Opinion

State ex rel. Leibowitz v. Family Vision Care, LLC

  • 2020 IL 124754
Court
Illinois Supreme Court
Filed
Nov 19, 2020
Status
Published
Cited by
33 cases
Authority
More cited than 83.0%

The opinion

2020 IL 124754

IN THE

SUPREME COURT

OF

THE STATE OF ILLINOIS

(Docket No. 124754)

THE STATE OF ILLINOIS ex rel. DAVID P. LEIBOWITZ, Appellee v.

FAMILY VISION CARE, LLC, et al., Appellants.

Opinion filed November 19, 2020.

JUSTICE MICHAEL J. BURKE delivered the judgment of the court, with

opinion.

Chief Justice Anne M. Burke and Justices Kilbride, Garman, Karmeier, Theis,

and Neville concurred in the judgment and opinion.

OPINION

¶1 This appeal involves a claim brought under the Insurance Claims Fraud

Prevention Act (Act) (740 ILCS 92/1 et seq. (West 2016)). The Act, which adopts

nearly word for word a statute from California’s Insurance Frauds Prevention Act

(see Cal. Ins. Code § 1871.7 (West 2016)), added civil penalties to existing criminal

remedies for fraud against private insurance companies.

¶2 The Act contains an enforcement provision allowing a claim to be raised on the

State’s behalf by a private person, known as a relator, in a qui tam action. 740 ILCS

92/15 (West 2016). The State retains control over the litigation, but the Act entitles

the relator to a portion of the proceeds or settlement if the lawsuit succeeds. Id.

§§ 15, 20, 25.

¶3 A relator must be an “interested person” under the Act to file an action on the

State’s behalf, but the Act does not define that term. Id. § 15(a). Also, the Act is

intended to remedy fraud against private insurers, where the only injury to the State

is to its sovereignty, based on a violation of criminal law. This injury is different

from the pecuniary injury addressed by the Illinois False Claims Act (740 ILCS

175/1 et seq. (West 2016)), which is a qui tam statute that confers standing on a

relator to sue for fraud resulting in pecuniary injury to the State (Scachitti v. UBS

Financial Services, 215 Ill. 2d 484, 508 (2005)).

¶4 The meaning of “interested person” and the nonpecuniary nature of the State’s

interest present two questions in this appeal regarding a relator’s standing to sue

under the Act: (1) whether a relator must have a personal claim, status, or right

related to the qui tam action to qualify as an “interested person” and (2) whether a

relator may bring a claim on behalf of the State for a violation of criminal law that

results in injury to the State’s sovereignty.

¶5 The issues arise in a qui tam action filed by the trustee of a bankruptcy estate

of a whistleblower who was formerly employed by the allegedly defrauding party.

The circuit court of Cook County determined that the trustee lacked standing to

conduct the qui tam action and dismissed the one-count complaint under section 2-

619(a)(9) of the Code of Civil Procedure (Code) (735 ILCS 5/2-619(a)(9) (West

2016)).

¶6 The appellate court affirmed the judgment in part but reversed the dismissal and

remanded the cause for further proceedings. The court held (1) a former employee-

whistleblower with personal, nonpublic information of possible wrongdoing

qualifies as an “interested person” under the Act and need not allege a personal

claim, status, or right related to the proceedings and (2) the State need not suffer

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money damages to partially assign its claim to a relator under the Act. 2019 IL App

(1st) 180697, ¶¶ 30, 37. We affirm the judgment of the appellate court.

¶7 I. BACKGROUND

¶8 As this appeal is based on the involuntary dismissal of the complaint under

section 2-619(a)(9) of the Code (735 ILCS 5/2-619(a)(9) (West 2016)), we set forth

and accept as true the well-pleaded facts alleged in the complaint as well as all

reasonable inferences that arise from them. Patrick Engineering, Inc. v. City of

Naperville, 2012 IL 113148, ¶ 31.

¶9 Defendant Family Vision Care, LLC (Family Vision Care), is an optometry

practice in LaGrange, Illinois. Marie A. Cahill served as the office administrator

from October 2012 through January 2016. She left her employment and filed for

bankruptcy protection. A month later, she signed a separation agreement and

general release that is not at issue in this appeal.

¶ 10 During her time with Family Vision Care, Cahill handled insurance billing

practices. According to Cahill, about 90% of Family Vision Care’s revenue came

from claims it submitted to Vision Service Plan (VSP), a vision care health

insurance company that is not a party to this action.

¶ 11 VSP covers claims from optometrists only if they have “majority ownership

and complete control” of their medical practices. VSP disburses payments only

after a practice signs a provider agreement certifying itself as “fully controlled and

majority-owned” by an optometrist.

¶ 12 At the time Cahill was submitting Family Vision Care’s claims to VSP, the

practice was in fact owned by defendant Surgery Partners, Inc. (Surgery Partners),

a medical practice management company that runs a network of more than 150

surgery centers and other medical practices in 29 states. Surgery Partners is a

publicly traded company, but it is majority owned by H.I.G. Private Equity, a global

private equity firm. Surgery Partners acquired Family Vision Care through a merger

with defendant NovaMed Management Service, LLC (NovaMed), a smaller

medical practice management company that owned the practice.

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¶ 13 Defendant Jennifer Gula, O.D. (Dr. Gula), is an optometrist who worked at

Family Vision Care while Cahill submitted the claims to VSP. Dr. Gula was

employed by Surgery Partners and has never had an ownership interest in the

practice.

¶ 14 Cahill alleges defendants engaged in fraud by knowingly and falsely certifying

Family Vision Care’s eligibility for VSP insurance payments and accepting

payments to which Family Vision Care was not entitled. Specifically, Dr. Gula

allegedly signed the provider agreements falsely certifying to VSP that she owned

Family Vision Care. And Frank Soppa, a Surgery Partners executive, allegedly

instructed Cahill to tell VSP that Dr. Gula owned Family Vision Care. Cahill alleges

that Surgery Partners and Dr. Gula were fully aware of VSP’s optometrist-

ownership requirement and that Surgery Partners’ management nevertheless

directed Cahill to falsify information about the ownership of the practice.

¶ 15 About a year after Cahill left Family Vision Care, David P. Leibowitz, the

trustee of Cahill’s bankruptcy estate (Estate), filed a one-count complaint alleging

defendants committed insurance fraud by submitting false claims to VSP. 1 The

complaint alleges the fraudulent scheme caused VSP to approve Family Vision

Care as a VSP network provider and pay “millions of dollars” of insurance claims

that Family Vision Care submitted on behalf of its patients. The complaint does not

allege Cahill suffered any injury or loss.

¶ 16 The complaint seeks relief under section 5(b) of the Act, which creates a private

cause of action against any person who violates any provision of the Act and the

criminal code relating to insurance fraud. 740 ILCS 92/5(b) (West 2016). The

complaint is based on defendants’ alleged insurance fraud against VSP in violation

of section 17-10.5 of the Criminal Code of 2012 (Criminal Code) 720 ILCS 5/17-

10.5(a)(1) (West 2016). Section 17-10.5(a)(1) provides that a person commits

insurance fraud

1

The complaint was filed under the caption “State of Illinois ex rel. Bankruptcy Estate of Marie

A. Cahill,” but federal law provides that it is the trustee who may prosecute an action on behalf of

the bankruptcy estate. 11 U.S.C. § 323(b) (2012). The record indicates that Leibowitz is the Estate’s

trustee.

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“when he or she knowingly obtains, attempts to obtain, or causes to be obtained,

by deception, control over the property of an insurance company *** by the

making of a false claim or by causing a false claim to be made on any policy of

insurance issued by an insurance company *** intending to deprive an

insurance company *** permanently of the use and benefit of that property.”

Id.

¶ 17 In turn, section 5(b) of the Act provides that a person who violates section 17-

10.5 of the Criminal Code

“shall be subject, in addition to any other penalties that may be prescribed by

law, to a civil penalty of not less than $5,000 nor more than $10,000, plus an

assessment of not more than 3 times the amount of each claim for compensation

under a contract of insurance. The court shall have the power to grant other

equitable relief, including temporary injunctive relief, as is necessary to prevent

the transfer, concealment, or dissipation of illegal proceeds, or to protect the

public. The penalty prescribed in this subsection shall be assessed for each

fraudulent claim upon a person in which the defendant participated.” 740 ILCS

92/5(b) (West 2016).

The complaint sought damages of three times the amount of the false insurance

claims plus civil penalties of $5000 to $10,000 per false claim. See id.

¶ 18 A claim for these civil penalties may be brought by the state’s attorney of the

county in which the conduct occurred or by the attorney general. Id. § 10. But the

Act also allows for the enforcement by private citizens by authorizing qui tam

actions in the name of the State. Id. § 15. A qui tam action is brought under a statute

authorizing an informant to bring a civil action to recover a penalty for the

commission or omission of a certain act and providing that a part of the penalty be

paid to the informer. Scachitti, 215 Ill. 2d at 494. The Estate filed the action under

the qui tam enforcement provisions of section 15, which allows private citizens

with undisclosed information about insurance fraud to sue on the State’s behalf for

civil penalties. 740 ILCS 92/15 (West 2016).

¶ 19 Defendants filed a combined motion to dismiss the complaint arguing,

inter alia, that the Estate lacks standing to bring the qui tam action. See 735 ILCS

5/2-619(a)(9), 2-619.1 (West 2016)). First, defendants argued that, because Cahill

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did not allege a direct injury, she was not an “interested person” under the Act and

her Estate could not bring a qui tam claim. Defendants asserted that only VSP could

file a qui tam action because, as the allegedly defrauded party, it had a personal

claim, status, or right to protect. Second, defendants argued that, although the State

would have had standing to enforce its criminal laws through the Act, it cannot

partially assign its nonpecuniary claim to a private citizen like Cahill. The circuit

court agreed and dismissed the complaint with prejudice.

¶ 20 The appellate court rejected the circuit court’s definition of “interested

person[s]” as those with a “personal claim, status, or right” because such a

restrictive definition would preclude claims by anyone other than an insurance

company that lost money from fraud. The court, noting the Act does not define

“interested person,” relied on (1) the plain language of section 15 of the Act, which

does not mention injury to the relator (740 ILCS 92/15 (West 2016)), (2) section

40 of the Act, which protects employees from retaliation for bringing qui tam

claims (id. § 40), and (3) the Act’s stated purpose of protecting the public from

insurance fraud (id. § 5(c)). 2019 IL App (1st) 180697, ¶¶ 37, 39. The appellate

court also relied on People ex rel. Alzayat v. Hebb, 226 Cal. Rptr. 3d 867, 889 (Ct.

App. 2017), which stated the California statute does not limit standing to insurers

or individual relators who have been personally injured. 2019 IL App (1st) 180697,

¶ 41. The appellate court concluded that the term “interested person” includes

whistleblowers, like Cahill, with nonpublic information of possible wrongdoing.

Id. ¶ 43.

¶ 21 The appellate court further held that the State suffered an “injury in fact” to its

sovereignty based on the violation of its laws and could partially assign to a relator

its claim for that type of injury. Id. ¶ 29. The court emphasized that section 15(a)

does not mention the State suffering pecuniary injury and that the Act’s stated

purpose is to combat insurance fraud, rather than recoup damages. The court

concluded, therefore, that the State need not suffer pecuniary injury for the Act to

confer standing on a relator. Requiring the State to assign damages to a relator to

establish standing would preclude a whistleblower from bringing a claim on the

State’s behalf, which the court concluded would defeat the purpose of the Act. Id.

¶ 22 Defendants filed a petition for leave to appeal, which we allowed pursuant to

Illinois Supreme Court Rule 315 (eff. July 1, 2018). We granted the Taxpayers

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Against Fraud Education Fund and the Coalition Against Insurance Fraud leave to

submit briefs amicus curiae in support of the Estate’s position, pursuant to Illinois

Supreme Court Rule 345 (eff. Sept. 20, 2010).

¶ 23 II. ANALYSIS

¶ 24 On appeal, defendants renew their argument that the Estate lacks standing for

two reasons. First, defendants assert the Estate is not an “interested person”

authorized to sue under section 15(a) of the Act because Cahill did not suffer an

injury related to the alleged fraud and did not allege how determination of the

controversy would affect a claim or right personal to her. Second, defendants

contend that criminal fraud against private insurance companies constitutes an

injury merely to the State’s sovereignty and that the State may not assign to private

citizens the authority to enforce criminal law. Defendants seek reversal of the

appellate court’s decision and reinstatement of the circuit court’s order dismissing

the complaint.

¶ 25 A. Standing

¶ 26 “The standing doctrine assures that issues are presented to a court only by

parties who have a sufficient stake in the outcome of the controversy.” People

ex rel. Hartigan v. E&E Hauling, Inc., 153 Ill. 2d 473, 482 (1992). A party lacking

an interest in the controversy has no standing to sue. Id.

¶ 27 The purpose of the doctrine is to ensure that courts are deciding actual, specific

controversies and not abstract questions or moot issues. In re Estate of Wellman,

174 Ill. 2d 335, 344 (1996). “Standing ‘is not simply a procedural technicality’ (59

Am. Jur. 2d Parties § 30, at 416 (1987)), but rather is an aspect or a component of

justiciability.” Id.

¶ 28 The essence of the standing inquiry is whether the litigant, either in an

individual or representative capacity, is entitled to have the court decide the merits

of a dispute or a particular issue. Id. at 345. This court has held repeatedly that

standing requires some injury in fact to a legally recognized interest. Id. The

claimed injury, whether actual or threatened, must be distinct and palpable, fairly

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traceable to the defendant’s actions, and substantially likely to be prevented or

redressed by the grant of the requested relief. Greer v. Illinois Housing

Development Authority, 122 Ill. 2d 462, 492-93 (1988).

¶ 29 A plaintiff need not allege facts establishing standing. Wexler v. Wirtz Corp.,

211 Ill. 2d 18, 22 (2004). Rather, the defendant bears the burden to plead and prove

lack of standing. Chicago Teachers Union, Local 1 v. Board of Education of the

City of Chicago, 189 Ill. 2d 200, 206 (2000).

¶ 30 The lack of standing is an “affirmative matter” that is properly raised as grounds

for involuntary dismissal under section 2-619(a)(9) of the Code (735 ILCS 5/2-

619(a)(9) (West 2016)). Scachitti, 215 Ill. 2d at 508; cf. Greer, 122 Ill. 2d at 494

(lack of standing is an “affirmative” defense).

¶ 31 A motion to dismiss under section 2-619 admits the legal sufficiency of the

complaint but raises a defense that allegedly defeats the complaint. Patrick

Engineering, 2012 IL 113148, ¶ 31. When we review a dismissal under section 2-

619, we accept as true all well-pleaded facts as well as all reasonable inferences

that arise from them. Id. However, we will disregard all legal and factual

conclusions in the complaint that are not supported by specific factual allegations.

Id. An involuntary dismissal based on a lack of standing is reviewed de novo.

Glisson v. City of Marion, 188 Ill. 2d 211, 220 (1999); Kedzie & 103rd Currency

Exchange, Inc. v. Hodge, 156 Ill. 2d 112, 116 (1993) (an order granting involuntary

dismissal is reviewed de novo on appeal). Accordingly, we review de novo the

circuit court’s dismissal of the Estate’s complaint and consider whether dismissal

was proper as a matter of law.

¶ 32 B. “Interested Person”

¶ 33 The qui tam enforcement provision of section 15 is labeled “Action by an

interested person.” Subsection (a) of section 15 provides that “[a]n interested

person, including an insurer, may bring a civil action for a violation of this Act for

the person and for the State of Illinois.” 740 ILCS 92/15(a) (West 2016). The Act

does not define the phrase “interested person,” so we apply the rules of statutory

interpretation.

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¶ 34 The fundamental rule of statutory interpretation is to ascertain and give effect

to the legislature’s intent, and the best indicator of that intent is the statutory

language, given its plain and ordinary meaning. Dew-Becker v. Wu, 2020 IL

124472, ¶ 12 (citing People v. Alexander, 204 Ill. 2d 472, 485 (2003)). When the

statutory language is clear and unambiguous, it is given effect as written without

resort to other aids of statutory interpretation. Id. (citing Petersen v. Wallach, 198

Ill. 2d 439, 445 (2002)).

¶ 35 A court must view the statute as a whole, construing words and phrases in light

of other relevant statutory provisions and not in isolation. Each word, clause, and

sentence of a statute must be given a reasonable meaning, if possible, and should

not be rendered superfluous. The court may consider the reason for the law, the

problems sought to be remedied, the purposes to be achieved, and the consequences

of construing the statute one way or another. Also, a court presumes the General

Assembly, in its enactment of legislation, did not intend absurdity, inconvenience,

or injustice. People v. Perez, 2014 IL 115927, ¶ 9. We afford the statutory language

the fullest, rather than narrowest, possible meaning to which it is susceptible. Lake

County Board of Review v. Property Tax Appeal Board, 119 Ill. 2d 419, 423 (1988).

The statutory interpretation of the term “interested person” is subject to de novo

review. See Dew-Becker, 2020 IL 124472, ¶ 12 (citing People v. Manning, 2018 IL

122081, ¶ 16).

¶ 36 In this appeal, defendants renew their argument that the Estate lacks standing

because Cahill does not have a pecuniary interest in defendants’ alleged fraud

against VSP. More generally, defendants assert that the plain and ordinary meaning

of section 15 limits relators to those with a personal claim, status, or right capable

of being affected by the controversy and that to hold otherwise would render the

term “interested” meaningless or superfluous. Defendants contend that “interested

person” must refer to someone with more than simple curiosity about the outcome

of a qui tam action.

¶ 37 The common definition of “interested” includes both “having curiosity

aroused” and “having a share or concern” in the outcome of some endeavor.

Webster’s Third New International Dictionary 1178 (2002) (defining “interested”

as “having the attention engaged : having curiosity aroused” or “having a share or

concern in some affair or project : liable to be affected or prejudiced”). Neither

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section 15(a) nor the dictionary definition provides much guidance on discerning

legislative intent. However, other provisions of the Act shed light on whom the

General Assembly considers to be an “interested person.”

¶ 38 For instance, section 15(b) requires that the interested person shall serve on the

state’s attorney and the attorney general “[a] copy of the complaint and a written

disclosure of substantially all material evidence and information the person

possesses.” 740 ILCS 92/15(b) (West 2016). Thus, the only explicit qualification

for a person filing a complaint under section 15 is possession of material evidence

and information of the alleged fraud.

¶ 39 Another example is in section 25, which prescribes a relator’s share of the

proceeds. When the state’s attorney or attorney general conducts an action initiated

under section 15, the “person is entitled to receive an amount that the court

determines is reasonable based upon the extent to which the person contributed to

the prosecution of the action,” amounting to at least 30% of the proceeds, subject

to subsection (d). (Emphasis added.) Id. § 25(a). Conversely, if the state’s attorney

or attorney general does not proceed with the action, the person “shall receive an

amount that the court decides is reasonable for collecting the civil penalty and

damages,” amounting to at least 40% of the proceeds, subject to subsection (d). Id.

§ 25(b). Thus, the relator’s share of the proceeds is intended to be commensurate

with his or her participation in the litigation.

¶ 40 Section 25 also contemplates a relator attempting to recover payments obtained

fraudulently.

“If the person bringing the action *** has paid money to the defendant or to an

attorney acting on behalf of the defendant in the underlying claim, then he or

she shall be entitled to up to double the amount paid to the defendant or the

attorney if that amount is greater than 50% of the proceeds.” (Emphasis added.)

Id. § 25(c).

If qui tam standing were conditioned on the relator’s pecuniary interest in payments

made to the defendant, section 25(c) would not use the word “if.”

¶ 41 Subsection (d) of section 25 imposes a 10% cap on a relator’s share of the

proceeds if the court finds the action is based primarily on disclosures of specific

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information, other than information provided by the relator, in which case the award

shall “tak[e] into account the significance of the information and the role of the

person bringing the action in advancing the case to litigation.” Id. § 25(d).

¶ 42 Section 25 illustrates how the relator’s share should reflect the relative

participation of the State and the relator in the litigation, any payments the relator

might have made to the defendant, and the content of the information disclosed by

the relator. Nothing in section 25 indicates that a pecuniary interest is a condition

of the relator attaining standing.

¶ 43 Yet another example is in section 40 of the Act, which offers protections for

employees who bring claims under the Act. Id. § 40. Section 40 provides, in

relevant part,

“An employee who is discharged, demoted, suspended, threatened, harassed, or

in any other manner discriminated against in the terms and conditions of

employment by his or her employer because of lawful acts done by the

employee on behalf of the employee or others in furtherance of an action under

this Act, including investigation for, initiation of, testimony for, or assistance

in an action filed or to be filed under this Act, shall be entitled to all relief

necessary to make the employee whole.” Id.

¶ 44 If an employee without a financial stake in his or her employer’s fraud lacked

standing under the Act, the General Assembly would not have enacted employee

protections against retaliation for filing a qui tam action. Adopting defendants’

interpretation would lead to the absurd result of an employee potentially needing to

invoke the protections of section 40 after his or her qui tam action is dismissed for

failure to show a personal legal interest.

¶ 45 Adopting defendants’ position would also mean an insurer with information but

without a “personal claim, status, or right capable of being affected” would not be

sufficiently interested to file a qui tam action, despite the Act explicitly identifying

insurers as interested persons. See id. § 15(a) (a claim may be brought by “[a]n

interested person, including an insurer” (emphasis added)). The Act explicitly

identifies employees and insurers as persons capable of filing a qui tam action,

regardless of whether they have a legal or pecuniary interest in the fraud.

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¶ 46 Sections 15, 25, and 40, when read together, illustrate that the defining

characteristic of an “interested person” under the Act is the disclosure of material

evidence of wrongdoing and involvement in the litigation, not a personal claim,

status, or right affected by the fraud. Thus, we agree with the appellate court that,

under the plain and ordinary meaning of the Act, Cahill is an “interested person”

due to her knowledge of nonpublic information of possible wrongdoing gained

through her employment with Family Vision Care.

¶ 47 Our interpretation is consistent with the Act’s legislative purpose of protecting

the public from insurance fraud. The civil penalties prescribed by section 5(b) are

intended to be remedial rather than punitive, with “the goals of disgorging unlawful

profit, restitution, compensating the State for the costs of investigation and

prosecution, and alleviating the social costs of increased insurance rates due to

fraud.” Id. § 5(c). The appellate court accurately characterized defendants’ position

as effectively excluding uninjured whistleblowers from the definition of “interested

person.” Excluding uninjured whistleblowers from qui tam proceedings would

defeat the purpose of the Act, as it would discourage employees from coming

forward to disclose their employers’ insurance fraud.

¶ 48 Defendants argue that dividing the proceeds between an uninjured relator and

the State effectively punishes the defrauding party without remedying the

defrauded party’s injury, contrary to section 5(c). However, a defrauded party can

pursue enhanced civil damages as part of a criminal prosecution for insurance fraud.

720 ILCS 5/17-10.5(e) (West 2016).

¶ 49 In fact, the Act contemplates a defrauded party seeking these civil damages

under section 17-10.5(e). The civil penalties under the Act “shall not preclude, nor

be precluded by, a criminal prosecution for the same conduct.” 740 ILCS 92/5(c)

(West 2016). If the qui tam court finds, after considering the Act’s legislative goals,

that the civil penalties would be punitive and would preclude, or be precluded by,

a criminal prosecution, the court shall reduce that penalty appropriately. Id.

Defendants focus on the relator and the State as the recipients of the proceeds of a

qui tam action, losing sight of the way the civil penalties of section 5(b) of the Act

and the civil damages of section 17-10.5(e) of the Criminal Code work in tandem

to root out the fraud and remedy the defrauded party’s injury.

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¶ 50 Moreover, defendants’ interpretation requires reading a limitation into the

statute to effectively bar claims by anyone other than an insurer that lost money

from fraudulent conduct. “We do not depart from the plain language of the statute

by reading into it exceptions, limitations, or conditions that conflict with the

expressed intent.” Accettura v. Vacationland, Inc., 2019 IL 124285, ¶ 11.

Defendants read into section 15(a) a limitation that conflicts with the remainder of

the Act and its expressed intent to prevent insurance fraud. We decline defendants’

invitation to read this limitation into the statute.

¶ 51 Defendants echo the circuit court’s attempt to distinguish the Act from the False

Claims Act, which also allows a relator to file a qui tam action for civil penalties

and triple damages. See 740 ILCS 175/3(a)(1) (West 2016). This court has held that

a relator has standing as a partial assignee of the State’s claim in a qui tam action

under the False Claims Act (Scachitti, 215 Ill. 2d at 508), but defendants claim the

General Assembly’s use of the modifier “interested” in the Act compels a different

result. The False Claims Act provides that “[a] person may bring a civil action” for

a violation of the statute (emphasis added) (740 ILCS 175/4(b)(1) (West 2016)),

but the Act requires the relator to be an “interested person” (emphasis added) (740

ILCS 92/15 (West 2016)).

¶ 52 As the appellate court astutely observed, the phrase “interested person” appears

in the Act only in section 15(a), while the qui tam plaintiff is described by the word

“person” at least 29 times elsewhere in the Act. 2019 IL App (1st) 180697, ¶ 43.

We conclude that the term “interested” is restrictive only to the extent that it

identifies the relator as a person presenting undisclosed information of wrongdoing

as defined in section 5(b). Contrary to defendants’ assertion, our interpretation

gives effect to the word “interested” in the Act.

¶ 53 Defendants also renew their argument that “interested person” should be given

the same meaning in the Act as in other contexts. For instance, the Probate Act of

1975 defines an “interested person” as “one who has or represents a financial

interest, property right or fiduciary status at the time of reference which may be

affected by the action, power or proceeding involved.” 755 ILCS 5/1-2.11 (West

2016). But the question of who can sue as an interested person in probate

proceedings has no bearing on who can file a qui tam action under the Act, and the

two statutes have different legislative purposes. Defendants propose similar

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definitions of “interested” as requiring a financial interest in other contexts, such as

an “interested shareholder” in corporate law or “interested” public officials in a

public contracting situation.

¶ 54 However, the meaning or definition of a term cannot be blindly transferred from

one context to another. See Cohen v. Chicago Park District, 2017 IL 121800, ¶ 22

(“Care must be taken when importing the definition of a term from one statute to

another, since ‘the context in which a term is used obviously bears upon its intended

meaning.’ ” (quoting People ex rel. Illinois Department of Labor v. E.R.H.

Enterprises, Inc., 2013 IL 115106, ¶ 29)); see 2019 IL App (1st) 180697, ¶ 42.

Defendants cite nothing to suggest the General Assembly, when it adopted the Act,

was referring to a definition of “interested person” found in any other context.

¶ 55 We note that the appellate court’s interpretation of “interested person” was

informed by Alzayat, where the California Court of Appeal addressed the statute on

which the Act is based. Subsections (b) and (e)(1) of section 1871.7 of the

California statute are the analogues to sections 5(b) and 15(a) of the Act.

¶ 56 Alzayat stated definitively, “ ‘[a]s a true qui tam provision, Insurance Code

section 1871.7 does not mandate that the relator has suffered his or her own

injury.’ ” 2019 IL App (1st) 180697, ¶ 41 (quoting Alzayat, 226 Cal. Rptr. 3d at

889). Alzayat noted that the lawsuit under the California statute was “ ‘based on an

injury allegedly suffered by the People of the State of California, and was not filed

for the purpose of remedying an injury suffered by [the relator].’ ” Id. (quoting

Alzayat, 226 Cal. Rptr. 3d at 888).

¶ 57 In this case, the appellate court concluded that, because the Act directly follows

the California statute, Alzayat supports a finding that qui tam claims under the Act

are not restricted only to insurance companies or individual relators who have been

personally injured. Id. ¶ 42.

¶ 58 We believe the appellate court’s reliance on Alzayat as persuasive authority was

misplaced, as the decision did not directly address the meaning of the term

“interested party” under the California statute. That said, the dicta in Alzayat is

consistent with our interpretation that claims under the Act are not restricted to

insurance companies or individual relators who have been personally injured.

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¶ 59 C. Injury to Sovereignty

¶ 60 Defendants next argue that, even if the Act authorized the Estate to bring a

qui tam action based on Cahill’s status as an “interested person,” the Estate did not

allege the State suffered an “injury in fact” that could be assigned. Defendants again

attempt to distinguish the False Claims Act and the Act, based on the different

injuries the two statutes remedy. The False Claims Act addresses allegations of

fraudulently obtained public funds and actual monetary damages suffered by the

State. In contrast, the Act addresses violations of statutes that criminalize insurance

fraud against private insurance companies. These criminal offenses result in an

injury to the State’s sovereignty, not to its treasury. Defendants conclude that the

State cannot assign this kind of nonmonetary injury to a private citizen.

¶ 61 This court has not previously addressed standing in the context of the Act, but

we are guided by our analysis in the context of qui tam litigation under the False

Claims Act, formerly known as the Whistleblower Reward and Protection Act (see

Pub. Act 96-1304, § 10 (eff. July 27, 2010)). Scachitti, 215 Ill. 2d at 504 (citing 740

ILCS 175/1 et seq. (West 2002)). The False Claims Act imposes civil liability upon

“ ‘[a]ny person’ who, inter alia, ‘knowingly presents, or causes to be presented, to

an officer or employee of the State *** a false or fraudulent claim for payment or

approval.’ ” Scachitti, 215 Ill. 2d at 504 (quoting 740 ILCS 175/3(a)(1) (West

2002)). A person who violates the False Claims Act is liable to the State for a civil

penalty of not less than $5000 and not more than $10,000, plus treble damages. Id.

at 505 (citing 740 ILCS 175/3(a) (West 2002)).

¶ 62 Like the Act, the False Claims Act provides that an action may be commenced

by the attorney general. 740 ILCS 175/4(a) (West 2016). A private person may also

bring a qui tam civil action under the False Claims Act “ ‘for the person and for the

State’ (emphasis added), ‘in the name of the State.’ ” Scachitti, 215 Ill. 2d at 505

(quoting 740 ILCS 175/4(b) (West 2002)).

¶ 63 In Scachitti, we acknowledged that in a qui tam action under the False Claims

Act there is “no cognizable injury in fact suffered by the relator.” Id. at 508. But

we held, relying on Vermont Agency of Natural Resources v. United States ex rel.

Stevens, 529 U.S. 765 (2000), that a relator has standing as a partial assignee of the

State’s claim. Scachitti, 215 Ill. 2d at 508.

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¶ 64 The United States Supreme Court in Vermont Agency held “the doctrine that

the assignee of a claim has standing to assert the injury in fact suffered by the

assignor” was an adequate basis for qui tam-relator standing because “[t]he [False

Claims Act] can reasonably be regarded as effecting a partial assignment of the

Government’s damages claim.” Vermont Agency, 529 U.S. at 773. Thus, the

relator’s complaint alleging an injury in fact to the United States conferred standing

on the relator. Id. at 774.

¶ 65 Adopting the reasoning in Vermont Agency, this court held that a qui tam claim

constitutes a partial assignment of the State’s claim under the False Claims Act,

permitting a private person to “ ‘bring a civil action for a violation of the [False

Claims Act] for the person and for the State.’ (Emphasis added.) 740 ILCS

175/4(b)(1) (West 2002).” Scachitti, 215 Ill. 2d at 508. “In other words, the interest

of a qui tam plaintiff in a claim under the [False Claims] Act is justified as a partial

assignment of the state’s right to bring suit.” Id.

¶ 66 The appellate court in this case accurately observed that both Scachitti and

Vermont Agency “hold that the government’s standing rests on the ‘injury to its

sovereignty based on the violation of its laws,’ as well as the ‘proprietary’ injury

suffered in False Claims Act cases. Scachitti, 215 Ill. 2d at 507; Vermont Agency,

529 U.S. at 771.” 2019 IL App (1st) 180697, ¶ 29. However, nothing in those

decisions imposes the requirement of a proprietary injury to the State as a condition

of a relator’s standing.

¶ 67 Neither section 5(b)’s provision for civil penalties nor the qui tam enforcement

provision of section 15 mentions pecuniary injury to the State. Furthermore, the

Act’s stated purpose of combating insurance fraud supports the interpretation that

the State need not suffer pecuniary damages for the Act to confer standing on a

relator. 740 ILCS 92/5(c) (West 2016) (“The penalties set forth in subsection (b)

are intended to be remedial rather than punitive, and shall not preclude, nor be

precluded by, a criminal prosecution for the same conduct.”). Conditioning

standing on the State’s assignment of pecuniary damages to a relator would bar an

uninjured whistleblower from bringing a claim on the State’s behalf, defeating the

purpose of the Act.

¶ 68 Defendants argue that the False Claims Act is fundamentally different from the

Act because the former facilitates recovery for the defrauded party and the latter

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does not. Defendants point out that private individuals may pursue claims under the

False Claims Act because the State has assigned to them its claim for damages and

that any recovery is divided between the State and the relator. In contrast, the State

suffers no pecuniary injury under the Act and therefore has no damages to assign.

Instead, the Act protects a private insurance company (or self-insured entity) that

is defrauded; the civil penalties from a successful claim may be divided between

the government and an uninjured relator, leaving the defrauded party to bring its

own action for damages against the defrauding party. See 720 ILCS 5/17-10.5(e)(1)

(West 2016) (a person who commits insurance fraud shall be civilly liable to the

defrauded party).

¶ 69 However, Scachitti held the government’s standing in an action under the False

Claims Act rests on the injury to its sovereignty based on the violation of its laws.

The violation of the laws, not the defrauded party’s opportunity for recovery under

the qui tam statute, is what makes the defrauding party liable for civil penalties,

under either the Act or the False Claims Act. See Scachitti, 215 Ill. 2d at 507;

Vermont Agency, 529 U.S. at 771; 2019 IL App (1st) 180697, ¶ 29. Under either

statute, the State suffers an “injury in fact” to its sovereignty based on violation of

its laws and can assign to a relator its claim for that injury.

¶ 70 Defendants characterize the Act as assigning the State’s power to enforce

criminal law, contending this assignment is inconsistent with the principle that the

power to assign is based on a cause of action being a property interest. Defendants

assert that, while Scachitti turned on the principle that the government’s claim is

based on a violation of its laws and damages resulting from fraud, a claim under

the Act addresses the State’s right to enforce its criminal statutes through the

imposition of civil penalties.

¶ 71 Defendants overstate the Act’s reach in prescribing qui tam actions. Contrary

to defendants’ assertion, the Act does not purport to transfer to a private citizen the

sovereign’s unique authority to investigate, charge, and prosecute offenses. The

Estate does not claim authority to perform any of these tasks. In fact, as the

appellate court accurately observed, a plaintiff may bring a qui tam claim only if

(1) the State authorizes the relator to sue on behalf of the State and the relator and

(2) the State retains control of the litigation. Scachitti, 215 Ill. 2d at 494. The Act

accomplishes both.

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¶ 72 Defendants conflate the civil penalties prescribed by the Act with the criminal

remedies under the Criminal Code. A stated purpose of the Act is to remedy, not

punish, a violation of section 17-10.5 of the Criminal Code (see 740 ILCS 92/5(c)

(West 2016)); it does not confer authority to prosecute an offense under that statute.

Instead, the Act grants the State a proprietary interest in civil penalties for the

offense, which the State may assign to a qui tam plaintiff.

¶ 73 Defendants also argue the appellate court erred in adopting the reasoning of

Stauffer v. Brooks Brothers, Inc., 619 F.3d 1321, 1325 (Fed. Cir. 2010), concerning

the government’s assignment of a purely sovereign interest to a relator under a

qui tam statute. In Stauffer, the relator claimed that a bow-tie manufacturer falsely

marked its products in violation of a statute that allowed anyone to sue on behalf of

the United States. See 35 U.S.C. § 292(b) (2006). The court reasoned that the

“qui tam provision operates as a statutory assignment of the United States’ rights,

and ‘the assignee of a claim has standing to assert the injury in fact suffered by the

assignor.’ ” Stauffer, 619 F.3d at 1325 (quoting Vermont Agency, 529 U.S. at 773).

The Stauffer court reasoned that Congress, by enacting the statute, determined that

a deceptive marking was harmful and prohibited, constituting an injury to the

United States. Id. The court further reasoned that, because the government would

have standing to enforce the statute, the relator, as the government’s assignee, also

had standing to enforce it. Citing Vermont Agency, the court stated, “we consider

the question decided, that the United States may assign even a purely sovereign

interest.” Id. at 1327 n.3.

¶ 74 Defendants argue that Stauffer should not guide our analysis because (1) the

decision does not bind this court, (2) unlike the Act, the false-marking statute in

Stauffer did not address criminal conduct, and (3) Congress has since repealed the

qui tam provision of the false-marking statute, rendering the decision immune from

further judicial review. In response, we note that lower federal court decisions are

not binding on Illinois courts but may be considered persuasive authority. People

ex rel. Ryan v. World Church of the Creator, 198 Ill. 2d 115, 127 (2001).

Furthermore, the difference between the type of conduct remedied by the Act and

the false-marking statute does not diminish the appellate court’s cogent

interpretation of Scachitti and Vermont Agency. Finally, the repeal of the qui tam

provision of the false-marking statute in Stauffer does not undermine the court’s

conclusion that the government may assign a purely sovereign interest.

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¶ 75 Finally, defendants argue that interpreting the Act to allow a private citizen

without a legal interest to exercise the State’s law-enforcement power is

unconstitutional because the attorney general is the sole officer authorized to

represent the people in any litigation in which the People of the State are the real

party in interest. The constitutionality of a statute is a question of law that we review

de novo. Scachitti, 215 Ill. 2d at 504. Statutes are presumed constitutional and

courts are required to construe statutes to “ ‘uphold their constitutionality whenever

reasonably possible.’ ” Id. (quoting Hill v. Cowan, 202 Ill. 2d 151, 157 (2002)).

¶ 76 As the chief legal officer of the state, the attorney general’s authority is derived

from the Illinois Constitution (Ill. Const. 1970, art. V, § 15). Lyons v. Ryan, 201 Ill.

2d 529, 541 (2002) (citing People ex rel. Scott v. Briceland, 65 Ill. 2d 485, 492

(1976)). The duties of the attorney general are prescribed by law and include those

powers traditionally held at common law. Id. (citing Gust K. Newberg, Inc. v.

Illinois State Toll Highway Authority, 98 Ill. 2d 58, 67 (1983)). Only the attorney

general is empowered to represent the State in litigation where the State is the real

party in interest. Id. (citing Fuchs v. Bidwill, 65 Ill. 2d 503, 510 (1976)). The

legislature may add to the powers of the attorney general, but it cannot reduce the

attorney general’s common-law authority in directing the legal affairs of the State.

Id. (citing Newberg, 98 Ill. 2d at 67). Thus, legislation that usurps the common-law

powers of the attorney general is invalid. Id. (citing Briceland, 65 Ill. 2d at 501-02).

¶ 77 The Act mirrors the False Claims Act in the way it entitles the State to receive

notice and to intervene at the various stages of qui tam litigation. Under both

statutes, the State may be represented by the attorney general, and under the Act,

also by the state’s attorney of the county in which the conduct occurred. The

Scachitti court found the attorney general retains sufficient control over qui tam

False Claims Act actions to render that statute constitutional, and we reach the same

conclusion regarding the Act.

¶ 78 A qui tam plaintiff pursuing a claim under either the Act or the False Claims

Act must serve the attorney general with a copy of the complaint and a written

disclosure of the material evidence and information, and the complaint remains

under seal for 60 days (plus any extensions granted by the court), during which the

attorney general may investigate the claim and decide whether to intervene.

Scachitti, 215 Ill. 2d at 505 (citing 740 ILCS 175/4(b)(2) (West 2002)); 740 ILCS

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92/15(b) (West 2016). When the attorney general intervenes under either statute, it

assumes “ ‘primary responsibility for prosecuting the action,’ ” and the qui tam

plaintiff has a right to continue as a party in the case, subject to certain limitations.

Scachitti, 215 Ill. 2d at 505 (quoting 740 ILCS 175/4(c) (West 2002)); 740 ILCS

92/20(a) (West 2016). The attorney general may dismiss or settle the action at any

time “ ‘notwithstanding the objections of the person initiating the action.’ ”

Scachitti, 215 Ill. 2d at 505 (quoting 740 ILCS 175/4(c)(2)(A), (c)(2)(B) (West

2002)); 740 ILCS 92/20(b) (West 2016). Both statutes also allow the attorney

general to restrict the qui tam plaintiff’s participation in the litigation. Scachitti, 215

Ill. 2d at 505 (citing 740 ILCS 175/4(c)(2)(C) (West 2002)); 740 ILCS 92/20(b)

(West 2016). If the attorney general declines to proceed with the action, the qui tam

plaintiff has the right to proceed, but the attorney general may intervene later.

Scachitti, 215 Ill. 2d at 505 (citing 740 ILCS 175/4(c)(3) (West 2002)); 740 ILCS

92/20(c) (West 2016).

¶ 79 The attorney general has the right to monitor the action and receive copies of

all pleadings and deposition transcripts. Scachitti, 215 Ill. 2d at 505 (citing 740

ILCS 175/4(c)(3) (West 2002)); 740 ILCS 92/20(c) (West 2016). If “ ‘certain

actions of discovery by the person initiating the action would interfere with the

State’s investigation or prosecution of a criminal or civil matter,’ ” the attorney

general may seek a stay of discovery or simply exercise the attorney general’s

ultimate authority and dismiss the qui tam action. Scachitti, 215 Ill. 2d at 505-06

(quoting 740 ILCS 175/4(c)(2)(A), (c)(4) (West 2002)); 740 ILCS 92/20(b), (d)

(West 2016).

¶ 80 The qui tam provisions of the False Claims Act impose significant restrictions

on qui tam plaintiffs. Scachitti, 215 Ill. 2d at 510. Although the qui tam plaintiffs

may “conduct” the litigation on the State’s behalf, the attorney general retains

authority to “control” the litigation. Scachitti held the qui tam provisions of the

False Claims Act do not usurp the constitutional powers of the attorney general to

represent the State (id.), and the Act affords the state’s attorney and the attorney

general the same control. Our interpretation of the Act to allow a private citizen

without a pecuniary interest to pursue a claim does not usurp the attorney general’s

constitutional powers to represent the State. See id.

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¶ 81 CONCLUSION

¶ 82 For the foregoing reasons, we hold that (1) the Estate has standing under section

15(a) because Cahill is an “interested person” by virtue of her nonpublic

information of possible wrongdoing and (2) the State suffered an “injury in fact” to

its sovereignty based on violation of its laws and could partially assign its claim to

the Estate under the Act. The appellate court therefore was correct when it reversed

the dismissal of the complaint. The judgment of the appellate court is affirmed.

¶ 83 Appellate court judgment affirmed.

¶ 84 Circuit court judgment reversed.

¶ 85 Cause remanded.

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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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