Justia U.S. 9th Circuit Court of Appeals Opinion SummariesArticles Posted in Government Contracts
GLOBAL RESCUE JETS, LLC V. KAISER FOUNDATION HEALTH PLAN
Global Rescue Jets, which does business as Jet Rescue, billed Kaiser at Jet Rescue’s usual and customary rates. Kaiser paid only a fraction of the billed amount, however, because in its view Jet Rescue’s services were covered by Medicare and thus subject to payment at the much lower Medicare-approved rates. Jet Rescue brought this action against Kaiser to recover the additional sums Kaiser allegedly owes. Jet Rescue argues that it was not required to exhaust administrative remedies before filing suit and that the exhaustion requirement should have been excused in any eventThe circuit court affirmed the district court’s dismissal, reasoning original Medicare beneficiaries must exhaust their administrative remedies before seeking judicial review of a claim for benefits. The panel also rejected Jet Rescue’s contention that the exhaustion requirement should be excused. The panel held that the exhaustion requirement may be excused if three conditions are satisfied: (1) the plaintiff’s claim is wholly collateral to a claim for Medicare benefits; (2) the plaintiff has made a colorable showing of irreparable harm; and (3) exhaustion would be futile. The panel concluded that Jet Rescue failed to meet the first and third requirements. Thus, the circuit court rejected both arguments and affirmed the district court’s judgment. View "GLOBAL RESCUE JETS, LLC V. KAISER FOUNDATION HEALTH PLAN" on Justia Law
Childs v. San Diego Family Housing LLC
Childs leased military family housing at Naval Amphibious Base Coronado, which was owned by SDFH, a public-private venture created by statute, in which the U.S. Navy is a minority LLC member. Lincoln managed the property. Childs reported water and mold problems to SDFH and Lincoln. The problems were not resolved. SDFH and Lincoln moved to dismiss Childs's subsequent lawsuit for lack of subject-matter jurisdiction, arguing they were government contractors acting at the direction of the federal government, and therefore had derivative sovereign immunity. The district court denied their motion.The Ninth Circuit dismissed an appeal for lack of appellate jurisdiction. The district court’s order was not immediately appealable under the collateral order doctrine, under which an order that does not terminate the litigation is nonetheless treated as final if it conclusively determines the disputed question, resolves an important issue completely separate from the merits of the action, and is effectively unreviewable on appeal from a final judgment. While the first two prongs were satisfied, the denial of derivative sovereign immunity was not effectively unreviewable on appeal from a final judgment because denying an immediate appeal would not imperil a substantial public interest. The public interest underlying derivative sovereign immunity is extending the federal government’s immunity from liability, in narrow circumstances, to government agents carrying out the federal government’s directions. That interest could be vindicated after trial. View "Childs v. San Diego Family Housing LLC" on Justia Law
Bird v. Oregon Commission for the Blind
Bird and other blind vendors filed a formal complaint with Oregon Commission for the Blind (OCB) seeking arbitration, prospective relief, and attorney’s fees as a consequence of OCB’s alleged mishandling of vending contracts and representation of blind vendors’ interests. The arbitration panel denied relief. The district court held that sovereign immunity did not apply to an arbitration panel’s decision under the Randolph-Sheppard Act (RSA), which creates a cooperative federal-state program that gives preference to blind applicants for vending licenses at federal facilities, 20 U.S.C. 107, and that the Eleventh Amendment did not protect OCB from liability for damages. The Ninth Circuit reversed. Neither the RSA nor the parties’ operating agreements unequivocally waived a state’s sovereign immunity from liability for monetary damages, attorney’s fees, or costs. Citing the Supreme Court’s 2011 "Sossamon" decision, the court rejected a “constructive waiver” argument, reasoning that a waiver of sovereign immunity must be explicit. An agreement to arbitrate all disputes simply did not unequivocally waive sovereign immunity from liability for monetary damages. The operating agreements incorporated the text of the RSA and contained no express waiver of immunity from money damages. Because no provision of the RSA or the operating agreements provided for attorney’s fees, Bird was not entitled to attorney’s fees. View "Bird v. Oregon Commission for the Blind" on Justia Law
Harris v. County of Orange
In 1993, the County and the Orange County Employee Retirement System (OCERS) entered into a Memorandum of Understanding (MOU), allowing the County to access surplus investment earnings controlled by OCERS and depositing a portion of the surplus into an account to pay for county retirees' health insurance. The county adopted the Retiree Medical Plan, funded by those investment earnings and mandatory employee deductions. The Plan explicitly provided that it did not create any vested rights. The labor unions then entered into MOUs, requiring the county to administer the Plan and that retirees receive a Medical Insurance Grant. In 1993-2007, retired employees received a monthly grant benefit to defray the cost of health insurance. In 2004, the county negotiated with its unions to restructure the underfunded program, reducing benefits for retirees.Plaintiffs filed suit. The Ninth Circuit affirmed summary judgment in favor of the county. The 1993 Plan explicitly provided that it did not create any vested right to benefits. The Plan was adopted by resolution and became law with respect to Grant Benefits, part of the MOUs. The MOUs expired on their own terms by a specific date. Absent express language providing that the Grant Benefits vested, the right to the benefits expired when the MOUs expired. The Plan was not unilaterally imposed on the unions and their employees without collective bargaining; the unions executed MOUs adopting the Plan. The court rejected an assertion that the Grant Benefit was deferred compensation and vested upon retirement, similar to pension benefits. View "Harris v. County of Orange" on Justia Law
GEO Group, Inc., v. Newsom
California AB 32 phases out private detention facilities within the state. Because of fluctuations in immigration, ICE relies exclusively on private detention centers in California. AB 32 carves out exceptions for the state’s private detention centers. The United States and GEO, which operates private immigration detention centers, sued. The district court ruled largely in favor of California.The Ninth Circuit reversed. California is not simply exercising its traditional police powers, but rather impeding federal immigration policy. . Under the Supremacy Clause, state law must fall if it stands as an obstacle to the accomplishment and execution of the full purposes and objectives of Congress. The presumption against preemption does not apply to areas of exclusive federal regulation, such as the detention of immigrants. California did more than just exercise its traditional state police powers – it impeded the federal government’s immigration policy. Congress granted the Secretary of the Department of Homeland Security broad discretion over immigrant detention, including the right to contract with private companies to operate detention facilities. AB 32 also discriminated against the federal government in violation of the intergovernmental immunity doctrine by requiring the federal government to close all its detention facilities, while not requiring California to close any of its private detention facilities until 2028. View "GEO Group, Inc., v. Newsom" on Justia Law
DePaul Industries v. Miller
Miller, an assistant city attorney, advised the City of Eugene not to renew contracts with DePaul, a qualified nonprofit agency for individuals with disabilities (QRF) under an Oregon law that requires cities to contract with QRFs in certain circumstances. DePaul sued under 42 U.S.C. 1983, alleging that it held a clearly established constitutionally protected property interest in two 12-month security-service contracts. In 2016, Eugene had decided to modify its security services by requiring that the security service employees be armed and decided not to renew the contracts.The Ninth Circuit reversed the district court and held that Miller was entitled to qualified immunity. No court has considered DePaul’s novel argument that the Oregon QRF statute created a protected property interest in city contracts. Nor does the QRF statute on its face definitively resolve that question. DePaul did not provide any precedent addressing Oregon’s QRF statute or anything closely related. There was no precedent clear enough that every reasonable official would interpret the QRF statute as creating a protected property interest in DePaul’s annual contracts. There was also no precedent considering whether the QRF statute allows the city to end a contract if it seeks new services, such as armed security. View "DePaul Industries v. Miller" on Justia Law
Winter v. Gardens Regional Hospital & Medical Center, Inc.
The Ninth Circuit reversed the district court's dismissal of a qui tam action brought by relator under the False Claims Act, alleging that defendants submitted, or caused to be submitted, Medicare claims falsely certifying that patients' inpatient hospitalizations were medically necessary.After determining that it had jurisdiction, the panel held that a plaintiff need not allege falsity beyond the requirements adopted by Congress in the FCA, which primarily punishes those who submit, conspire to submit, or aid in the submission of false or fraudulent claims. The panel wrote that Congress imposed no requirement of proving "objective falsity," and the panel had no authority to rewrite the statute to add such a requirement. The panel held that a doctor’s clinical opinion must be judged under the same standard as any other representation. The panel explained that a doctor, like anyone else, can express an opinion that he knows to be false, or that he makes in reckless disregard of its truth or falsity. Therefore, a false certification of medical necessity can give rise to FCA liability. The panel also held that a false certification of medical necessity can be material because medical necessity is a statutory prerequisite to Medicare reimbursement. View "Winter v. Gardens Regional Hospital & Medical Center, Inc." on Justia Law
United States ex rel Godecke v. Kinetic Concepts, Inc.
The Ninth Circuit reversed the district court's dismissal of relator's qui tam action under the False Claims Act (FCA) against KCI, alleging that the company submitted false claims to Medicare. The panel held that relator sufficiently alleged that KCI violated the Act by adequately alleging a fraudulent scheme to submit false claims and reliable data that led to a strong inference that false claims were actually submitted. The panel also held that relator sufficiently alleged that KCI acted with the requisite scienter under the Act, and KCI's false claims were material to the government's payment decision. View "United States ex rel Godecke v. Kinetic Concepts, Inc." on Justia Law
Posted in: Government Contracts
Global Linguist Solutions, LLC v. Abdelmeged
Petitions for review of compensation orders arising under the Defense Base Act should be filed in the circuit where the relevant district director is located. The Ninth Circuit denied a petition for review challenging the Benefits Review Board's decision concluding that a linguist who supported the military in Iraq was entitled to workers' compensation under the Defense Base Act.The panel held that substantial evidence supported the ALJ's determination that claimant met both the medical and the economic aspect of disability as defined by the statute; the ALJ applied the correct legal standard when considering the evidence in this case; and the ALJ correctly concluded that claimant met his burden to show that he was disabled. View "Global Linguist Solutions, LLC v. Abdelmeged" on Justia Law
Solis v. Millenium Pharmaceuticals, Inc.
Solis alleged that his former employers violated the federal False Claims Act (FCA) by promoting dangerous off-label uses of a cardiovascular drug, Integrilin, and by paying physicians kickbacks to prescribe Integrilin and an antibiotic drug, Avelox. The district court found that Solis’s FCA claims were foreclosed by the public disclosure bar, which deprives federal courts of subject matter jurisdiction over FCA suits when the alleged fraud has already been publicly disclosed unless the relator is deemed an original source. The Ninth Circuit affirmed in part, holding that Solis’s Integrilin claims were substantially similar to those in prior public disclosures, and were close enough in kind and degree to have put the government on notice to investigate the alleged fraud before Solis filed his complaint. The court vacated the dismissal of Solis’s Integrilin claims and remanded for a determination of whether Solis qualified for the “original source” exception, 31 U.S.C. 3730(e)(4). Concerning Solis’s Avelox claims, the court held that the district court clearly erred in finding that the Avelox claims were publicly disclosed based on court complaints that never mentioned Avelox but affirmed the dismissal of Solis’s Avelox claims on the alternative ground of failure to plead with particularity as required by Fed.R.Civ.P. 9(b). View "Solis v. Millenium Pharmaceuticals, Inc." on Justia Law