ARTICLE
13 September 2018

Patients Fail To State Claim For Reimbursement Of Medical Expenses Related To Kickbacks

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Holland & Knight

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In S.B. v. Tenet Healthcare Corp., No. 17-141-2, 2018 WL 1836029 (11th Cir. April 18, 2018) (per curiam), the Eleventh Circuit affirmed dismissal of S.B.'s complaint for fraud, negligent misrepresentation ...
United States Food, Drugs, Healthcare, Life Sciences

Nathan A Adams IV is a Partner in Holland & Knight's Tallahassee office

In S.B. v. Tenet Healthcare Corp., No. 17-141-2, 2018 WL 1836029 (11th Cir. April 18, 2018) (per curiam), the Eleventh Circuit affirmed dismissal of S.B.'s complaint for fraud, negligent misrepresentation, money had and received, unjust enrichment, breach of contract, and breach of the implied duty of good faith and fair dealing. In 2016, Tenet agreed to pay $513 million to resolve criminal and civil litigation involving kickbacks that Tenet hospital paid Clinica de la Mama (Clinica) to refer pregnant immigrants who were eligible for emergency Medicaid coverage to Tenet-owned hospitals for labor and delivery services, but the settlement did not compensate Clinica or Tenet patients. S.B. sought, on behalf of herself and other Hispanic women, reimbursement for travel and medical expenses allegedly incurred as a result of the agreement between Tenet and Clinica. The district court ruled and court of appeals affirmed that S.B. failed to state claims for negligent misrepresentation or fraud because she provided no factual allegations to show that Tenet held out Clinica as its agent in order to hold Tenet liable for Clinica's alleged misrepresentations; that S.B. failed to state a claim for money had and received or unjust compensation due to the statute of frauds not tolled for lack of allegations that Tenet knowingly or willfully concealed material facts about its wrongdoing; and that she failed to state claims for breach of contract or the implied duty of good faith because she failed to allege a contract that Tenet breached.

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