# United States v. Integracare Home Health Services, Inc.

> District Court, E.D. Texas · October 21, 2024

URL: https://www.frixlaw.com/law-library/cases/10670669

## Case

- **Court:** District Court, E.D. Texas
- **Decided:** October 21, 2024
- **Opinion:** 100trialcourt
- **Cited by:** 0 later opinions in the Frix Law Library

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## Opinion text

IN THE UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF TEXAS
TYLER DIVISION

§
UNITED STATES OF AMERICA, ex §
rel. SIMONE SPARKS, §
§
Plaintiff, §
§ Case No. 6:14-cv-480-JDK-KNM
v. §
§
INTEGRACARE HOME HEALTH §
SERVICES, INC. and KINDRED §
HEALTHCARE, INC., §
§
Defendants. §
§

ORDER ADOPTING REPORT AND RECOMMENDATION
OF THE UNITED STATES MAGISTRATE JUDGE
Relator Simone Sparks brought this action pursuant to the qui tam provisions
of the False Claims Act (“FCA”), as amended, 31 U.S.C. §§ 3729–3733, and the
Federal Anti-Kickback Statute, 42 U.S.C. §§ 1320a-7b. The case was referred to
United States Magistrate Judge K. Nicole Mitchell pursuant to 28 U.S.C. § 636.
Before the Court is Defendants’ motion to dismiss Relator’s Third Amended
Complaint. Docket No. 93. The Magistrate Judge issued a Report and
Recommendation recommending that the Court grant the motion. Docket No. 112.
Relator filed written objections, and Defendants responded to those objections.
Docket Nos. 115 and 118.
Where a party timely objects to the Report and Recommendation, the Court
reviews the objected-to findings and conclusions of the Magistrate Judge de novo. 28
U.S.C. § 636(b)(1). In conducting a de novo review, the Court examines the entire
record and makes an independent assessment under the law. Douglass v. United
Servs. Auto. Ass’n, 79 F.3d 1415, 1430 (5th Cir. 1996) (en banc), superseded on other
grounds by statute, 28 U.S.C. § 636(b)(1) (extending the time to file objections from

ten to fourteen days).
Relator alleges that Defendants engaged in an “overarching scheme to ‘grow’
Defendants’ business by increasing patient enrollments by any means necessary and
maximizing revenues through fraudulent billing.” Docket No. 91 ¶ 3. The Third
Amended Complaint is Relator’s fourth attempt to meet the applicable pleading
standard. The Court previously dismissed Relator’s First Amended Complaint and
Second Amended Complaint as deficient and provided Relator the opportunity to

amend based on the identified deficiencies. Docket Nos. 58 and 89.
Despite the Court’s guidance, Relator made few substantive changes in the
Second Amended Complaint and Third Amended Complaint. Accordingly, Judge
Mitchell’s Report concludes that the Third Amended Complaint still does not meet
the requisite pleading standard. The Report also suggests that Relator should not be
afforded an additional, fourth opportunity to amend the pleadings as a result of the

prior, repeated opportunities.
Properly pleading an FCA violation requires a relator to plead that “(1) there
was a false statement or fraudulent course of conduct; (2) made or carried out with
the requisite scienter; (3) that was material; and (4) that caused the government to
pay out money or to forfeit moneys due (i.e., that involved a claim).” United States ex
rel. Longhi v. Lithium Power Tech. Inc., 575 F.3d 458, 467 (5th Cir. 2009) (adopting
the requirements of United States ex rel. Wilson v. Kellogg Brown & Root, Inc., 525
F.3d 370, 376 (4th Cir.2008)). To be material, the alleged fraud must have “a natural
tendency to influence, or be capable of influencing, the payment or receipt of money

or property.” 31 U.S.C. § 3729(b)(4); Universal Health Servs. Inc. v. United States ex
rel. Escobar, 579 U.S. 176, 192–93 (2016).
Relator’s objections re-assert the same facts and arguments that Relator has
previously raised, and which the Court previously rejected. But Relator has not
pleaded specific factual details of a fraudulent scheme to submit false claims to the
government. The Court has also already considered and distinguished the case
Relator relies on—United States ex rel. Prather v. Brookdale Senior Living

Communities, Inc., 838 F.3d 750 (6th Cir. 2016). See Docket Nos. 89 at 3, 112
at 15–16. The Third Amended Complaint also relies on the same documents
submitted with earlier pleadings and the same general allegations of an overarching
scheme. And it repeats the same conclusory allegations—previously rejected by the
Court—that final bills were submitted to Medicare with incomplete or missing
documentation. These allegations are still insufficient to plead a certification claim.

See Docket No. 89 at 3. Relator’s objections do not dispute the Report’s finding that
she has abandoned any claim for a violation of the Anti-Kickback Statute and any
claims against Defendant Kindred Healthcare, Inc. or Girling.
The Court notes that Relator has two pending motions for leave to file a Fourth
Amended Complaint. Docket Nos. 109, 113. As stated in the Report, the Court may
dismiss a claim without granting leave to amend if a party “has failed to plead with
particularity after being afforded repeated opportunities to do so.” Docket No. 112
at 18 (citing Hart v. Bayer Corp., 199 F.3d 248 n.6 (5th Cir. 2000)). Here, Relator has
amended her claims multiple times after the Court dismissed for failure to meet the
requisite pleading standard. Relator has exhausted her opportunities to amend the
pleadings.
Having conducted a de novo review of the record in this case and the
Magistrate Judge’s Report, the Court has determined that the Report of the
Magistrate Judge is correct, and Relator’s objections are without merit. Accordingly,
the Court OVERRULES Relator’s objections (Docket No. 115) and ADOPTS the
Report of the Magistrate Judge (Docket No. 112) as the opinion of the District Court.
The Court GRANTS Defendants’ motion to dismiss (Docket No. 93) and DISMISSES
Relator’s claims with prejudice, but without prejudice to the United States to bring
these claims. Relator’s motions for leave to file an amended complaint (Docket
Nos. 109, 113) are DENIED.
So ORDERED and SIGNED this 21st day of October, 2024.
fen J Korb
JHREMYD. KERN DLE
UNITED STATES DISTRICT JUDGE

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Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/10670669. Public record. Not legal advice.
