(1). (Id. at PageID

7.) Joseph House now moves to dismiss arguing that Dr. Slagh failed to plead a claim for False

Claims Act retaliation upon which relief can be granted. The Motion to Dismiss is ripe for

adjudication.

II. STANDARDS GOVERNING MOTIONS TO DISMISS

Federal Rule of Civil Procedure 12(b)(6) allows a party to move to dismiss a complaint

for “failure to state a claim upon which relief can be granted.” Fed. R. Civ. P. 12(b)(6). To

withstand a motion to dismiss, a complaint must comply with Federal Rule of Civil Procedure

8(a), which requires “a short and plain statement of the claim showing that the pleader is entitled

to relief.” Ashcroft v. Iqbal, 556 U.S. 662, 677–678 (2009) (quoting Rule 8(a)(2)).

A complaint must include sufficient facts to state a claim that is plausible on its face and

not speculative. Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 570 (2007). “A claim has facial

plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable

inference that the defendant is liable for the misconduct alleged.” Iqbal, 556 U.S. at 678. Mere

“labels and conclusions [or] a formulaic recitation of the elements of a cause of action” will not

suffice. Twombly, 550 U.S. at 555. A complaint must contain “either direct or inferential

allegations respecting all material elements to sustain a recovery under some viable legal

theory.” DiGeronimo Aggregates, LLC v. Zemla, 763 F.3d 506, 509 (6th Cir. 2014) (citation

omitted). However, it “does not need detailed factual allegations” or “heightened fact pleading

of specifics.” Twombly, 550 U.S. at 555, 570. A district court examining the sufficiency of a

complaint must accept well-pleaded facts as true, but not legal conclusions or legal conclusions

couched as factual allegations. Iqbal, 556 U.S. at 678–679; DiGeronimo Aggregates, 763 F.3d at

509.

III. ANALYSIS

Defendant moves to dismiss the retaliation claim against it for failure to state a claim

upon which relief can be granted. The False Claims Act retaliation provision provides in

relevant part as follows:

(h) Relief from retaliatory actions.--

(1) In general.--Any employee, contractor, or agent shall be entitled to all relief

necessary to make that employee, contractor, or agent whole, if that employee,

contractor, or agent is discharged, demoted, suspended, threatened, harassed, or in

any other manner discriminated against in the terms and conditions of

employment because of lawful acts done by the employee, contractor, agent or

associated others in furtherance of an action under this section or other efforts to

stop 1 or more violations of this subchapter.

31 U.S.C. § 3730. The last clause, “or other efforts to stop 1 or more violations of this

subchapter[,]” was added in 2009.

“To establish a prima facie case [of False Claims Act retaliation], the plaintiff must show

the following elements: (1) she was engaged in a protected activity; (2) her employer knew that

she engaged in the protected activity; and (3) her employer discharged or otherwise

discriminated against the employee as a result of the protected activity.” Jones-McNamara v.

Holzer Health Sys., 630 F. App’x 394, 398 (6th Cir. 2015). “[I]nternal reports may constitute

protected activity, provided such internal reports allege fraud on the government.” Id. (internal

quotation and citation omitted); see also Mikhaeil v. Walgreens Inc., No. 13-14107, 2015 WL

778179, at *7 (E.D. Mich. Feb. 24, 2015) (“To be protected . . . the internal report must

specifically allege fraudulent claims for federal funds and not merely address concerns about

general misconduct.”) (internal quotation and citation omitted).

The Joseph House contends that Dr. Slagh’s allegations are insufficient. It asserts that

Dr. Slagh’s job duties included ensuring compliance, and therefore she had a heightened

obligation to provide notice to Joseph House that she was reporting violations of the False

Claims Act, not merely performing her job duties. See United States ex rel. Seabury v.

Cookeville Reg’l Med. Center Auth., No. 2:15-cv-00065, 2021 WL 4594784, at *8 (M.D. Tenn.

2021) (“[T]o adequately plead notice, a compliance employee must allege facts that, viewed in

her favor, make clear that her employer had been put on notice that she was trying to stop it from

violating the False Claims Act and not merely doing her job.”).1

Dr. Slagh does not allege in the Complaint that she had any regulatory compliance or

fraud detection job duties. Rather, she alleges that her job duties included “overseeing the work

of mental health professionals providing mental health care to Joseph House’s patients.” (Doc. 1

at PageID 2.) She also alleges that, because the counselors had to bill Medicaid under her

licensure, the law required her to conduct weekly supervisory meetings with the counselors.

(Id.) Nonetheless, the Joseph House identifies administrative regulations and professional codes

of conduct required for counselors that Dr. Slagh was obligated to follow. (Doc. 5 at PageID 16–

18.) These regulations and codes of conduct required Dr. Slagh to report other counselors who

act in an unethical manner. (Id.)2 Joseph House asserts that Dr. Slagh was merely complying

with these regulations and codes of conduct when she reported to her supervisors about the

alleged misconduct of other counselors. It argues that, because she had this ethical duty to report

misconduct, she had to do more to put Joseph House on notice that she was trying to stop a False

Claims Act violation. The Court does not agree with Joseph House’s position at this pleading

stage.

Dr. Slagh’s reports to Waits and Patterson about fraudulent billing to Medicaid,

particularly those related to Englehardt’s misconduct and the urinalysis services, were much

more specific than simply reporting to her supervisors that a counselor engaged in an unethical

manner. Her allegations are sufficient under Jones-McNamara, 630 F. App’x at 398, and

1 Dr. Slagh argues that the Seabury decision is incorrect insofar as it purports to require a higher pleading standard

for employees whose regular job duties include regulatory compliance. The Court need not resolve that dispute

here.

2 The regulations and codes of conduct for counselors identified by the Joseph House appear unrelated to the

allegation that Dr. Slagh reported potentially inadvertent incidents of double billing for urinalysis services.

§ 3730(h)(1) to have put the Joseph House on notice that she was trying to stop fraudulent

Medicaid billing, a practice in violation of the False Claims Act. Therefore, Dr. Slagh stated a

plausible claim for retaliation in violation of the False Claims Act in the Complaint.

IV. CONCLUSION

For the foregoing reasons, Defendant’s Motion to Dismiss Plaintiff’s Complaint (Doc. 5)

is DENIED.

IT IS SO ORDERED.

BY THE COURT:

S/Susan J. Dlott

Susan J. Dlott

United States District Judge

This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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