Attorneys for Life Care Centers of America are seeking a direct appeal to the Sixth Circuit Court of Appeals on a key issue in the case in which the federal government is seeking millions of dollars in reimbursements, plus treble damages, against the Cleveland, Tn.,-based firm.
The attorneys want to appeal a decision by Federal Judge Sandy Mattice that would allow the testimony of statistician Constantin T. Yiannoutsos.
The suit says the government brings the False Claims Act action against Life Care Centers of America, Inc. "to recover millions of dollars that Life Care caused the Medicare and TRICARE programs to pay for services that were not covered by the skilled nursing facility benefit, that were not medically reasonable and necessary, and that were not skilled in nature."
The government entered the case after two whistle blower lawsuits were filed in federal court in Chattanooga in 2008.
Attorneys for Life Care said, "The Government’s complaint identifies alleged claims for payment in violation of the FCA for services Life Care provided to 10 patients. But, the Government does not intend to prove liability and damages for only claims connected to those 10 patients. Rather, it contends that it will conduct its own medical review of claims for payment relating to a sample of 400 admissions of patients who received services at approximately 80 Life Care facilities to determine how many of those claims sought payment for medically unnecessary and unreasonable services - i.e., how many claims the Government intends to prove were “false” under the FCA."
Judge Mattice ruled after earlier hearing testimony from Mr. Yiannoutsos.
The judge said, "Based on the reports submitted, the Court finds that Dr. Yiannoutsos is an expert proposing to testify as to scientific knowledge of statistics, which will ultimately assist the trier of fact to determine facts at issue. See Fed. R. Civ. P. 104(a); United States v. Jones, 107 F.3d 1147, 1152 (6th Cir. 1997). The number of claims and the loss associated with those claims are certainly facts of consequence in this action, even if they are not specific elements under the FCA. These facts indicate the size and scope of the Government’s case, which further supports them being deemed relevant. Accordingly, consistent with Daubert, the Court finds that the proposed testimony and evidence is relevant to the instant case and would be helpful to the fact finder. As the Court has now concluded that Dr. Yiannoutsos’ testimony is both reliable and relevant, defendant's motion will be denied."
At the same time, Judge Mattice signed an order dismissing all claims in the suit against Forrest L. Preston, Angelina Y. Clayton, Stephen J. Zeigler, Hunter Beecham, Ivy Sinisi, Terry Kilowski, Winnie Lim Ventulan, Terry Kocher and Kathryn McCarten.