Opinion

Lowery v. All Medicines, Inc.

Court
District Court, E.D. North Carolina
Filed
Apr 14, 2021
Cited by
0 cases
Authority
More cited than 31.5%

The opinion

IN THE UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF NORTH CAROLINA

SOUTHERN DIVISION

NO. 7:17-CV-128-FL

UNITED STATES OF AMERICA and )

STATE OF NORTH CAROLINA ex rel. )

BRONSON LOWERY, )

)

Plaintiffs, )

)

v. ) ORDER

)

ALL MEDICINES, INC. d/b/a Townsend’s )

Pharmacy; JAMES CRAIG BELL; and )

MELISHA WEST, )

)

Defendants. )

This matter is before the court on motion to dismiss (DE 52) by defendants All Medicines,

Inc. (“All Medicines”) and James Craig Bell (“Bell”) (collectively, “defendants”).1 The motion

has been briefed fully, and in this posture, the issues raised are ripe for ruling. For the following

reasons the motion is denied.

STATEMENT OF THE CASE

Plaintiffs commenced this False Claims Act case on June 26, 2017, by filing a complaint

in camera and under seal, claiming that defendants submitted false claims to the United States and

to the State of North Carolina (the “government”), through Medicare and Medicaid healthcare

programs, in the course of pharmacy billing and reimbursement practices over a period of years.

1 As set forth herein, the court entered default against defendant Melisha West (“West”) on December 14,

2020, and defendant West did not participate in briefing on the instant motion. All references to “defendants” herein

without qualification are to defendant All Medicines and defendant Bell, only. In addition, on December 10, 2020,

the court denied in part the instant motion to dismiss as it pertains to claims brought solely by plaintiff/relator, Bronson

Lowery (“relator”), and the instant order addresses the remaining part of the motion pending for decision.

Relator, 2 who is a former pharmacist employed by defendant All Medicines, asserted initially the

following claims on behalf of himself and the government:

1. False claims and statements in violation of the False Claims Act, 31 U.S.C. § 3729(a)(1)(A)

and (B);

2. Conspiracy to commit violations of False Claims Act, in violation of 31 U.S.C. §

3729(a)(1)(C);

3. False claims and statements in violation of the North Carolina False Claims Act, § 1-

607(a)(1) and (2);

4. Conspiracy to commit violations of the North Carolina False Claims Act, in violation of §

1-607(a)(3).

5. Fraud;

6. Payment under mistake of fact/restitution;

7. Unjust enrichment/restitution;

8. Wrongful termination (on behalf of relator only).

Relator sought in the original complaint trebled damages, compensatory damages, punitive

damages, civil penalties, costs, and fees.

Upon motions by the government, the court extended the time to intervene five times, until

March 31, 2020. On that date, the court unsealed the case and allowed the government to intervene

2 The False Claims Act allows a person to bring a civil action “for the person and for the United States

Government,” wherein, as here, “[t]he action shall be brought in the name of the Government.” 31 U.S.C. §

3730(b)(1). The government thereafter may elect to “proceed with the action, in which case the action shall be

conducted by the Government; or . . . notify the court that it declines to take over the action, in which case the person

bringing the action shall have the right to conduct the action.” Id. § 3730(b)(4). Although the terms “relator” and “ex

rel.” are not defined in the statute, they are the names commonly used to denote a private individual suing on behalf

of the government under the False Claims Act. E.g., Cochise Consultancy, Inc. v. United States ex rel. Hunt, 139 S.

Ct. 1507, 1514 (2019).

in part and to decline to intervene in part, on the basis of its notice filed March 30, 2020. In

particular, the court allowed the government 90 days to file a complaint in intervention.3

The government filed the operative complaint in intervention on June 16, 2020, which

again asserts claims under the False Claims Act and the North Carolina False Claims Act, as well

as common law claims, enumerated as follows:

1. Submission of False Claims in violation of 31 U.S.C. § 3729(a)(1)(A) and N.C. Gen. Stat.

§ 1-607(a)(1);

2. False Statements Material to False Claims in violation of 31 U.S.C. § 3729(a)(1)(B) and

N.C. Gen. Stat. § 1-607(a)(2);

3. Conspiracy to submit false claims and statements in violation of 31 U.S.C. § 3729(a)(1)(C)

and N.C. Gen. Stat. § 1-607(a)(3);

4. Common law fraud;

5. Unjust enrichment;

6. Payment by mistake;

The government seeks treble damages, civil penalties, actual damages, costs, and interest.

Defendants filed the instant motion to dismiss on October 6, 2020, seeking to dismiss the

claims against them for failure to state a claim and for insufficient pleading under Federal Rules

3 In its notice of intervention, the government stated that it elected to intervene in that part of the action

“regarding false claims for prescription drugs falsely billed,” and declined to intervene as to relator’s “employment

retaliation claims.” (DE 31 at 1). The court’s order allowing intervention directed relator to serve an amended

complaint “as to any remaining issues upon defendants,” with further instructions regarding that “part of the action in

which the Governments have declined to intervene.” (DE 32 at 2). As described further herein, the court has stayed

all case activities with respect to the claims for which the government has declined to intervene.

of Civil Procedure 12(b)(6) and 9(b).4 The government responded in opposition to the instant

motion on October 27, 2020.

STATEMENT OF FACTS

The facts alleged in the complaint5 may be summarized as follows. Defendant All

Medicines, doing business as Townsend’s Pharmacy (the “pharmacy”), was owned by defendant

Bell and operated in Red Springs, Robeson County, North Carolina, until it closed in

approximately July 2017, while under investigation by the North Carolina Board of Pharmacy.

(Compl. ¶ 11). The pharmacy submitted claims that were reimbursed by Medicare and Medicaid

from 2014 through 2017. (Id.).

Defendant Bell, who is a resident of Robeson County, was a licensed pharmacist in North

Carolina, was the pharmacy manager, and was ultimately responsible for all pharmacy claims

submitted for reimbursement from Medicare and Medicaid. (Id. ¶ 12). Defendant West, who was

a licensed pharmacist technician, was the office manager over the day to day pharmacy operations,

including billing and recordkeeping and managing other pharmacy employees. (Id. ¶ 13).

Defendants Bell and West oversaw, authorized, or approved the billing for prescription drugs at

issue in 2014 to 2017. (Id. ¶ 14). Relator is a licensed pharmacist who was employed by the

pharmacy from May 2014, to April 2017, and who worked under the supervision of Bell and West.

(Id. ¶ 16).

4 Defendants also moved to dismiss relator’s original complaint “[o]ut of an abundance of caution,” for lack

of standing, lack of personal jurisdiction, insufficient process, and insufficient service of process; as well as on the

basis that the operative complaint in intervention supersedes relator’s complaint. (DE 52 at 1). On December 10,

2020, upon the parties’ joint motion to stay, the court denied without prejudice defendants’ motion to dismiss as it

pertains to relator’s claims not subject to government intervention, and stayed all case activities regarding those claims

pending resolution of the government’s operative claims in intervention. (DE 63).

5 All references to the complaint or “compl.” in citations herein are to the operative complaint in intervention,

filed June 16, 2020.

Defendants billed more than $8,000,000.00 for prescription drugs and medications

between 2014 and 2017 that was reimbursed by Medicare and Medicaid. (Id. ¶ 62). On numerous

occasions a prescription drug label was printed, a prescription drug was billed, and payment was

received, even though the prescription drug was never filled, picked up or provided to a patient.

(Id. ¶ 73). Defendants routinely printed and kept the pending medication label in a bin for

prescription drugs that had not yet been billed. (Id. ¶ 74). A label would then be pulled from the

bin and filled only if the patient came into the pharmacy to pick up a medication into the pharmacy

system and already billed. (Id.). This “labels-in-bin practice was abruptly changed in 2016 by

Bell and West, and these saved labels for billed prescriptions were discarded, after questions were

raised about possible fraudulent billing.” (Id. ¶ 75).

Defendants and their pharmacy technicians knew that claims were being billed for

prescription drugs that were often not dispensed, or the pharmacy often dispensed a medication

that was cheaper than the one billed. (Id. ¶ 79). “Defendants West and Bell admitted to Relator

Lowery that they knew that prescription drugs were not being provided as billed.” (Id. ¶ 80).

Defendants engaged in four types of false claim billing schemes, comprising falsely 1)

billing for prescription drugs that were not in the pharmacy inventory, 2) billing for more expensive

extended release medications rather than cheaper generic immediate release medications that had

been dispensed, 3) billing for prescription drugs based on fake prescriptions, and 4) billing for

name brand prescription drugs rather than the generic drugs actually dispensed. (Id. ¶ 83).

For example, “[f]or each of the[] fake prescriptions, Defendant West or Bell opened the

[billing software] system at the Pharmacy, typed in the name of a current patient at the Pharmacy,

and then fabricated a record of a prescription for that patient so that a false billing claim would be

submitted for reimbursement.” (Id. ¶ 145). In addition, “[d]efendants’ Pharmacy techs routinely

filled bottles with generic drugs rather than the name brand equivalent drugs printed on the label.”

(Id. ¶ 160). “Defendants’ techs stated that Defendant West had directly instructed them to fill

prescriptions in this manner, and this pattern and practice was known to both Defendants Bell and

West.” (Id. ¶ 161). “Defendant Bell directed a physical count for all controlled substances in [the

pharmacy software] system based upon an audit, which was memorialized in [a] ‘Physical Count

Worksheet’ dated January 31, 2017,” attached to the complaint. (Id. ¶ 169). “The Physical Count

Worksheet documents many controlled substances with large negative numbers in the ‘Quantity

on Hand’ column, which is evidence suggesting Defendants billed for controlled substances that

they never purchased.” (Id. ¶ 175).

Defendants increased their profits, salaries and cash withdrawals through these schemes by

receiving Medicare and Medicaid reimbursement for prescription items that they never purchased

and, contrary to claims submitted, never dispensed to patients. (Id. ¶ 86). “Defendants Bell and

West often withdrew or transferred large cash amounts from the Pharmacy during 2015 through

2017 for personal use.” (Id. ¶ 87).

COURT’S DISCUSSION

A. Standard of Review

To survive a motion to dismiss under Rule 12(b)(6), “a complaint must contain sufficient

factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’” Ashcroft v.

Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)).

“Factual allegations must be enough to raise a right to relief above the speculative level.”

Twombly, 550 U.S. at 555. In evaluating whether a claim is stated, “[the] court accepts all well-

pled facts as true and construes these facts in the light most favorable to the plaintiff,” but does not

consider “legal conclusions, elements of a cause of action, . . . bare assertions devoid of further

factual enhancement[,] . . . unwarranted inferences, unreasonable conclusions, or arguments.”

Nemet Chevrolet, Ltd. v. Consumeraffairs.com, Inc., 591 F.3d 250, 255 (4th Cir. 2009) (quotations

omitted).

B. Analysis

1. Defendant Bell

Defendants argue that all claims against defendant Bell should be dismissed because the

complaint is devoid of non-conclusory allegations of defendant Bell’s involvement in the alleged

fraud.

Plaintiff’s first three claims are based upon submission of false claims and false statements

to the government in violation of the False Claims Act and the North Carolina False Claims Act.

Those statutes provide liability, in pertinent part, for:

any person who--

(A) knowingly presents, or causes to be presented, a false or fraudulent claim for

payment or approval;

(B) knowingly makes, uses, or causes to be made or used, a false record or statement

material to a false or fraudulent claim; [or]

(C) conspires to commit a violation of subparagraph (A) [or] (B).

31 U.S.C. § 3729(a); see N.C. Gen. Stat. § 1-607(a).

To state a False Claims Act claim, a plaintiff must allege: “(1) that the defendant made a

false statement or engaged in a fraudulent course of conduct; (2) such statement or conduct was

made or carried out with the requisite scienter; (3) the statement or conduct was material; and (4)

the statement or conduct caused the government to pay out money or to forfeit money due.” United

States ex rel. Harrison v. Westinghouse Savannah River Co., 352 F.3d 908, 913 (4th Cir. 2003)

(“Harrison II”). 6

In addition, plaintiff’s claims under the False Claims Act, as well as plaintiff’s common

law claims sounding in fraud, are subject to pleading requirements of Federal Rule of Civil

Procedure 9(b). “Rule 9(b) requires that [a] . . . plaintiff must, at a minimum, describe the time,

place, and contents of the false representations, as well as the identity of the person making the

misrepresentation and what he obtained thereby.” United States v. Triple Canopy, Inc., 775 F.3d

628, 634 (4th Cir. 2015). The purposes of Rule 9(b) are to 1) “ensure[] that the defendant has

sufficient information to formulate a defense by putting it on notice of the conduct complained

of,” 2) “protect defendants from frivolous suits,” 3) “eliminate fraud actions in which all the facts

are learned after discovery,” and 4) “protect[] defendants from harm to their goodwill and

reputation.” Harrison v. Westinghouse Savannah River Co., 176 F.3d 776, 784 (4th Cir. 1999)

(“Harrison I”).

In the context of a False Claims Act case, “[a] court should hesitate to dismiss a complaint

under Rule 9(b) if the court is satisfied (1) that the defendant has been made aware of the particular

circumstances for which she will have to prepare a defense at trial, and (2) that plaintiff has

substantial prediscovery evidence of those facts.” Id. In addition, where a complaint asserts a

scheme to defraud, a complaint may “outline the dealings” that “form a solid foundation” for the

plaintiff’s theory of liability. United States ex rel. Bunk v. Gov’t Logistics N.V., 842 F.3d 261,

276 (4th Cir. 2016); see U.S. ex rel. Grubbs v. Kanneganti, 565 F.3d 180, 190 (5th Cir. 2009)

(holding that in a False Claims Act case, it is sufficient to allege “particular details of a scheme to

6 In all citations to cases in this order, internal quotation marks and citations are omitted unless otherwise

specified.

submit false claims paired with reliable indicia that lead to a strong inference that claims were

actually submitted”).

Here, plaintiffs have alleged sufficient facts to state their claims with particularity against

defendant Bell. As an initial matter, the complaint alleges the time, place, and contents of the false

representations, being multiple types of repeating patterns of prescription drug claims submitted

to Medicaid and Medicare, from the pharmacy, during the time frame from 2014 to 2017. (E.g.,

Compl. ¶¶ 73, 77, 79, 83, 108-109, 118-120, 145, 159-160). The contents of the false

representations are alleged with detail, including through examples, and by describing the structure

of each of the asserted schemes. (Id.). With respect to identity, the complaint alleges sufficient

facts regarding the nature of the closely-held business of the pharmacy and the structure of the

schemes to permit an inference that the representations were made by pharmacy employees, with

defendant Bell causing those representations to be made by virtue of his management and

supervision over them.

In particular, facts regarding the nature of the business of the pharmacy and defendant

Bell’s role include that defendant is “a resident of Robeson County,” and that he owned the

pharmacy, which operated also in Red Springs, Robeson County. (Compl. ¶¶ 11-12). It is

reasonable to infer that the pharmacy, by virtue of the fact that it was both owned and under

management of defendant Bell, in a small town, was a small, closely held and managed, business.

Defendant Bell “was the [p]harmacy manager, and was ultimately responsible for all [p]harmacy

claims submitted for reimbursement from Medicare and Medicaid.” (Id. ¶ 12). In addition,

“[d]efendants Bell and West oversaw, authorized, or approved the billing for prescription drugs at

issue in 2014 to 2017, and actively participated in the fraudulent schemes,” asserted in the

complaint. (Id. ¶ 14). Moreover, defendant Bell was himself a “licensed pharmacist.” (Id.).

Based on the foregoing allegations, it is reasonable to infer that defendant directed,

oversaw, or caused false statements to be made by employees of the pharmacy acting within the

scope of their employment, including: 1) defendant West, who was a “pharmacist technician,”

acting as the “office manager over the day to day of the pharmacy, including billing and

recordkeeping” and “manag[ing] other [p]harmacy employees”; (Id. ¶ 13); 2) Relator, who was a

“licensed pharmacist” who “worked under the supervision of Bell and West.” (Id. ¶ 16); and 3)

other “pharmacy technicians.” (Id. ¶ 79).

Furthermore, plaintiffs make additional allegations further supporting an inference of

personal participation by defendant Bell in the asserted false claims schemes. They allege that the

“labels-in-bin practice was abruptly changed in 2016 by Bell and West, and these saved labels for

billed prescriptions were discarded, after questions were raised about possible fraudulent billing.”

(Id. ¶ 75). They allege that “[f]or each of the[] fake prescriptions, Defendant West or Bell opened

the [billing software] system at the Pharmacy, typed in the name of a current patient at the

Pharmacy, and then fabricated a record of a prescription for that patient so that a false billing claim

would be submitted for reimbursement.” (Id. ¶ 145). They also allege that “[d]efendants West and

Bell admitted to Relator Lowery that they knew that prescription drugs were not being provided

as billed.” (Id. ¶ 80) (emphasis added).

Moreover, plaintiffs allege that “[d]efendants’ techs stated that Defendant West had

directly instructed them to fill prescriptions in this manner [using generic drugs instead of brand

name drugs indicated on the labels], and this pattern and practice was known to both Defendants

Bell and West.” (Id. ¶ 161) (emphasis). “Defendant Bell directed a physical count for all

controlled substances in” January 31, 2017. (Id. ¶ 169). Finally, “defendants Bell and West often

withdrew or transferred large cash amounts from the Pharmacy during 2015 through 2017 for

personal use.” (Id. ¶ 87) (emphasis added).

Accordingly, viewing the allegations in the light most favorable to plaintiffs, it is

reasonable to infer that defendant Bell caused false claims to be submitted, and caused the alleged

fraudulent schemes to persist, through his management of employees of the pharmacy.

Defendants raise several arguments in support of dismissal that are unavailing. For

example, defendants argue that “the complaint does not allege that defendant Bell was the

‘manager’ of the pharmacy during the period that the alleged fraud occurred.” (Defs’ Mem. (DE

53) at 7). Defendants assert that “Defendant West and Relator managed the pharmacy throughout

the period of the alleged fraud, and, during that time, Defendant Bell was an absentee owner.”

(Id.) (emphasis added). Defendants further assert that “[i]n reality, although Defendant Bell was

the owner of the pharmacy, by 2014, his health had deteriorated such that he needed someone else

to run the pharmacy.” (Id. at 5 n. 2). “So, he hired Relator in May 2014 to run the pharmacy along

with Defendant West.” (Id.).

None of these facts asserted by defendants, however, are alleged in the complaint. As

noted previously, the complaint instead alleges that defendant Bell “was the [p]harmacy manager,

and was ultimately responsible for all [p]harmacy claims submitted for reimbursement from

Medicare and Medicaid.” (Id. ¶ 12) (emphasis added). The combination of this and additional

allegations set forth in the court’s analysis above permit the inference of management and direction

by defendant Bell. Contrary facts asserted by defendants are not proper for consideration at this

juncture, but rather may be raised at a later juncture in the case.

Defendants also argue that defendant Bell’s involvement in the fraud “is not plausible given

the lack of factual detail of his involvement and the alleged fact the Defendant Bell ‘directed a

physical count’ of medications, which obviously would (and allegedly, in fact did) memorialize

the fraud.” (Defs’ Mem. (DE 53) at 8). This argument, however, draws inferences in defendants’

favor, without crediting plausible inferences that may arise from the facts as actually alleged in the

complaint. In particular, while it is conceivable that defendant Bell had no knowledge of

fraudulent representations to Medicare or Medicaid, and while defendants may later bring forth

facts that foreclose a reasonable inference of his involvement or knowledge, it is reasonable at this

juncture to infer that defendant Bell directed the physical count to portray responsiveness or

cooperation with an audit. (Compl. ¶ 169). Moreover, at this juncture, the fact that defendant Bell

directed a physical count is significant not solely because of what the physical count revealed, but

also as an example of his personal involvement in managing the pharmacy.

Defendants next argue that the complaint is deficient because it “does not take a firm

position on whether Defendant Bell had actual knowledge of the fraud” versus “implied

knowledge.” (Defs’ Resp. (DE 53) at 9). But, under the False Claims Act, plaintiffs may proceed

under either a theory that the defendant “has actual knowledge” or “acts in deliberate ignorance

of” or “in reckless disregard of the truth or falsity of the information” underlying the false claims.

31 U.S.C. § 3729(b). The complaint need not choose one theory of knowledge over the other, but

rather may plead them in the alternative, as it does here. (Compl. ¶¶ 186-187, 192, 195).7

Defendants also challenge the allegation that defendant Bell “admitted to Relator Lowery

that they knew that prescription[] drugs were not being provided as billed.” (Defs’ Mem. (DE 53)

at 9 (quoting Compl. ¶ 80)). Defendants assert that the complaint “does not state when Defendant

7 The case U.S. ex rel. Davis v. Prince, No. 1:08CV1244, 2010 WL 2679761 (E.D. Va. July 2, 2010), cited by

defendants, is instructively distinguishable. There, the complaint alleged only that an owner of a company “received

proceeds from the fraudulent conduct,” but did not allege his “involvement in the alleged fraudulent scheme.” Id. at

*4. By contrast, in that case, the court determined the complaint properly alleged claims against “specific managers .

. . who collaborated to engage in the alleged fraudulent activity.” Id. Here, plaintiffs allege management by defendant

Bell, not just receipt of proceeds. (E.g., Compl. ¶¶ 12, 14). Therefore, the partial dismissal in Davis is inapposite.

Bell allegedly made this admission, the contents or circumstances of this alleged admission, or any

additional factual detail supporting that this ‘admission’ occurred at all or at a relevant time.” (Id.

at 9-10). Accordingly, defendants argue that this allegation is a “naked assertion” that need not be

accepted as a factual allegation under Iqbal and Twombly. However, Iqbal and Twombly do not

require factual allegations about an admission to state with particularity the time, contents, or

circumstances of the alleged admission, or additional factual details to be credited upon a motion

to dismiss. See, e.g., Iqbal, 556 U.S. at 678. Rather, the standard is that the court accepts

allegations of “factual matter[s]” and “factual content,” id. as opposed to “legal conclusions,

elements of a cause of action, . . . bare assertions devoid of further factual enhancement[,] . . .

unwarranted inferences, unreasonable conclusions, or arguments.” Nemet Chevrolet, Ltd., 591

F.3d at 255; see Iqbal, 556 U.S. at 678-679. Here, the allegation that defendants West and Bell

made an admission to relator “that they knew that prescription drugs were not being provided as

billed” is a qualifying factual allegation about a statement that was made by an opposing party.

(Compl. ¶ 80). It is not a mere legal conclusion or a bare assertion subject to being disregarded

under Iqbal and Twombly. Therefore, for purposes of the instant motion, the court cannot

disregard this allegation.

Defendants suggest that the complaint is insufficient to state a claim against defendant Bell

for conspiracy, “because the Complaint fails to allege the details of any conspiratorial agreement

between any of the Defendants.” (Defs’ Mem. (DE 53) at 10). “To plead a claim for an FCA

conspiracy, the relator must allege that the conspirators agreed that a false record or statement

would have a material effect on the Government's decision to pay a false or fraudulent claim.”

United States ex rel. Ahumada v. NISH, 756 F.3d 268, 280 (4th Cir. 2014). Here, the same

allegations that support plaintiffs’ first two False Claims Act claims, and common law claims

sounding in fraud, also support plaintiffs’ conspiracy claim against defendant Bell. In particular,

the allegations in the complaint permit an inference that defendant Bell directed the false claims

and statements by employees of the pharmacy, including defendant West, (see, e.g., Compl. ¶¶ 11-

14, 16, 75, 80, 87, 145, 161, 169), and that they thus together agreed to engage in a course of

activity to cause the government to pay false or fraudulent claims.8

Defendants argue that dismissal is warranted because “40 percent of the paragraphs in the

section of the Complaint outlining the alleged fraud are made ‘upon information and belief.’”

(Defs’ Br. (DE 53) at 11). Defendants cite Romani v. Shearson Lehman Hutton, 929 F.2d 875,

878 (1st Cir. 1991) for the proposition that “[w]here allegations of fraud are explicitly or, as in this

case, implicitly, based only on information and belief, the complaint must set forth the source of

the information and the reasons for the belief.” (Defs’ Mem. (DE 53) at 11). Here, however,

multiple allegations pertinent to defendant Bell’s participation in causing false claims and

statements to be made are not based upon information and belief. (See, e.g., Compl. ¶¶ 11-14, 16,

80, 161, 169). Likewise, the court need not rely solely upon allegations made upon information

and belief to establish critical elements of time, place, and contents of false statements made, where

the complaint alleges the circumstances of multiple patterns of fraudulent claims in detail. (See,

e.g., Compl. ¶¶ 85-86, 89, 93-95, 98-106, 110, 112-123, 125-126, 128, 132-133, 138-139, 141-

144, 146-147, 157-159, 161-162, 175-179, 181-182). Moreover, those same allegations not made

on information and belief provide the support factually for the remaining allegations made on

8 Defendants also suggest that plaintiffs have not pleaded an unjust enrichment claim against defendant Bell

because the complaint does not allege that plaintiffs conferred a measurable benefit upon defendant Bell and that

defendant Bell consciously accepted that benefit. (Defs’ Mem. (DE 53) at 12 n. 4). But, the complaint sufficiently

meets these elements, including by alleging that defendants Bell and West “often withdrew or transferred large cash

amounts from the Pharmacy during 2015 through 2017 for personal use.” (Compl. ¶ 87).

information and belief. Thus, dismissal is not required due to the presence of allegations made on

information and belief.

In sum, the complaint sufficiently alleges facts permitting an inference that defendant Bell

personally participated in conduct causing the alleged false claims and statements to be made.

Therefore, dismissal of claims against defendant Bell is not warranted.

2. Defendant All Medicines

Defendants argue that defendant All Medicines should be dismissed because the complaint

fails to allege facts imputing the alleged fraudulent conduct to the company. However, “a

corporation is liable for the . . . acts of its employees and agents done within the scope of their

employment with the intent to benefit the corporation.” United States v. Oceanic Illsabe Ltd., 889

F.3d 178, 195 (4th Cir. 2018). “Corporate liability can also arise if the employee or agent has

acted for his own benefit as well as that of his employer.”

Here, plaintiffs allege that employees of defendant All Medicines, particularly defendant

Bell and defendant West, as well as unnamed pharmacy technicians, caused submission of alleged

false claims and false statements in connection with Medicare and Medicaid claims submitted on

behalf of All Medicines. (E.g., Compl. ¶¶ 73, 77, 79, 83, 108-109, 118-120, 145, 159-160). At a

minimum, it is plausible to infer that these employees acted for their employer as well as for their

own benefit. Therefore, the complaint alleges sufficiently claims against defendant All Medicines.

Defendants cite to Ward v. AutoZoners, LLC, 958 F.3d 254 (4th Cir. 2020), for the

following proposition:

Agency law provides only four ways an employer can be held vicariously liable for

punitive damages based on the act of an employee: (1) when the employer

authorizes the employee’s tortious act; (2) when an employee is unfit and the

employer acts recklessly in employing the employee; (3) when the employee served

in a managerial capacity and was acting within the scope of employment; or (4)

when the employer or managerial agent of the employer ratified or approved the

act.

Id. at 263 (emphasis added). Where punitive damages are not at issue in the instant motion, this

citation is not helpful to the court’s analysis. In any event, the complaint alleges actions by

employees who “served in a managerial capacity . . . acting within the scope of employment,” id.,

thus satisfying this test.

Defendants also argue that “by alleging a conspiracy to violate the [False Claims Act], . . .

[p]laintiffs appear to be acknowledging that the conduct at issue was not committed by people

acting as agents of the corporation.” (Defs’ Mem. (DE 53) at 13). This is because, defendants

suggest, “if the conduct were conducted by corporate agents, the conspiracy count would be barred

by the intracorporate conspiracy doctrine.” (Id.). This argument misses the mark on two fronts.

First, “the intracorporate immunity doctrine does not apply where a corporate officer has an

independent personal stake in achieving the corporation’s illegal objectives.” ePlus Tech., Inc. v.

Aboud, 313 F.3d 166, 179 (4th Cir. 2002). Here, the complaint alleges that defendants Bell and

West withdrew proceeds for their personal use. (Compl. ¶ 87). Second, corporate liability may

attaches where employees act both in the interest of the corporation and in their own personal

interest. Oceanic Illsabe Ltd., 889 F.3d at 195. Accordingly, plaintiffs’ assertion of a conspiracy

claim does not necessarily preclude other claims against defendant All Medicines.

In sum, plaintiffs’ claims against defendant All Medicines are supported by applicable legal

standards and the allegations in the complaint. Therefore, defendants’ motion to dismiss defendant

All Medicines must be denied.

CONCLUSION

Based on the foregoing, defendants’ motion to dismiss (DE 52) is DENIED. Where the

court previously stayed case scheduling conference activities, on October 9, 2020, pending

decision on the instant motion, the court now LIFTS in part such stay for that part of the case

pertaining to claims asserted by the government.’ An initial order regarding planning and

scheduling will follow.

SO ORDERED, this the 14th day of April, 2021.

CG ipa W. FLANASAN

United States District Judge

? Per the court’s December 10, 2020, order, a stay remains in place regarding relator’s non-intervened claims,

pending resolution of the litigation of the government’s intervened claims in this action.

17

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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