§Why CasetextPricing

Schubert v. All Children's Health System, Inc. et al

MOTION to dismiss Second Amended Complaint

51 Cited authorities

  1. Ashcroft v. Iqbal

    556 U.S. 662 (2009)   Cited 255,314 times   280 Legal Analyses
    Holding that a claim is plausible where a plaintiff's allegations enable the court to draw a "reasonable inference" the defendant is liable

  2. Bell Atl. Corp. v. Twombly

    550 U.S. 544 (2007)   Cited 269,063 times   367 Legal Analyses
    Holding that a complaint's allegations should "contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face' "

  3. Papasan v. Allain

    478 U.S. 265 (1986)   Cited 16,811 times   6 Legal Analyses
    Holding that Ex parte Young would not support a suit against a state for ongoing liability for an alleged past breach of trust, since "continuing payment of the income from the lost corpus is essentially equivalent in economic terms to a one-time restoration of the lost corpus itself"

  4. TRW Inc. v. Andrews

    534 U.S. 19 (2001)   Cited 1,191 times   10 Legal Analyses
    Holding a cardinal principal of statutory interpretation is that “no clause, sentence, or word shall be superfluous, void, or insignificant”

  5. U.S. ex Rel. Clausen v. Laboratory Corp.

    290 F.3d 1301 (11th Cir. 2002)   Cited 822 times   14 Legal Analyses
    Holding Rule 9(b) applies to False Claims Act claims

  6. Corsello v. Lincare, Inc.

    428 F.3d 1008 (11th Cir. 2005)   Cited 540 times   2 Legal Analyses
    Holding that trial court did not err in denying relator's request to file an amended complaint where there was a repeated failure to cure deficiencies in three prior complaints

  7. Atkins v. McInteer

    470 F.3d 1350 (11th Cir. 2006)   Cited 494 times   4 Legal Analyses
    Holding that denial of leave to amend was not an abuse of discretion where the relator “failed to include the proposed amendment or the substance thereof” with his request

  8. Hopper v. Solvay Pharmaceuticals

    588 F.3d 1318 (11th Cir. 2009)   Cited 237 times   5 Legal Analyses
    Holding a complaint deficient when it "d[id] not link the alleged false statements to the government's decision to pay false claims."

  9. U.S. v. RF Properties of Lake County, Inc.

    433 F.3d 1349 (11th Cir. 2005)   Cited 200 times   3 Legal Analyses
    Holding that Rule 9(b) was satisfied where the relator was a nurse practitioner in the defendant's employ who was required to bill under a doctor's provider number and whose conversations about the defendant's billing practices with the office manager formed the basis for the relator's belief that fraudulent claims were actually submitted to the government

  10. United States v. Medco Health Solutions, Inc.

    671 F.3d 1217 (11th Cir. 2012)   Cited 161 times   1 Legal Analyses
    Holding that relator plead compliance certification with particularity by identifying the specific documents and statements alleged to be false, along with who made them, how they were used, and when they were submitted

  11. Rule 8 - General Rules of Pleading

    Fed. R. Civ. P. 8   Cited 157,673 times   196 Legal Analyses
    Holding that "[e]very defense to a claim for relief in any pleading must be asserted in the responsive pleading. . . ."

  12. Rule 9 - Pleading Special Matters

    Fed. R. Civ. P. 9   Cited 39,122 times   321 Legal Analyses
    Requiring that fraud be pleaded with particularity

  13. Section 1320a-7b - Criminal penalties for acts involving Federal health care programs

    42 U.S.C. § 1320a-7b   Cited 1,455 times   316 Legal Analyses
    Prohibiting the solicitation or receipt of "remuneration" in exchange for referrals

  14. Section 1395y - Exclusions from coverage and medicare as secondary payer

    42 U.S.C. § 1395y   Cited 1,303 times   66 Legal Analyses
    Granting the government subrogation rights

  15. Section 1396b - Payment to States

    42 U.S.C. § 1396b   Cited 617 times   5 Legal Analyses
    Setting forth, inter alia, requirements of state Medicaid fraud units

  16. Section 1395ww - Payments to hospitals for inpatient hospital services

    42 U.S.C. § 1395ww   Cited 608 times   35 Legal Analyses
    Providing for a wage-index adjustment

  17. Section 1395c - Description of program

    42 U.S.C. § 1395c   Cited 501 times
    Referring to 42 U.S.C. § 402, 414

  18. Section 1395nn - Limitation on certain physician referrals

    42 U.S.C. § 1395nn   Cited 419 times   134 Legal Analyses
    Approving of compensation rates that " do not exceed fair market value"

  19. Section 1320a - Uniform reporting systems for health services facilities and organizations

    42 U.S.C. § 1320a   Cited 61 times   2 Legal Analyses

    (a) Establishment; criteria for regulations; requirements for hospitals For the purposes of reporting the cost of services provided by, of planning, and of measuring and comparing the efficiency of and effective use of services in, hospitals, skilled nursing facilities, intermediate care facilities, home health agencies, health maintenance organizations, and other types of health services facilities and organizations to which payment may be made under this chapter, the Secretary shall establish by

  20. Section 1395ss - Certification of medicare supplemental health insurance policies

    42 U.S.C. § 1395ss   Cited 35 times
    Requiring Medigap insurers to provide individuals, "before the sale of the policy, an outline of coverage which describes the benefits under the policy . . . on a standard form approved by the State regulatory program or the Secretary (as the case may be) consistent with the 1991 NAIC Model Regulation . . ."

  21. Section 1001.952 - Exceptions

    42 C.F.R. § 1001.952   Cited 130 times   164 Legal Analyses
    Concerning "payment made by a lessee to a lessor"

  22. Section 411.354 - Financial relationship, compensation, and ownership or investment interest

    42 C.F.R. § 411.354   Cited 35 times   53 Legal Analyses
    Defining a financial relationship to include direct or indirect relationships

  23. Section 411.353 - Prohibition on certain referrals by physicians and limitations on billing

    42 C.F.R. § 411.353   Cited 23 times   27 Legal Analyses

    (a)Prohibition on referrals. Except as provided in this subpart, a physician who has a direct or indirect financial relationship with an entity, or who has an immediate family member who has a direct or indirect financial relationship with the entity, may not make a referral to that entity for the furnishing of DHS for which payment otherwise may be made under Medicare. A physician's prohibited financial relationship with an entity that furnishes DHS is not imputed to his or her group practice or

  24. Section 59G-1.010 - Definitions

    Fla. Admin. Code R. 59G-1.010   Cited 19 times
    Defining "Active treatment plan"

  25. Section 411.15 - Particular services excluded from coverage

    42 C.F.R. § 411.15   Cited 15 times

    The following services are excluded from coverage: (a) Routine physical checkups such as: (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening tests, screening pelvic exams, prostate cancer screening tests, glaucoma screening exams, ultrasound screening for abdominal aortic aneurysms (AAA), cardiovascular disease screening tests, diabetes screening tests, a screening

  26. Section 411.351 - Definitions

    42 C.F.R. § 411.351   Cited 9 times   3 Legal Analyses
    Defining "fair market value" and "general market value"

  27. Section 64J-2.011 - Trauma Center Requirements

    Fla. Admin. Code R. 64J-2.011

    (1) The standards for Level I, Level II and Pediatric trauma centers are published in DH Pamphlet (DHP) 150-9, January 2010, Trauma Center Standards, which is incorporated by reference and available from the department, as defined by subsection 64J-2.001(4), F.A.C. Any hospital that has been granted Provisional trauma center status or has been granted a 7 year Certificate of Approval to operate as a verified trauma center at the time this rule is amended must be in full compliance with the revised