United States District Court, N.D. Mississippi, Greenville Division
THE UNITED STATES OF AMERICA ex rel. CANDI SIBLEY PLAINTIFFS
DELTA REGIONAL MEDICAL CENTER DEFENDANT
Emergency Medical Treatment Act, 42 U.S.C. § 1395dd,
requires that hospitals that receive Medicare funds provide
medical treatment to patients who present with emergency
medical conditions and stabilize them before transferring
them to another facility. Candi Sibley claims that on
numerous occasions Delta Regional Medical Center failed to
treat patients with emergency medical conditions before
transferring them to other facilities as EMTALA requires.
False Claims Act, 31 U.S.C. §§ 3729 et.
seq, imposes liability on anyone seeking payment from
the United States government, such as a hospital seeking
Medicare or Medicaid reimbursements, for knowingly submitting
a false or fraudulent claim for that payment. Sibley asserts
that Delta Regional's EMTALA violations, and its failure
to report them to the government, make the subsequent
Medicare and Medicaid reimbursements Delta Regional sought
False Claims Act permits private individuals, such as Sibley,
who know of fraudulent claims to bring an action on the
government's behalf. But the Act provides that even when
a private individual brings that action, the government may
step in and move to dismiss any claims against the defendant.
The question this case presents is what standard the Court
should use to determine whether the government's motion
to dismiss ought to be granted.
Court sets out below, both the text of the False Claims Act
and case law establish that the government's decision to
dismiss a False Claims Act case is one committed to the its
discretion. And even if the government must show that
dismissal is rational related to a valid government purpose,
as Sibley claims it must, the government meets that burden
here. Thus, the United States' motion to dismiss, Doc.
60, should be granted.
Emergency Medical Treatment and Labor Act
Emergency Medical Treatment and Labor Act
("EMTALA") requires that when a patient comes into
a hospital emergency room, the hospital perform a medical
screening to determine if the patient has an emergency
condition. 42 U.S.C.A. § 1395dd(a). If the screening
reveals that the patient has an emergency medical condition,
the hospital must treat the patient until the emergency
condition is stabilized. § 1395dd(b)(1)(A).
the patient is first stabilized and no longer has an
emergency medical condition, the hospital can transfer the
patient to another facility under only two conditions. First,
if the patient, after being informed of the hospital's
EMTALA obligations, requests in writing to be transferred;
and second, when a physician or other qualified medical
person certifies that the medical benefits of transfer
outweigh the risks. § 1395dd(c)(1).
False Claims Act
False Claims Act, in relevant part, imposes liability on
(A) knowingly presents, or causes to be presented, a false or
fraudulent claim for payment or approval;
(B) knowingly makes, uses, or causes to be made or used, a
false record or statement material to a false or fraudulent
(D) has possession, custody, or control of property or money
used, or to be used, by the Government and knowingly
delivers, or causes to be delivered, less than all of that
money or property
(G) knowingly makes, uses, or causes to be made or used, a
false record or statement material to an obligation to pay or
transmit money or property to the Government, or knowingly
conceals or knowingly and improperly avoids or decreases an
obligation to pay or transmit money or property to the
31 U.S.C. § 3729(A)(1). To establish a violation of the
False Claims Act, the plaintiff must show that "(1)
there was a false statement or fraudulent course of conduct;
(2) made or carried out with the requisite scienter; (3) that
was material; and (4) that caused the Government to pay out
money or to forfeit moneys due (i.e. that involved a
claim)." U.S., ex rel. Jamison v. McKesson
Corp., 784 F.Supp.2d 664, 675 (N.D. Miss. 2011) (citing
U.S. ex rel. Longhi v. Lithium Power Tech, Inc., 575
F.3d 458, 467 (5th Gir. 2009)).
False Claims Act permits a private individual, known as a
relator, to "bring a civil action for a violation of
§ 3729 ... in the name of the Government."
Id. § 3730(b). The Government may intervene and
conduct the action itself, or it may decline intervention and
permit the citizen to conduct the action. Id. §
3730(b)(4). Even where the Government does not intervene,
however, it "may dismiss the action notwithstanding; the
objections of the person initiating the action." §
Factual and Procedural Background
previously worked at Delta Regional in its emergency
department. Compl., Doc. 16 at 15 ¶ 57; Declaration of
Candi Sibley, Doc. 45-1, at 1, ¶ 2. During her
employment, she came to believe that Delta Regional was
intentionally failing to provide appropriate emergency care
to individuals who came into Delta Regionil's emergency
room. Declaration, Doc. 45-1 at 4, ¶¶ 8-9. She
employed an outside physician to review Delta Regional's
medical records. The physician identified several potential
EMTALA violations. M at 4-5, ¶ 10 Sibley filed the
present qui tarn action. In her amended complaint
she identifies 52 instances where a Delta Regional failed to
render emergency care as required by EMTALA. Compl., Doc. 16
at 15-35, ¶¶ 58-243 In 44 of those instaices, she
alleges only that the "unstable patient was
inappropriately transferred." Four of the five counts in
the complaint relate to those EMTALA
government elected not to intervene. Notice of Election to
Decline Intervention, Doc. 13. Delta Regional filed a motion
to dismiss. Doc. 34. The Court took notice of a similar False
Claims Act case in the Southern District of Mississippi, also
asserting False Claims Act claims based on EMTALA
violations. The government also declined to intervene
there but was nonetheless considering moving for dismissal.
This Court ordered the government to state whether they
intended to move to dismiss this case. The government
responded by filing the instant motion seeking to dismiss the
first four counts of the complaint. In addition to her response
in opposition to the government's motion, Sibley has also
filed a motion to convert the motion to one for summary
judgment and allow discovery under Rule 56(d). Doc. 74.
Dismissal as of right vs. dismissal for good cause
False Claims Act case, it is the government, not the relator,
who is the injured party. Even when the government declines
to intervene and conduct the case itself, the False Claims
Act gives the government certain powers over the litigation.
These powers include the right to dismiss the case
"notwithstanding the objections of the [relator]."
31 U.S.C. § 3730(c)(2)(A).
government argues that this provision gives it unilateral
power to dismiss any False Claims Act action-if the
government wants to dismiss the case, the government can.
Sibley, however, argues that the government must put forward
some reason that bears a rational relation to a valid
government responds by saying that even if that were true,
there are valid reasons for dismissal here. Namely, the
government asserts that maintaining [his case will interfere
with the Department of Health and Humans Services efforts to
enforce EMTALA; that the case will require the use of scarce
government resources; and finally, that the complaint does
not allege any viable false claims.
section of the False Claims Act at issue here provides that:
The Government may dismiss the action notwithstanding the
objections of the person initiating the action if the person
has been notified by the Government of the filing of the
motion and the court has provided the person with an
opportunity for a hearing on the motion.
31 U.S.C. § 3730(c)(2)(A). Courts agree that it is
unnecessary for the government to formally intervene before
moving to dismiss. United States v. Everglades Coll,
Inc., 855 F.3d 1279, 1286 (11th Cir. 2017) (citing
Ridenour v. Kaiser-Hill Co., 397 F.3d 925, 933 (10th
Cir. 2005)). Courts are split, however, on whether this
statute permits the government to unilaterally dismiss
qui tarn actions brought under the False Claims Act
without reason, or whether the United States must show that
dismissal serves a valid government purpose. Compare
Swift v. United States, 318 F.3d 250, 252 (D.C. Cir.
2003) with U.S. ex rel, Sequoia Orange Co. v. Baird-Neece
Packing Corp., 151 F.3d 1139, 1145 (9th Cir. 1998).
United States argues that the Fifth Circuit would adopt the
D.C. Circuit's reasoning in Swift and hold that
the United States may dismiss this case without first showing
good cause supports dismissal. Sibley argues that the Court
should use the Ninth Circuit's Sequoia Orange
standard. Beyond that, she asserts that the Swift
standard is inapplicable once the defendant has been
served. Thus, the Court sets out to determine when the
government may dismiss a qui tarn False Claims Act
Ninth Circuit first considered this question in U.S. ex
rel, Sequoia Orange Co. v. Baird-Neece Packing Corp.,
151 F.3d 1139 (9th Cir. 1998). The dispute there arose out of
alleged violations of prorate restrictions and reporting
requirements on marketing orders for navel and Valencia
oranges. Id. at 1141. After protracted litigation,
the USDA amended its citrus industry policies and decided to
no longer enforce the statutes and regulations the defendants
had violated. To that end, the government moved to dismiss
all of the pending False Claims Act cases premised on
violations of those regulations. Id. at 1142. The
district court granted the motion, and in doing so, held that
the government must identify a valid government purpose and
show a rational relationship between that purpose and
dismissal. Id. at 1145 (citing U.S. ex rel.
Sequoia Orange Co. v. Sunland Packing House Co., 912
F.Supp. 1325, 1341 (E.D. Cal. 1995)).
appeal, the Ninth Circuit first determined that §
3730(c)(2)(A) did not identify a standard to apply.
Id. They reasoned that the district court's
standard was reasonable because it conformed with the notion
that the government must not act i arbitrarily. Id.
at 1145. Further, the Ninth Circuit gave weight to a Senate
report on the statute which "explained that relators may
object if the government moves to dismiss without
reason." Id. (citing S. Rep. No. 99-345, at 26
(1986)). Finally, they dismissed any separation of powers
concerns by holding that standard applied was no greater than
"mandated by the Constitution itself." Id.
at 1146. Thus, the standard did not impermissible require
judicial approval over executive authority. Id. at
in Swift v. United States, 318 F.3d 250 (D.C. Cir.
2003), the D.C. Circuit considered whether a lower court was
correct in applying the Sequoia Orange rational
relationship standard. The Court held the rational
relationship test was incorrect, and that the government
possesses "an unfettered right to dismiss a [qui
tarn] act on." 318 F.3d at 252.
D.C. Circuit first started with statute's text, noting
that the statute appears to give the executive the power to
dismiss unilaterally: "The section states that 'The
Government'-meaning the Executive Branch, not the
Judicial-'may dismiss the action, '. . . suggests the
absence of judicial constraint." Id. (quoting
§ 3730(c)(2)(A)). The court also equated a motion to
dismiss in this context with a decision not to prosecute,
which was "a decision generally committed to [the
government's] absolute discretion." Id. at
253 (quoting Heckler v. Chaney, 470 U.S. 821,
831-33, 105 S.Ct. 1649, 1655-57, 84 L.Ed.2d 714 (1985)
(alteration in original)). The court discounted the Senate
Report cited by the Ninth Circuit, noting that that report
concerned an unenacted version of the Act. Id.
Finally, the D.C. Circuit concluded that the requirement that
the Court provide the relator with an "opportunity for
hearing" did not impose judicial oversight. Instead, it
was intended to "give the relator a formal opportunity
to convince the government not to end the case. Id.
motion will not be converted to one for summary judgment.
addition to outright opposing the government's motion to
dismiss, Sibley also seeks to convert it to a motion for
summary judgment. She contends this is appropriate because
all parties have ...