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United States v. Hawaii Pacific Health Group Plan for Employees of Hawaii Pacific Health

Citation: 343 F. App'x 279Docket: No. 07-17174

Court: Court of Appeals for the Ninth Circuit; August 27, 2009; Federal Appellate Court

Narrative Opinion Summary

The case involves a relator, James Lockyer, who appealed the district court's summary judgment dismissing his qui tam complaint under the False Claims Act (FCA) and related state laws against his former employer. The primary legal issue centered on whether the defendants knowingly submitted false claims in violation of the FCA and whether Lockyer engaged in protected conduct under the FCA's retaliation provision. The court affirmed the summary judgment, finding that Lockyer failed to demonstrate a genuine issue of material fact regarding the defendants' scienter, as their actions were likely due to a good faith misunderstanding of Medicare regulations rather than knowing misconduct. Additionally, the court determined that Lockyer did not establish the defendants' awareness of any protected conduct on his part, a necessary element for a retaliation claim. The court declined to address state law violations, as these issues were not raised on appeal. The decision is not suitable for publication as precedent under Ninth Circuit Rule 36-3.

Legal Issues Addressed

False Claims Act Liability and Scienter Requirement

Application: The court applied the scienter requirement of the False Claims Act, which necessitates proof that the defendants knowingly submitted false claims. In this case, the evidence indicated that any noncompliance was due to a good faith misunderstanding or negligence, thus negating scienter and supporting summary judgment for the defendants.

Reasoning: The FCA requires proof that the defendants knew the claims were false. The court cited precedent indicating that a defendant's good faith interpretation of regulations negates liability, as it shows a lack of the requisite scienter.

FCA Retaliation Provision and Protected Conduct

Application: The court found that Lockyer failed to establish a genuine issue of material fact regarding his engagement in protected conduct under the FCA's retaliation provision, as well as the defendants' awareness of such conduct.

Reasoning: Lockyer did not establish a genuine issue of material fact concerning whether he engaged in protected conduct or whether the defendants were aware of such conduct, both crucial for a claim under the FCA's retaliation provision.

State Law Claims on Appeal

Application: The court did not address state law claims as no state law issues were raised in the appeal, focusing solely on the federal claims.

Reasoning: While the complaint also included state law violations, the court did not address these since no state law issues were raised in the appeal.

Summary Judgment Standards

Application: In this case, summary judgment was affirmed due to the lack of genuine issues of material fact concerning both the scienter required for FCA liability and the engagement in protected conduct for FCA retaliation claims.

Reasoning: Lockyer failed to demonstrate a genuine issue of material fact regarding the defendants' scienter necessary for liability under the FCA.