U.S. ex rel. Prose v. Molina Healthcare of Illinois (Appellate Case No. 20-2243)
The Firm scored a major win this week when the United States Court of Appeals for the 7th Circuit declined en banc rehearing in U.S. ex rel. Prose v. Molina Healthcare of Illinois (Case No. 17-cv-06638), making only minor amendments to its August 20, 2021 opinion, reinstating relator’s qui tam lawsuit against managed care organization Molina Healthcare for violations of the federal False Claims Act (FCA) and its Illinois counterpart. The case was filed in the U.S. District Court for the Northern District of Illinois by FVLD client and whistleblower Dr. Thomas Prose, the founder of General Medicine, P.C., a team of board-certified physicians and advanced nurse practitioners specializing in treating patients residing in Skilled Nursing Facilities (SNFs).
The lawsuit seeks to recover overcharges to Illinois’ Medicaid program for expensive SNF-related services that were not provided. The District Court had dismissed the case in June 2020, which prompted the Seventh Circuit Appeal. In reversing that order, the 7th Circuit majority found, among other things, that the District Court “failed to give proper weight to the complaint’s description of Molina as a highly sophisticated member of the medical services industry” with knowledge of the capitated payment process.
The FCA imposes significant liability and penalties on persons and companies who defraud the federal government. Cases are initiated by whistleblowers, or “relators” who may prosecute the actions on the government’s behalf in exchange for a percentage of the recovery.
International Financial Services Corporation v. Chromas Technologies Canada, Inc., 356 F.3d 731 (7th Cir. 2004).Deciding a question of constitutional significance, the Seventh Circuit held that there is no Seventh Amendment right to a jury trial when a plaintiff is seeking to “pierce the corporate veil.” The “piercing” remedy is frequently used to hold one corporation liable for the obligations of its (typically insolvent) affiliate. The Seventh Circuit agreed with FVLD that veil piercing is an equitable remedy that can only be determined by the judge and not by a jury. The court vacated a jury verdict against a foreign corporation that had been based on a default of its domestic affiliate. This decision has widespread ramifications for every corporation that conducts business in Illinois through affiliates and subsidiaries.
Chrissafis v. Continental Airlines, Inc., 940 F. Supp. 1292 (N.D. Ill. 1996).This case presented the novel issue in the Seventh Circuit of whether a passenger can bring a claim for false arrest and imprisonment against an airline or whether the claim is preempted by the Federal Airline Deregulation Act. While recognizing that courts in other jurisdictions have come to divergent conclusions on the issue, the District Court for the Northern District of Illinois (with jurisdiction over the nation’s busiest airport) held that our client’s claim was not preempted. Our client, who had been arrested at the behest of the airline, went on to win nearly $500,000 in compensatory and punitive damages after the subsequent jury trial.
Eskridge v. Farmers New World Life Ins. Co., 250 Ill.App.3d 603, 621 N.E.2d 164, 190 Ill. Dec. 295 (1st Dist. 1993).Elsie Eskridge was found dead in a house where she had formerly resided with the plaintiff, her estranged second husband. Prior to her death, Elsie had taken out several hundred thousand dollars worth of insurance on her life and named her husband as the beneficiary. After her death, the husband made a claim for the proceeds of the policies, as did Elsie’s three children from a previous marriage. When the authorities declined to prosecute Elsie’s husband for her death, the Firm represented the three children and proved not only that Elsie’s death was caused by criminal means but also that the plaintiff was the one who caused it. The court awarded all of the insurance proceeds, and the interest thereon, to the three children, and the determination was upheld on appeal.This case became the subject of a 60 Minutes story conducted in our offices by Ed Bradley of CBS.
Blanco Oso International Trading Company v. Southern Scrap Material Co., Ltd. 735 F. Supp. 294 (N.D. Ill. 1990)This suit was brought against a Louisiana client arising out of its contract to buy scrap metal located in the Virgin Islands from an Illinois company. We nevertheless obtained dismissal of the claim on the grounds that our client did not “transact business” in Illinois within meaning of Illinois long-arm statute.
In re Nu-Kote Holding, Inc., 257 BR 855 MD Tenn (Jan. 5, 2001)Our client, a foreign holding company, brought an adversary proceeding against a Chapter 11 debtor that had purchased assets from our client prior to the debtor having filed for bankruptcy. The debtor challenged the arbitration clause, and the Firm obtained a declaratory judgment that held that no substantial bankruptcy interests existed to overcome enforcement of the arbitration procedures against the debtor.