United States v. William Nelson

1 GIPSON HOFFMAN & PANCIONE

A Professional Corporation

2 DANIEL R. PALUCH (SBN 287231)

dpaluch@ghplaw.com

3 DANIEL B. LIFSCHITZ (SBN 285068)

dlifschitz@ghplaw.com

4 1901 Avenue of the Stars, Suite 1100

Los Angeles, California 90067-6002

5 Telephone: (310) 556-4660

Facsimile: (310) 556-8945

6

Attorneys for Plaintiff and Relator

7 INTEGRA MED ANALYTICS LLC

8 UNITED STATES DISTRICT COURT

9 CENTRAL DISTRICT OF CALIFORNIA

10

11 UNITED STATES OF AMERICA and Case No.: 2:21-cv-05265-JFW-RAOx

THE STATE OF CALIFORNIA, ex rel,

12 INTEGRA MED ANALYTICS LLC, [PROPOSED] PROTECTIVE

ORDER GOVERNING THE

13 Plaintiff, DISCLOSURE OF HEALTH

INFORMATION AND

14 v. CONFIDENTIAL INFORMATION

15 WILLIAM NELSON, an individual; [Stipulation submitted concurrently]

VICKI ROLLINS, an individual;

16 TORRANCE CARE CENTER WEST,

INC.; GLENDORA GRAND, INC.;

17 CENTINELA GRAND, INC.; LONG

BEACH CARE CENTER, INC.;

18 PACIFIC VILLA, INC.; FLOWER

VILLA, INC.; CENTURY VILLA,

19 INC.; VILLA DEL RIO WINTER,

INC.; VILLA DEL RIO CENTER,

20 INC.: WEST COVINA MEDICAL

CENTER, INC.; L.A. DOWNTOWN

21 MEDICAL CENTER, INC.,

22 Defendants.

23

24

25

26

27

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1 1. A. PURPOSES AND LIMITATIONS

2 Discovery in this action is likely to involve production of confidential,

3 proprietary, or private information for which special protection from public

4 disclosure and from use for any purpose other than prosecuting this litigation may

5 be warranted. Accordingly, the parties hereby stipulate to and petition the Court to

6 enter the following Stipulated Protective Order. The parties acknowledge that this

7 Order does not confer blanket protections on all disclosures or responses to

8 discovery and that the protection it affords from public disclosure and use extends

9 only to the limited information or items that are entitled to confidential treatment

10 under the applicable legal principles.

11 B. GOOD CAUSE STATEMENT

12 This FCA action alleges a “patient recycling scheme” by Defendants,

13 implicating sensitive materials. Plaintiff’s claims rely on statistical models,

14 government communications, patient-level data, financial records, communications

15 with current and former employees of Defendants, and internal analyses.

16 Unrestricted disclosure of this information is critical to Defendants’ ability to

17 challenge the allegations, and to Plaintiff’s ability to prove up its claims. Both

18 Plaintiff’s and Defendants’ production will include protected health information as

19 defined in 45 C.F.R. § 160.103 and individually identifiable information that may

20 be subject to the provisions of the Privacy Act, 5 U.S.C. § 552a, or the provisions of

21 42 U.S.C. § 1306 (“Protected Health Information” or “PHI”), claims data,

22 operational policies, and internal leadership communications, the public release of

23 which could harm patient privacy, competitive standing, and litigation claims or

24 defenses. A protective order is justified under FRCP 26(c) to expedite discovery,

25 resolve confidentiality disputes, ensure production of entitled information, protect

26 entitled information, and permit reasonable use in preparation for and conduct of

27 trial, while ensuring designations are made in good faith and not for tactical delay or

28 obstruction of discovery.

1 C. ACKNOWLEDGEMENT OF PROCEDURE FOR FILING UNDER

2 SEAL

3 The parties further acknowledge, as set forth in Section 12.3, below, that this

4 Stipulated Protective Order does not entitle them to file confidential information

5 under seal; Local Civil Rule 79-5 sets forth the procedures that must be followed

6 and the standards that will be applied when a party seeks permission from the court

7 to file material under seal.

8 There is a strong presumption that the public has a right of access to judicial

9 proceedings and records in civil cases. In connection with non-dispositive motions,

10 good cause must be shown to support a filing under seal. See Kamakana v. City and

11 County of Honolulu, 447 F.3d 1172, 1176 (9th Cir. 2006); Phillips v. Gen. Motors

12 Corp., 307 F.3d 1206, 1210-11 (9th Cir. 2002); Makar-Welbon v. Sony Electrics,

13 Inc., 187 F.R.D. 576, 577 (E.D. Wis. 1999) (even stipulated protective orders require

14 good cause showing), and a specific showing of good cause or compelling reasons

15 with proper evidentiary support and legal justification, must be made with respect to

16 Protected Material that a party seeks to file under seal. The parties’ mere designation

17 of Disclosure or Discovery Material as CONFIDENTIAL does not—without the

18 submission of competent evidence by declaration, establishing that the material

19 sought to be filed under seal qualifies as confidential, privileged, or otherwise

20 protectable—constitute good cause.

21 Further, if a party requests sealing related to a dispositive motion or trial,

22 then compelling reasons, not only good cause, for the sealing must be shown, and

23 the relief sought shall be narrowly tailored to serve the specific interest to be

24 protected. See Pintos v. Pacific Creditors Ass’n, 605 F.3d 665, 677-79 (9th Cir.

25 2010). For each item or type of information, document, or thing sought to be filed

26 or introduced under seal in connection with a dispositive motion or trial, the party

27 seeking protection must articulate compelling reasons, supported by specific facts

28 and legal justification, for the requested sealing order. Again, competent evidence

1 supporting the application to file documents under seal must be provided by

2 declaration.

3 Any document that is not confidential, privileged, or otherwise protectable

4 in its entirety will not be filed under seal if the confidential portions can be

5 redacted. If documents can be redacted, then a redacted version for public

6 viewing, omitting only the confidential, privileged, or otherwise protectable

7 portions of the document shall be filed. Any application that seeks to file

8 documents under seal in their entirety should include an explanation of why

9 redaction is not feasible.

10 2. DEFINITIONS

11 2.1 Action: This pending federal lawsuit, Case No. 2:21-cv-05265-JFW-

12 RAOx.

13 2.2 Challenging Party: A Party or Non-Party challenging a designation

14 under this Order.

15 2.3 “CONFIDENTIAL” Information or Items: Information (regardless of

16 how it is generated, stored, or maintained) or tangible things that qualify for

17 protection under Federal Rule of Civil Procedure 26(c), including PHI (e.g., patient

18 records, identifiers), proprietary or financial information (e.g., trade secrets,

19 statistical models, algorithms, government communications, financial records,

20 claims data, operational policies, internal leadership communications, raw data sets),

21 where the Designating Party reasonably believes public disclosure would cause

22 specific, identifiable harm. This excludes information foundational to claims or

23 defenses (e.g., statistical analyses or patient data subsets identified in pleadings or

24 discovery responses) unless specific justification is provided at designation.

25 2.4 Counsel: Outside Counsel of Record and House Counsel (as well as

26 their support staff).

27

28

1 2.5 Designating Party: a Party or Non-Party that designates information or

2 items that it produces in disclosures or in responses to discovery as

3 “CONFIDENTIAL.”

4 2.6 Disclosure or Discovery Material: all items or information, regardless

5 of the medium or manner in which it is generated, stored, or maintained (including,

6 among other things, testimony, transcripts, and tangible things) that are produced or

7 generated in disclosures or responses to discovery in this matter.

8 2.7 Expert: a person with specialized knowledge or experience in a matter

9 pertinent to the litigation who has been retained by a Party or its counsel to serve as

10 an expert witness or as a consultant in this Action.

11 2.8 House Counsel: attorneys who are employees of a party to this Action.

12 House Counsel does not include Outside Counsel of Record or any other outside

13 counsel.

14 2.9 Non-Party: any natural person, partnership, corporation, association or

15 other legal entity not named as a Party to this action.

16 2.10 Outside Counsel of Record: attorneys who are not employees of a party

17 to this Action but are retained to represent or advise a party to this Action and have

18 appeared in this Action on behalf of that party or are affiliated with a law firm that

19 has appeared on behalf of that party, and includes support staff.

20 2.11 Party: any party to this Action, including all of its officers, directors,

21 employees, consultants, retained experts, and Outside Counsel of Record (and their

22 support staffs).

23 2.12 Producing Party: a Party or Non-Party that produces Disclosure or

24 Discovery Material in this Action.

25 2.13 Professional Vendors: persons or entities that provide litigation support

26 services (e.g., photocopying, videotaping, translating, preparing exhibits or

27 demonstrations, and organizing, storing, or retrieving data in any form or medium)

28 and their employees and subcontractors.

1 2.14 Protected Material: Disclosure or Discovery Material designated as

2 “CONFIDENTIAL.”

3 2.15 Receiving Party: a Party that receives Disclosure or Discovery Material

4 from a Producing Party.

5 2.16 “Unredacted Complaint” means the unredacted version of the original

6 complaint filed by Relator on June 29, 2021, containing personally identifiable

7 information and/or PHI, which is to be maintained as confidential pursuant to the

8 Joint Stipulation to Maintain Confidentiality of Pleadings Filed Under Seal (ECF

9 No. 45) and this Protective Order.

10 3. SCOPE

11 The protections conferred by this Stipulation and Order cover not only

12 Protected Material (as defined above), but also (1) any information copied or

13 extracted from Protected Material; (2) all copies, excerpts, summaries, or

14 compilations of Protected Material; and (3) any testimony, conversations, or

15 presentations by Parties or their Counsel that might reveal Protected Material.

16 Any use of Protected Material at trial shall be governed by the orders of the

17 trial judge. This Order does not govern the use of Protected Material at trial.

18 This Order applies to all materials responsive to pending discovery requests,

19 including those previously withheld pending its entry, which must be produced

20 within fourteen (14) days of this Order’s entry unless objected to on non-

21 confidentiality grounds, with failure to comply subject to sanctions absent good

22 cause.

23 For the avoidance of doubt, this Protective Order applies to the Unredacted

24 Complaint. The Unredacted Complaint shall be deemed “CONFIDENTIAL” under

25 this Order and treated in accordance with all provisions applicable to Protected

26 Material.

27 //

28 //

1 4. DURATION

2 Once a case proceeds to trial, information that was designated as

3 CONFIDENTIAL or maintained pursuant to this protective order used or introduced

4 as an exhibit at trial becomes public and will be presumptively available to all

5 members of the public, including the press, unless compelling reasons supported by

6 specific factual findings to proceed otherwise are made to the trial judge in advance

7 of the trial. See Kamakana, 447 F.3d at 1180-81 (distinguishing “good cause”

8 showing for sealing documents produced in discovery from “compelling reasons”

9 standard when merits-related documents are part of court record). Accordingly, the

10 terms of this protective order do not extend beyond the commencement of the trial.

11 5. DESIGNATING PROTECTED MATERIAL

12 5.1 Exercise of Restraint and Care in Designating Material for Protection.

13 Each Party or Non-Party that designates information or items for protection

14 under this Order must take care to limit any such designation to specific material

15 that qualifies under the appropriate standards. The Designating Party must designate

16 for protection only those parts of material, documents, items, or oral or written

17 communications that qualify so that other portions for which protection is not

18 warranted are not swept unjustifiably within the ambit of this Order. For materials

19 foundational to a party’s claims or defenses, such as statistical data, analytical

20 methodologies, or witness statements identified in pleadings or discovery responses,

21 the Designating Party must provide a brief written justification for the designation

22 at the time of production.

23 Mass, indiscriminate, tactical, or routinized designations are prohibited.

24 Designations that are shown to be clearly unjustified or made for an improper

25 purpose (e.g., to unnecessarily encumber the case development process or impose

26 unnecessary expenses and burdens on other parties) may expose the Designating

27 Party to sanctions. Sanctions apply for frivolous designations or failure to justify

28 foundational material designations.

1 If a Designating Party learns that designated information does not qualify for

2 protection, it must promptly notify all other Parties and withdraw the designation.

3 5.2 Manner and Timing of Designations.

4 Except as otherwise provided in this Order or stipulated, Disclosure or

5 Discovery Material that qualifies for protection must be clearly designated before

6 disclosure or production. Designation requires:

7 (a) For documentary information, the Producing Party must affix

8 “CONFIDENTIAL” to each page containing protected material. If only a portion

9 qualifies, the protected portion(s) must be clearly identified (e.g., by margin

10 markings). For materials produced in native format (e.g., Excel, PowerPoint), the

11 Producing Party must include a written notice identifying specific protected portions

12 with production. Within seven (7) business days of production, the Producing Party

13 must provide a log (e.g., privilege log or confidentiality index) listing each

14 designated document (by Bates number) and the specific basis for designation (e.g.,

15 trade secret, PHI, competitive harm). Failure to comply waives the designation

16 unless good cause is shown.

17 (b) For deposition testimony, the Designating Party must identify protected

18 testimony on the record before the deposition closes.

19 (c) For other tangible items, the Producing Party must affix the

20 “CONFIDENTIAL” legend on the container or identify protected portions to the

21 extent practicable.

22 A Party or Non-Party making original documents available for inspection

23 need not designate them until after the inspecting Party selects documents for

24 copying. During inspection, all materials are deemed “CONFIDENTIAL.” After

25 selection, the Producing Party must designate qualifying documents before

26 production.

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1 5.3 Inadvertent Failures to Designate.

2 If timely corrected, within 10 days of discovery, an inadvertent failure to

3 designate qualified information or items does not, standing alone, waive the

4 Designating Party’s right to secure protection under this Order for such material.

5 Upon timely correction of a designation, the Receiving Party must make reasonable

6 efforts to assure that the material is treated in accordance with the provisions of this

7 Order.

8 6. CHALLENGING CONFIDENTIALITY DESIGNATIONS

9 6.1 Timing of Challenges

10 Any Party or Non-Party may challenge a confidentiality designation at any

11 time consistent with the Court’s Scheduling Order.

12 6.2 Meet and Confer

13 The Challenging Party shall initiate the dispute resolution process under Local

14 Rule 37.1 et seq. The Designating Party must respond in writing within seven (7)

15 business days, justifying the designation with particularity. Parties are encouraged

16 to pursue Judge Oliver’s informal discovery dispute resolution process (joint email

17 to RAO_Chambers@cacd.uscourts.gov before filing a motion), per her procedures.

18 6.3 Burden and Resolution

19 The burden of persuasion in any challenge proceeding rests on the

20 Designating Party proving confidentiality via declaration within fourteen (14) days

21 of challenge notice, detailing specific harm (e.g., competitive injury, privacy breach)

22 per FRCP 26(c). Frivolous challenges or those made for improper purposes may

23 expose the Challenging Party to sanctions. Unless the Designating Party has waived

24 or withdrawn the designation, all parties shall treat the material as CONFIDENTIAL

25 until the Court rules. If the parties cannot resolve the dispute within fourteen (14)

26 business days of the initial challenge notice, either party may file a motion under

27 Local Rule 37, provided disputes are raised at least four (4) weeks before the

28 discovery cutoff per the District Judge’s scheduling order. For foundational

1 materials (e.g., statistical data or methodologies underlying claims), the Court may

2 expedite review to ensure timely access.

3 7. ACCESS TO AND USE OF PROTECTED MATERIAL

4 7.1 Basic Principles

5 A Receiving Party may use Protected Material only for prosecuting,

6 defending, or settling this Action. Such material may be disclosed only to authorized

7 persons under this Order and must be stored securely.

8 7.2 Disclosure of “CONFIDENTIAL” Information or Items

9 Unless otherwise ordered or permitted by the Designating Party, a Receiving

10 Party may disclose “CONFIDENTIAL” information only to:

11 (a) the Receiving Party’s Outside Counsel of Record in this Action, as

12 well as employees of said Outside Counsel of Record to whom it is reasonably

13 necessary to disclose the information for this Action;

14 (b) the officers, directors, and employees (including House Counsel)

15 of the Receiving Party to whom disclosure is reasonably necessary for this Action;

16 (c) Experts (as defined in this Order) of the Receiving Party to whom

17 disclosure is reasonably necessary for this Action and who have signed the

18 “Acknowledgment and Agreement to Be Bound” (Exhibit A);

19 (d) the court and its personnel;

20 (e) court reporters and their staff;

21 (f) professional jury or trial consultants, mock jurors, and Professional

22 Vendors to whom disclosure is reasonably necessary for this Action and who have

23 signed the “Acknowledgment and Agreement to Be Bound” (Exhibit A);

24 (g) the author or recipient of a document containing the information or

25 a custodian or other person who otherwise possessed or knew the information;

26 (h) during their depositions, witnesses, and attorneys for witnesses, in

27 the Action to whom disclosure is reasonably necessary provided: (1) the deposing

28 party requests that the witness sign the form attached as Exhibit A hereto; and (2)

1 they will not be permitted to keep any confidential information unless they sign the

2 “Acknowledgment and Agreement to Be Bound” (Exhibit A), unless otherwise

3 agreed by the Designating Party or ordered by the court. Pages of transcribed

4 deposition testimony or exhibits to depositions that reveal Protected Material may

5 be separately bound by the court reporter and may not be disclosed to anyone except

6 as permitted under this Stipulated Protective Order; and

7 (i) any mediator or settlement officer, and their supporting personnel,

8 mutually agreed upon by any of the parties engaged in settlement discussions.

9 (j) For foundational materials underlying a party’s claims or defenses

10 (e.g., statistical data, patient data subsets, or analytical methodologies identified in

11 discovery responses), the Receiving Party may disclose redacted or de-identified

12 versions to additional persons as reasonably necessary for litigation (e.g., experts or

13 counsel staff), provided PHI is protected per HIPAA and trade secrets are

14 safeguarded; Plaintiff’s personnel must sign Exhibit A to access Defendants’

15 foundational materials, and Defendants’ personnel may access Plaintiff’s

16 foundational materials without signing Exhibit A if previously known to them. To

17 the extent there is any inconsistency between Exhibit A to the Joint Stipulation to

18 Maintain Confidentiality of Pleadings Filed Under Seal and Exhibit A to this

19 Protective Order, the terms of this Protective Order shall control, and Exhibit A

20 hereto shall govern acknowledgments going forward.

21 8. PROTECTED MATERIAL SUBPOENAED OR ORDERED

22 PRODUCED IN OTHER LITIGATION

23 If a Party is served with a subpoena or a court order issued in other litigation

24 that compels disclosure of any information or items designated in this Action as

25 “CONFIDENTIAL,” that Party bears the burden of seeking protection and must:

26 (a) promptly notify in writing the Designating Party. Such notification

27 shall include a copy of the subpoena or court order;

28

1 (b) promptly notify in writing the party who caused the subpoena or

2 order to issue in the other litigation that some or all of the material covered by the

3 subpoena or order is subject to this Protective Order. Such notification shall include

4 a copy of this Stipulated Protective Order; and

5 (c) cooperate with respect to all reasonable procedures sought to be

6 pursued by the Designating Party whose Protected Material may be affected.

7 (d) If a Party seeks to obtain financial information about another Party

8 from a third party in this Action via subpoena under FRCP 45, the subpoenaing Party

9 must notify the affected Party within five (5) business days of issuance, providing a

10 copy of the subpoena. The affected Party may object within seven (7) days,

11 triggering a meet-and-confer under Local Rule 37.1 and, if unresolved, Judge

12 Oliver’s informal dispute resolution process (joint email to

13 RAO_Chambers@cacd.uscourts.gov). Such subpoenas must demonstrate specific

14 relevance to claims or defenses (e.g., funding of statistical analyses for Plaintiff or

15 operational practices for Defendants), and the affected Party may move to quash

16 under FRCP 45(d)(3) if unduly burdensome or unrelated to FCA allegations. Any

17 third-party material produced shall be designated ‘CONFIDENTIAL’ and subject to

18 this Order unless the Court rules otherwise.

19 If the Designating Party timely seeks a protective order, the Party served with

20 the subpoena or court order shall not produce any information designated in this

21 action as “CONFIDENTIAL” before a determination by the court from which the

22 subpoena or order issued, unless the Party has obtained the Designating Party’s

23 permission. The Designating Party shall bear the burden and expense of seeking

24 protection in that court of its confidential material and nothing in these provisions

25 should be construed as authorizing or encouraging a Receiving Party in this Action

26 to disobey a lawful directive from another court.

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1 9. A NON-PARTY’S PROTECTED MATERIAL SOUGHT TO BE

2 PRODUCED IN THIS LITIGATION

3 (a) The terms of this Order are applicable to information produced by

4 a Non-Party in this Action and designated as “CONFIDENTIAL.” Such information

5 produced by Non-Parties in connection with this litigation is protected by the

6 remedies and relief provided by this Order. Defendants may seek third-party

7 discovery of Plaintiff’s financial information relevant to claims or defenses, with

8 Non-Parties encouraged to produce under this Order’s protections. Nothing in these

9 provisions should be construed as prohibiting a Non-Party from seeking additional

10 protections.

11 (b) In the event that a Party is required, by a valid discovery request,

12 to produce a Non-Party’s confidential information in its possession, and the Party is

13 subject to an agreement with the Non-Party not to produce the Non-Party’s

14 confidential information, then the Party shall:

15 (1) promptly notify within five (5) days of discovery requests in

16 writing the Requesting Party and the Non-Party that some or all of the information

17 requested is subject to a confidentiality agreement with a Non-Party;

18 (2) promptly provide the Non-Party with a copy of the Stipulated

19 Protective Order in this Action, the relevant discovery request(s), and a reasonably

20 specific description of the information requested; and

21 (3) make the information requested available for inspection by

22 the Non-Party, if requested.

23 (c) If the Non-Party fails to seek a protective order from this court

24 within fourteen (14) days of receiving the notice and accompanying information, the

25 Receiving Party may produce the Non-Party’s confidential information responsive

26 to the discovery request. If the Non-Party timely seeks a protective order, the

27 Receiving Party shall not produce any information in its possession or control that

28 is subject to the confidentiality agreement with the Non-Party before a determination

1 by the court. Absent a court order to the contrary, the Non-Party shall bear the

2 burden and expense of seeking protection in this court of its Protected Material.

3 10. TERMS SPECIFIC TO PROTECTED HEALTH INFORMATION

4 10.1 This Order is a Qualified Protective Order under 45 C.F.R. §

5 164.512(e).

6 10.2 PHI use is restricted to this litigation, including all appellate

7 proceedings or the expiration of time to commence such appellate proceedings

8 (“Litigation”). Covered entities as defined in 45 C.F.R. § 160.103 (“Covered

9 Entities”) may disclose PHI responsive to discovery to authorized persons, including

10 de-identified data sets where feasible.

11 10.3 Pursuant to 45 C.F.R. § 164.512(e)(1) and for purposes of compliance

12 with the Health Insurance Portability and Accountability Act (“HIPAA”), the parties

13 and the parties’ legal counsel in this case, the employees and agents of each party

14 and each party’s legal counsel in this case, and all non-party Covered Entities are

15 expressly and specifically prohibited from using or disclosing PHI in accordance

16 with this order for any purpose other than the Litigation.

17 10.4 Pursuant to 45 C.F.R. § 164.512(e)(1) and for purposes of HIPAA

18 compliance, each deponent noticed for deposition in this case, including but not

19 limited to a party, a fact witness, a records custodian, an expert, or a Covered Entity

20 of any type, is expressly and specifically authorized to use or to disclose to the

21 parties’ legal counsel in this case and the employees and agents of each party and

22 each party’s legal counsel in this case, the PHI that is responsive to deposition

23 questions or a valid subpoena duces tecum.

24 10.5 Pursuant to 45 C.F.R. § 164.512(e)(1) and for purposes of HIPAA

25 compliance, any person or entity authorized or ordered above to use or disclose PHI

26 is expressly and specifically authorized to do so with, to, or before any court reporter

27 service, videographer service, translation service, photocopy service, document

28 management service, records management service, graphics service, or other such

1 litigation service provider (“service providers”), engaged by a party or a party’s legal

2 counsel in this case. The protections and requirements of Paragraphs 4 and 9 of this

3 Protective Order apply to such service providers. Each party or the party’s legal

4 counsel is charged with obtaining advance consent of such service provider to

5 comply with this paragraph. Upon such consent, the service provider will be deemed

6 to have voluntarily submitted to this court’s jurisdiction during the pendency of this

7 case for purposes of enforcement of this paragraph, including but not limited to the

8 imposition of such sanctions as may be appropriate for any non- compliance.

9 10.6 Service providers must sign Exhibit A and comply.

10 10.7 Except for business associate agreements (as defined by HIPAA)

11 entered into by a party or a party’s legal counsel for purposes of satisfying the

12 requirements of Paragraph 11 above, the uses and disclosures of PHI authorized

13 under this Protective Order are separate from, and not to be deemed subject to, any

14 business associate agreement that has been or will be executed by any party, any

15 party’s legal counsel, or any disclosing person or entity. No use or disclosure made

16 pursuant to this Protective Order shall be deemed to require the execution of a

17 business associate agreement (as defined by HIPAA). The intent of this Protective

18 Order is that such business associate agreements, including any requirement for such

19 agreements under the HIPAA regulations, should be construed as inapplicable to

20 uses and disclosures under this Protective Order and as limited only to uses and

21 disclosures of PHI outside of this Protective Order.

22 11. TERMS SPECIFIC TO PROPRIETARY INFORMATION

23 11.1 Production does not waive confidentiality rights.

24 11.2 Objections to designations must be raised within fourteen (14) days,

25 followed by meet-and-confer. The Designating Party must justify via motion with a

26 declaration within fourteen (14) days thereafter, or protection lapses. Failure to

27 produce responsive documents after designation lapses incurs sanctions unless good

28

1 cause is shown. Parties are encouraged to use Judge Oliver’s informal resolution

2 process before motion practice.

3 12. UNAUTHORIZED DISCLOSURE OF PROTECTED MATERIAL

4 If a Receiving Party learns that, by inadvertence or otherwise, it has disclosed

5 Protected Material to any person or in any circumstance not authorized under this

6 Stipulated Protective Order, the Receiving Party must immediately (a) notify in

7 writing the Designating Party of the unauthorized disclosures, (b) use its best efforts

8 to retrieve all unauthorized copies of the Protected Material, (c) inform the person

9 or persons to whom unauthorized disclosures were made of all the terms of this

10 Order, and (d) request such person or persons to execute the “Acknowledgment and

11 Agreement to Be Bound” that is attached hereto as Exhibit A.

12 The Unredacted Complaint shall not be filed publicly or attached to any filing

13 unless redacted or filed under seal pursuant to Local Rule 79-5. The parties agree

14 that the Unredacted Complaint qualifies as Protected Material under this Order and

15 that good cause exists to maintain its confidentiality.

16 13. INADVERTENT PRODUCTION OF PRIVILEGED OR OTHERWISE

17 PROTECTED MATERIAL

18 When a Producing Party gives notice to Receiving Parties that certain

19 inadvertently produced material is subject to a claim of privilege or other protection,

20 the obligations of the Receiving Parties are those set forth in Federal Rule of Civil

21 Procedure 26(b)(5)(B). This provision is not intended to modify whatever procedure

22 may be established in an e-discovery order that provides for production without prior

23 privilege review. Pursuant to Federal Rule of Evidence 502(d) and (e), insofar as

24 the parties reach an agreement on the effect of disclosure of a communication or

25 information covered by the attorney-client privilege or work product protection, the

26 parties may incorporate their agreement in the stipulated protective order submitted

27 to the court.

28 \\

1 14. MISCELLANEOUS

2 14.1 Right to Further Relief

3 Nothing in this Order abridges the right of any person to seek modification by

4 the Court for good cause.

5 14.2 Right to Assert Other Objections

6 This Order does not affect a party’s right to object to discovery on other

7 grounds.

8 14.3 Filing Protected Material

9 Without Designating Party consent, Protected Material may not be filed

10 publicly. A party seeking to file Protected Material must follow Local Civil Rule 79-

11 5. For foundational materials, the filing party may propose redactions to avoid

12 sealing where practicable, subject to Court approval.

13 15. FINAL DISPOSITION

14 Within 60 days of the Action’s termination, each Receiving Party must return

15 or destroy all Protected Material, including copies, and provide written certification.

16 Defendants may retain copies of foundational materials necessary to defend against

17 subsequent claims or investigations arising from this litigation, provided such

18 materials remain subject to this Order. Counsel may retain archival copies of

19 pleadings, motions, transcripts, exhibits, legal memoranda, correspondence, drafts,

20 raw data, or work product containing Protected Material, subject to this Order’s

21 protections.

22 16. VIOLATION

23 Any violation of this Order may be punished by appropriate measures,

24 including contempt proceedings and/or monetary sanctions.

25

26 IT IS SO STIPULATED, THROUGH COUNSEL OF RECORD.

27

28

Dated: May 13, 2025 Respectfully submitted,

2 /s/ Daniel R. Paluch

3 GIPSON HOFFMAN & PANCIONE

Daniel R. Paluch

4 Daniel B. Lifschitz

5 Attorneys for Plaintiff and Relator

61) Dated: May 13, 2025

7 /s/ Matthew Donald Umhofer

8 UMHOFER, MITCHELL & KING, LLP

Matthew Donald Umhofer

9 Elizabeth A. Mitchell

10 Eugene Lim

4 Attorneys for Defendants

2. 2

FOR GOOD CAUSE SHOWN, IT IS SO ORDERED.

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1 EXHIBIT A

2 ACKNOWLEDGMENT AND AGREEMENT TO BE BOUND

3

4 I, _____________________________ [print or type full name], of

5 _________________ [print or type full address], declare under penalty of perjury

6 that I have read in its entirety and understand the Stipulated Protective Order that

7 was issued by the United States District Court for the Central District of California

8 on ___________ [date] in the case of United States of America and the State of

9 California, ex rel., Integra Med Analytics LLC, v. William Nelson, an individual, et

10 al., 2:21-cv-05265-JFW-RAOx. I agree to comply with and to be bound by all the

11 terms of this Stipulated Protective Order and I understand and acknowledge that

12 failure to so comply could expose me to sanctions and punishment in the nature of

13 contempt. I solemnly promise that I will not disclose in any manner any

14 information or item that is subject to this Stipulated Protective Order to any person

15 or entity except in strict compliance with the provisions of this Order.

16 I further agree to submit to the jurisdiction of the United States District Court

17 for the Central District of California for enforcing the terms of this Stipulated

18 Protective Order, even if such enforcement proceedings occur after termination of

19 this action. I hereby appoint __________________________ [print or type full

20 name] of _______________________________________ [print or type full address

21 and telephone number] as my California agent for service of process in connection

22 with this action or any proceedings related to enforcement of this Stipulated

23 Protective Order.

24 Date: ______________________________________

25 City and State where sworn and signed: _________________________________

26 Printed name: _______________________________

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