AI Case Brief
Generate an AI-powered case brief with:
đKey Facts
âïžLegal Issues
đCourt Holding
đĄReasoning
đŻSignificance
Estimated cost: $0.10â$0.50 per brief, depending on opinion length and retries
Full Opinion
MEMORANDUM OPINION AND ORDER GRANTING SUMMARY JUDGMENT TO DEFENDANT, UNITED STATES OF AMERICA JOHNSON, United States Magistrate Judge. This matter is before the Court upon cross-motions for summary judgment *655 (DE# 14, 18). The parties have consented to final disposition before the Magistrate Judge. Having carefully considered the entire record, including the Motions (DE# 14, 18) with supporting memoranda (DE# 16, 19), Affidavit (DE# 15), Responses (DE#20, 21), and Replies (DE# 23, 24), the undersigned Magistrate Judge finds as follows: I. Facts and Procedural History Plaintiff, Dr. J. Hilton Brooks, III, was on the active medical staff at Pineville Community Hospital as a physician and was a member of the hospitalâs âquality assurance committeeâ. After the death of a patient, certain concerns were raised at the hospital. While carrying out his committee duties, Dr. Brooks discovered what he determined to be numerous billing improprieties by Pineville Community Hospital and two physicians, Dr. Jerry L. Woo-lum and Dr. Talmadge Hays. Rather than correcting the improprieties, the hospital rebuffed Dr. Brookâs efforts and subjected him to a variety of retaliatory abuses 1 . Dr. Brooks persevered, and through counsel, filed a lawsuit on behalf of the United States under the False Claims Act, asserting that Pineville Community Hospital, Dr. Jerry L. Woolum, and Dr. Tal-madge Hays had submitted fraudulent Medicare and Medicaid billings to the government for payment. Initially, the United States declined to intervene. Plaintiff litigated the FCA action through discovery and to a scheduled trial date, when the United States then opted to enter the case 2 . See DE# 1, Exh. 1. Rather than proceed to trial, defendants agreed to pay a total of $2.5 million dollars to settle the FCA action for fraudulent billing. In a written settlement agreement (# 1) signed on April 18, 1995, defendants expressly admitted that from 1986 to 1995, they had âviolated regulations governing Medicare, Medicaid, Federal Black Lung, UMWA Health and Welfare, and CHAM-PUS programs in Kentucky relating to payments for authorized procedures and examinations.â See DE# 1, Exh. 2, ¶ 1. The settlement agreement also required the defendants to undergo mandatory training in proper billing procedures for Medicare and Medicaid. The settlement agreement indicated that the defendants were paying the agreed amount of $2.5 million âin full financial settlement and satisfaction of all monetary claims... arising out of the factual scenario alleged in the Amended Complaint.â DE# 1, Exh. 2, ¶ 3. On April 19,1995, the court approved the settlement agreement and granted Dr. Brooks a relatorâs award of 25% of the recovery. DE# 1, Exh. 5. The settlement agreement specified that the qui tam award would be 25% of the net settlement amount remaining after payment of attorney fees and reimbursable costs of the FCA action. The net dollar amount of the qui tam award was $210,067.30, which resulted in income tax of $78,607.00. See DE# 16, p. 4-5; and see DE# 1, Exh. 8. The calculation of the *656 net amount of the qui tam award is not at issue here. In addition, a separate settlement agreement (#2) was signed, setting forth that âit is the desire of Dr. Brooks, the Defendants and Dr. Rader and Dr. Morgan to settle and discharge absolutely all possible claims which might exist between Dr. Brooks and any or all of the Defendants or Dr. Rader or Dr. Morgan upon the terms and conditions set forth herein.â DE# 1, Exh. 4, p. 1-2. The defendant hospital agreed, as part of this separate settlement agreement, to pay Dr. Brooks the sum of $300,000.00 for âdamages received on account of alleged personal injuries within the meaning of Section 104(a)(2)...â See DEI, Exh. 4, ¶ 1. The document further indicates that in consideration of such sum, Dr. Brooks was releasing the defendant hospital, Dr. Woolum, Dr. Hayes, and two other doctors from any claims, including retaliation and defamation, against them. DE# 1, Exh. 4, ¶ 2. The hospital agreed to withdraw all claims against Dr. Brooks in the pending peer review. DE# 1, Exh. 4, ¶ 5. Dr. Brooks timely paid federal $78,607.00 in income taxes on the relator award as part of his 1995 income. The separate settlement award of $300,00.00 in compensatory damages for âpersonal injuriesâ was excluded from income, with full disclosure to the I.R.S, which approved such exclusion under 26 U.S.C. § 104 (a)(2). Dr. Brooks thereafter timely filed Form 1040X for a refund of the $78,607.00 tax he paid on the relator award, asserting that the net amount of the relator award should also be excludable from income under § 104(a)(2). On November 4, 1999, the I.R.S. disallowed Dr. Brooksâ claim for refund on the ground that the qui tam relator award was a ârewardâ, and thus, was taxable income. DE# 1, Exh. 9. Dr. Brooks timely filed an administrative appeal, which the I.R.S. denied on October 12, 2001. DE# 1, Exh. 10, 11. On October 31, 2001, Dr. Brooks filed the present federal action, seeking a refund of the income tax he had paid on the qui tam relator award. II. Issues Presented The main issue is whether, for purposes of federal income taxation, the qui tam relator award that plaintiff received upon settlement of the FCA action is excludable from income pursuant to 26 U.S.C. § 104 (a)(2). III. Procedural Analysis Jurisdiction âAlthough a taxpayer must first pay the amount in dispute, he may contest his tax liability by way of a refund suit in the appropriate district court or in the Court of Federal Claims.... â Barlow v. Commissioner of Internal Revenue, 301 F.3d 714, 720 (6th Cir.2002). Such jurisdiction is based upon 28 U.S.C. § 1346 (a)(1), which provides that federal district courts have original jurisdiction, concurrent with the United States Court of Federal Clams, of: âAny civil action against the United States for the recovery of any internal-revenue tax alleged to have been erroneously or illegally assessed or collected, or any penalty claimed to have been collected without authority or any sum alleged to have been excessive or in any manner wrongfully collected under the internal-revenue laws.â Burden The party claiming the tax exemption bears the burden of establishing his entitlement to the exemption based on a specific provision of the tax code. See Abrahamsen v. United States, 228 F.3d 1360, 1363 (C.A.Fed.2000), (citing United States v. Janis, 428 U.S. 433, 440-41 , 96 S.Ct. 3021 , 49 L.Ed.2d 1046 (1976)). In *657 the present case, Dr. Brooks bears the burden of showing that, for purposes of federal income taxation, his qui tam relator award is excludable from income pursuant to 26 U.S.C. § 104 (a)(2). Both the plaintiff taxpayer and the defendant United States have moved for summary judgment. Standard for Summary Judgment Summary judgment is appropriately granted pursuant to Fed. Rule Civ. P. 56(c) when there is no genuine issue as to any material fact, and thus, upon the established facts, the moving party is entitled to judgment as a matter of law. See Terry Barr Sales Agency, Inc. v. All-Lock Co., 96 F.3d 174, 178 (6th Cir.1996). The movant bears the burden of clearly establishing the lack of any triable issue of fact by the record properly before the court, and supporting evidentiary material must be construed most favorably to the non-moving party. See Celotex Corp. v. Catrett, 477 U.S. 317, 323 , 106 S.Ct. 2548 , 91 L.Ed.2d 265 (1986). Entry of summary judgment is appropriate âagainst a party who fails to make a showing sufficient to establish the existence of an element essential to that partyâs case, and on which that party will bear the burden of proof at trial.â Celotex, 477 U.S. at 322 , 106 S.Ct. 2548 ; Morgan v. Utica Mutual Insurance Co., 229 F.3d 1153 , 2000 WL 1276755 , *2 (6th Cir.2000). The party seeking summary judgment bears the initial burden of identifying the portion of the record which demonstrates that there is no genuine issue of material fact, and the non-moving party must thereafter produce specific facts demonstrating that a genuine issue of material fact exists. Anderson v. Liberty Lobby, Inc. 477 U.S. 242, 247-248 , 106 S.Ct. 2505 , 91 L.Ed.2d 202 (1986). âA dispute about a material fact is genuine only if the evidence is such that a reasonable jury could return a verdict for the nonmoving party.â Bauer v. Montgomery, 215 F.3d 656 (6th Cir.2000), quoting Anderson, 477 U.S. at 248 , 106 S.Ct. 2505 . Cross-motions for summary judgment âauthorize the court to assume that there is no evidence which needs to be considered other than that which has been filed by the parties.â Greer v. United States, 207 F.3d 322, 326 (6th Cir.2000), quoting Harrison Western Corp. v. Gulf Oil Co., 662 F.2d 690, 692 (10th Cir.1981). IV. Substantive Analysis In determining whether there are any genuine issues of material fact with respect to this claim for tax refund, it is noted that the basic facts regarding the circumstances of the underlying FCA action, the terms of the two settlement agreements, and the pertinent amount of income tax at stake are not disputed. The issue here is whether the 25% qui tam relator award is ânon-taxable compensationâ for personal injuries, as argued by the taxpayer, or is âtaxable incomeâ, as argued by the United States. The Internal Revenue Code defines gross income as âall income from whatever source derived.â 26 U.S.C. § 61 (a). Exclusions from gross income are narrowly construed. United States v. Burke, 504 U.S. 229, 248 , 112 S.Ct. 1867, 1878 , 119 L.Ed.2d 34 (1992); Commissioner of Internal Revenue v. Schleier, 515 U.S. 323, 327-28 , 115 S.Ct. 2159, 2163 , 132 L.Ed.2d 294 (1995). Dr. Brooks argues that the net amount of his relator award should be excluded from income under § 104(a)(2). The version of 26 U.S.C. § 104 (a)(2) in effect in 1995, and applicable here, provides that: â... gross income does not includeâ (2) the amount of any damages received (whether by suit or agreement and whether as lump sums or as periodic payments) on account of personal injuries or sickness...â *658 The rationale underlying such exclusion is the âhuman capitalâ principle. The Supreme Court has explained that such principle derives from several early cases that established âthat a restoration of capital was not income.â OâGilvie v. United States, 519 U.S. 79, 84 , 117 S.Ct. 452 , 136 L.Ed.2d 454 (1996), citing Doyle v. Mitchell Bros. Co., 247 U.S. 179, 187 , 38 S.Ct. 467 , 62 L.Ed. 1054 (1918) and Southern Pac. Co. v. Lowe, 247 U.S. 330, 335 , 38 5.Ct. 540, 62 L.Ed. 1142 (1918). âThe statute that eventually became § 104(a)(2) resulted from an extension of the restoration of capital principle to personal injuries .... a recovery for personal injury âmerely take[s] the place of capital in human ability which was destroyed by the accident.ââ OâGilvie, 519 U.S. at 85-86 , 117 S.Ct. 452 , citing 31 Op. Atty. Gen. 304, 308 (1918)(recovery of damages for personal injury âaim[s] to substitute for a victimâs physical or personal well-being â personal assets that the Government does not tax and would not have taxed had the victim not lost them.â). Hence, damages for personal injury are excluded from income because they are compensatory, that is, they are intended to make the person âwholeâ. 3 The Supreme Court has interpreted the term âpersonal injuriesâ to include physical and non-physical injuries. Schleier, 515 U.S. at 330 , 115 S.Ct. at 2164 (â § 104(a)(2) encompasses recoveries based on intangible as well as tangible harmsâ), citing Burke, 504 U.S. at 235, n. 6 , 112 S.Ct. at 1871, n. 6 ; and see, Burke, 504 U.S. at 244, n. 3 , 112 S.Ct. at 1876, n. 3 (the term âpersonal injuries or sicknessâ includes nonphysical injuries). The implementing Treasury regulation, 26 C.F.R. § 1.104 -l(c) (1994), provides that: âSection 104(a)(2) [of the Internal Revenue Code] excludes from gross income the amount of any damages received (whether by suit or agreement) on account of personal injuries or sickness. The term âdamages received (whether by suit or agreement)â means an amount received (other than workmenâs compensation) through prosecution of a legal suit or action based upon tort or tort type rights, or through a settlement agreement entered into in lieu of such prosecution.â (Italic added). In determining âexcludabilityâ, the United States Supreme Court has held that: â...the plain language of § 104(a)(2), the text of the applicable regulation, and our decision in Burke establish two independent requirements that a taxpayer must meet before a recovery may be excluded under § 104(a)(2). First, the taxpayer must demonstrate that the underlying cause of action giving rise to the recovery is âbased upon tort or tort type rightsâ; and second, the taxpayer must show that the damages were received âon account of personal injuries or sicknessâ.â Schleier, supra, 515 U.S. at 336-337 , 115 S.Ct. at 2167 , citing Burke, 504 U.S. 229 , 112 S.Ct. at 1871 (finding amount not excludable from income because underlying claim was not based on tort or tort-type rights). The characterization of damages and their excludability under § 104(a)(2) has resulted in frequent litigation. See H.R. Conf. Rep. No. 104-737, at 300, reprinted in 1996 U.S.C.C.A.N. 1677; H.R.Rep. No. 104-586, at 142-43 (âThe confusion as to the tax treatment of damages received in cases not involving physical injury or physical sickness has led to substantial litigationâ). To address this problem, Congress *659 amended § 104(a)(2) in 1996 to read âon account of personal âąphysical injuries or physical sickness.â (italics added). See, Young v. United States, 2001 WL 1480296 , *2 (W.D.Ky.2001)(âAccording to the legislative history that accompanies the [1996] amendments to § 104(a)(2), the Congress sought to establish a uniform policy regarding taxation of damages awards and prevent, or at least reduce, litigation regarding the question of whether or not damage awards were taxableâ). However, such amended version does not apply to the present case. Dr. Brooks was granted his qui tam relator award in 1995, prior to the 1996 amendment, and his counsel correctly argues that the tax statute in effect at the time of the qui tam award should apply. See Greer v. United States, 207 F.3d 322, 328 (6th Cir.2000)(holding that âbecause the amendment took effect after AOI and Greer executed their agreement, it is not applicable to this caseâ). Dr. Brooks, through counsel, asserts that âduring, and by reason of, his prosecution of the FCA case, Dr. Brooks suffered substantial personal injury arising from, but not limited to, defamation of his business reputation and stress-related emotional and physical injuriesâ. DE# 1, p. 2, ¶ 10. Plaintiff contends that the underlying FCA action was âa tort or tort-likeâ and that his 25% qui tam relator award derived from the settlement of such claim thus constitutes âdamages received ... on account of personal injuries or sicknessâ within the meaning of 26 U.S.C. § 104 (a)(2). As to whether the underlying cause of action giving rise to the recovery is âbased upon tort or tort type rightsâ, the Supreme Court has recognized that a primary characteristic of tort actions is the availability of compensatory damages. Schleier, 515 U.S. at 324, 335 , 115 S.Ct. at 2161, 2166-2167 ; Burke, 112 S.Ct. at 1871 (âone of the hallmarks of traditional tort liability is the availability of a broad range of damages to compensate the plaintiff...â). The primary purpose of the FCA is to ensure that the United States gains restitution of money fraudulently obtained from it. U.S. ex rel. Marcus v. Hess, 317 U.S. 537, 551-52 , 63 S.Ct. 379 , 87 L.Ed. 443 (1943); U.S. ex rel. Compton v. Midwest Specialties, Inc., 1995 WL 811966 (N.D.Ohio 1995), aff'd 142 F.3d 296 (6th Cir.(Ohio)1998). The purpose of the FCA is largely remedial, that is, âto compensate the UnitĂ©d States for the fraudulent billing in order to make the United States âwholeâ.â Hammond v. Northland Counseling Center, Inc. 218 F.3d 886, 892 (8th Cir.2000). Even assuming that the FCA action for fraudulent billing was âa tort or tort-likeâ, it was a tort upon the United States, not the relator himself. The âtortâ upon the relator is essentially âretaliationâ, which is separately compensated under § 3730(h) of the FCA. Section 3730(h) provides: âAny employee who is discharged, demoted, suspended, threatened, harassed, or in any other manner discriminated against in the terms and conditions of employment by his or her employer because of lawful acts done by the employee on behalf of the employee or others in furtherance of an action under this section, including investigation for, initiation of, testimony for, or assistance in an action filed or to be filed under this section, shall be entitled to all relief necessary to make the employee whole. Such relief shall include reinstatement with the same seniority status such employee would have had but for the discrimination, 2 times the amount of back pay, interest on the back pay, and compensation for any special damages sustained as a result of the discrimination, *660 including litigation costs and reasonable attorneysâ fees. An employee may bring an action in the appropriate district court of the United States for the relief provided in this subsection.â The FCAâs âwhistleblowerâ provision expressly provides compensation for general and special damages sustained by the relator. Neal v. Honeywell Inc., 191 F.3d 827, 831-32 (7th Cir.l999)(holding that compensation for emotional distress caused by an employerâs retaliatory conduct is available under 31 U.S.C. § 3730 (h)). Such compensation is in accordance with the FCAâs requirement under 31 U.S.C. § 3730 (h) that the whistle-blowing employee âbe entitled to all relief necessary to make the employee whole.â Hammond, 218 F.3d at 892-93 . Damages under § 3730(h) are intended to compensate the employee for harm caused by retaliation, such as harassment and discharge, and are not a substitute for the separate relatorâs award that such employee might obtain in the qui tarn action. Neal v. Honeywell Inc., 33 F.3d 860, 865 (7th Cir.1994). âSection 3730(h), added to the False Claims Act in 1986, is designed to protect persons who assist the discovery and prosecution of fraud...â Id. at 861 . Thus, while the action for fraudulent billing is intended to make the United States âwholeâ, âthe overarching purpose of... .[ 31 U.S.C. § 3730 (h) ] is.... to provide an aggrieved plaintiff with complete compensation for any injuries incurred as a result of the employerâs retaliatory conduct, namely âall relief necessary to make the employee wholeâ.â Hammond, 218 F.3d at 892 . The existence of two separate settlements illustrates this point. Settlement # 2 expressly indicates that it is intended to compensate for Dr. Brooksâ claimed personal injuries, whereas settlement # 1 was intended to compensate the United States for the fraudulent billing asserted in the amended complaint. The amount paid to Dr. Brooks under settlement #2 has already been appropriately excluded from income under 26 U.S.C. § 104 (a)(2). Although plaintiff argues that his relator award should also be deemed âcompensatory damagesâ on account of personal injury based on tort or tort type rightsâ, the 25% relator award was derived from settlement of fraudulent billing upon the United States, not a tort upon the relator that resulted in personal injury. Claims regarding any torts upon the relator, and any resulting personal injury, were settled separately (in settlement #2) with compensatory damages of $300,00.00. Review of the two settlements reflects that the intent of the payor in making two separate settlements was to settle the claims of fraudulent billing against the United States in one and the personal claims of Dr. Brooks in the other. The fact that Dr. Brooks was granted a statutory percentage of the United Statesâs settlement for his contribution to the prosecution does not transform such recovery into one âon account of personal injuriesâ. See e.g., Cook v. United States, 243 F.3d 561 , 2000 WL 1471620 (Fed.Cir.)(granting summary judgment to United States and denying claim for tax refund, because amount received in settlement âwas not designed to compensate for her specific injuriesâ); Reisman v. Commissioner of Internal Revenue, 3 Fed. Appx. 374 , 2001 WL 111616 (6th Cir.)(finding taxpayer not entitled to exclusion because, even if underlying claim was a tort, the settlement was not âon account of personal injuryâ). The United States asserts that a relator award is a ârewardâ for the relatorâs contribution to a successful prosecution of an FCA action for fraud upon the government, rather than a settlement of claims for the relatorâs personal injuries. The language of the statute itself supports such interpretation. The FCA, in Section § 3730(d)(1), provides in relevant part: âIf *661 the Government proceeds with an action brought by a person under subsection (b), such person shall, subject to the second sentence of this paragraph, receive at least 15 percent but not more than 25 percent of the proceeds of the action or settlement of the claim, depending upon the extent to which the person substantially contributed to the prosecution of the actionâ. (Italics added). The False Claims Act (FCA) was originally enacted in response to defrauding of the federal government by suppliers during the Civil War, and in more recent times, by the rampant defrauding of the government by defense contractors. See Rep. No. 99-345, 99th Cong. 2nd Sess. (1986). The legislative history indicates that the qui tam provisions are intended âto encourage private individuals who are aware of fraud being perpetrated against the Government to bring such information forward.â H.R. Rep. 660, 99th Cong., 2nd Sess. 23 (1986); see also, e.g., U.S. ex rel. Roby v. Boeing Co., 995 F.Supp. 790 (S.D.Ohio 1998). This supports the characterization of the relator award as a ârewardâ. The qui tam provisions of the FCA enable private individuals to sue in the name of the United States and to share in any proceeds recovered. In re Schimmels, 85 F.3d 416 (9th Cir.1996). The express language of the separate settlement agreements indicates what claims were settled by each agreement. See DE# 1, Exh. 2, ¶ 8. Settlement agreement # 1 expressly indicated that the defendants were paying the agreed amount of $2.5 million to the United States âin full financial settlement and satisfaction of all monetary claims... arising out of the factual scenario alleged in the Amended Complaint.â DE# 1, Exh. 2, ¶ 3. Settlement agreement # 2 expressly indicated that the defendants were paying the agreed amount of $300,000.00 to Dr. Brooks because âit is the desire of Dr. Brooks, the Defendants and Dr. Rader and Dr. Morgan to settle and discharge absolutely all possible claims which might exist between Dr. Brooks and any or all of the Defendants or Dr. Rader or Dr. Morgan upon the terms and conditions set forth herein.â DE# 1, Exh. 4, p. 1-2. The defendant hospital agreed to pay Dr. Brooks the sum of $300,000.00 for âdamages received on account of alleged personal injuries within the meaning of Section 104(a)(2)...â See DEI, Exh. 4, ¶1. The document further indicates that Dr. Brooks was releasing the defendant hospital, Dr. Woolum, Dr. Hayes, and two other doctors from any claims, including retaliation and defamation, against them. DE# 1, Exh. 4, ¶ 2, 5. â[I]t is the nature of the settled claim itself which controls whether any of the settlement constituted compensation for a torttype personal injury.â Metzger v. Commissioner, 88 T.C. 834, 847 , 1987 WL 49302 (1987), aff'd, 845 F.2d 1013 (3rd Cir.1988); Glynn v. Commissioner, 76 T.C. 116, 119 , 1981 WL 11320 (1981), aff'd, 676 F.2d 682 (1st Cir.1982). A claim for fraudulent billing under the False Claims Act includes the following elements: (1) the defendants made a claim against the Government; (2) the claim was false or fraudulent; and (3) the defendants knew the claim was false or fraudulent. 31 U.S.C.A. § 3729 ; and see, United States v. Southland Management Corp., 288 F.3d 665 (5th Cir.2002). Personal injury to the relator is not an element of such cause of action, nor are any compensatory damages for such claim calculated on the basis of personal injury. The amount the United States received under settlement # 1 was paid in compromise of the fraudulent billing claims. The relatorâs award derived from that settlement was statutorily provided as a reward for the relatorâs contribution to the FCA action, rather than an amount received in *662 compromise of his own claim for personal injuries. See Alexander v. I.R.S., 72 F.3d 938, 942 (1st Cir.1995) (âamounts received in compromise of a claim must be considered as having the same nature as the right compromisedâ); Riley v. St. Lukeâs Episcopal Hosp., 252 F.3d 749, 769 (5th Cir.2001)(discussing the type of claim pursued by a relator in an FCA action, in which a private citizen sues âto vindicate an injury to the government and is rewarded with a share of the recoveryâ). Significantly, the FCA provides for the award of separate damages for retaliation suffered by the whistleblower, and Dr. Brooks did in fact receive a separate settlement of $300,000.00 for damages due to his own personal injuries. The parties discuss Greer v. United States, 207 F.3d 322, 325 (6th Cir.2000) at length. There, Ashland had fired its environmental compliance officer (Greer) for truthfully reporting environmental violations. In lieu of litigating a wrongful discharge action (a tort under state law), it paid Greer a large amount over and above the usual amount of severance pay. Ash-land withheld taxes from the entire settlement amount. In 1996, Greer filed for a tax refund, arguing that the settlement proceeds were excludable from income pursuant to 26 U.S.C. § 104 (a)(2). In reviewing the grant of summary judgment to the defendant, the Sixth Circuit Court of Appeals held that the additional payment beyond the usual severance pay was in lieu of the taxpayerâs wrongful discharge claim, but remanded to determine whether such payment was actually made âon account of personal injuriesâ. Such case is readily distinguishable from the present case because, even assuming that Dr. Brooks suffered personal injury in pursuing the FCA action, the record reflects that no part of the payment under settlement # 1 was âon account of such personal injuriesâ. The settlement of the FCA claims was based on the amount of the false medical billing. Nothing in the record suggests that the amount of settlement # 1 ($2.5 million) was calculated, based on, or âon account ofâ, any individual injuries of Dr. Brooks. The claims of fraudulent billing and the amount of settlement # 1 were not dependent on the existence or extent of any personal injuries to Dr. Brooks. See Schleier, 515 U.S. at 330 , 115 S.Ct. 2159 ; see also, e.g., Abrahamsen v. United States, 228 F.3d 1360, 1363 (C.A.Fed.2000)(finding settlement payment was not due to âpersonal injuryâ). The 25% relator award paid to Dr. Brooks out of settlement # 1 was not âon account ofâ his personal injury, but rather, was a reward for his contribution to the FCA action. His âcontributionâ to the action is not the fact that he undoubtedly suffered stress and retaliation in pursuing the action, but rather, the value of the information and other assistance he provided to the prosecution of the case. The relatorâs personal injuries, such as emotional distress and stress-related physical injury, were separately compensated. Plaintiff alternatively argues that a portion of his relator award may be deemed compensation for âpersonal injuriesâ under the version of 26 U.S.C. § 104 (a)(2) in effect in 1995 and that a genuine issue of material fact exists as to what portion of the relator award is excludable from income. Plaintiff asserts that, in cases where the government has intervened 4 , *663 the False Claims Act allows the court to award the relator from 15% to 25% of the settlement amount. The plaintiff points to several cases from other circuits where courts awarded the maximum 25% relator award and indicated that the whistleblower plaintiff had suffered âpersonal expenseâ in pursuing the case. Plaintiff argues that the relator award was therefore âon account of personal injuriesâ suffered in pursuing the FCA action. However, as already discussed, the fact that the relator suffered stress and personal expense in connection with his pursuit of the FCA action does not mean that settlement # 1, or the relator award derived from settlement # 1, were âon account of personal injuriesâ. Most plaintiffs suffer significant stress and expense in pursuing legal actions, but such fact does not transform the nature of the action into one based on personal injuries. Under the plain language of the statute, the relator is rewarded with a percentage of the settlement with the United States due to his contribution to the action. See e.g., United States v. Blue Cross and Blue Shield of Florida, 882 F.Supp. 166 (1995)(âthe maximum recovery is reserved for situations where the relator actively and uniquely aids the government in the prosecution of the case.â). The defendant hospital paid $2.5 million to the United States under settlement # 1 in order to resolve claims that it had fraudulently billed the United States. Dr. Brooks received a statutory 25% relatorâs award from such proceeds for his contribution to the prosecution. The defendant hospital separately paid $300,000.00 to Dr. Brooks under settlement #2 in order to resolve claims of personal injury by Dr. Brooks. Hence, the relator award is not subject to exclusion under § 104(a)(2). Accordingly, It is ORDERED that: a) the âMotion for Partial Summary Judgmentâ (DE#14) by plaintiff is DENIED; b) the âMotion for Summary Judgmentâ (DE# 18) by defendant is GRANTED. A separate Judgment will enter on this date. 1 . The record reflects that Dr. Brooks was pressured to cease investigating the fraudulent billing practices and to relocate his practice elsewhere. He was threatened with loss of clinical privileges, was reviewed "unfavorablyâ, was advised by the hospital administrator that the Executive Committee has recommended that he not be reappointed to medical staff, and was criticized by defendants in the hospital newsletter for his purportedly âdisruptive attitudeâ. 2 . 31 U.S.C.A. § 3730 (c)(3) provides in relevant part: "If the Government elects not to proceed with the action, the person who initiated the action shall have the right to conduct the action.the court... may nevertheless permit the Government to intervene at a later date upon a showing of good cause.â 3 . Punitive damages are not awarded "on account of personal injuries or sicknessâ, and are not excludable. OâGilvie, 519 U.S. at 79 , 117 S.Ct. 452 ; Srivastava v. C.I.R., 220 F.3d 353, 356 (5th Cir.2000). 4 . Although the plaintiff does not concede that the "government proceededâ with the action in the underlying FCA action, and hence, disputes that his relator award was made pursuant to § 3730(d)(1), rather than § 3730(d)(2), such distinction is not "materialâ to the present action for tax refund. In any event, the record reflects that the government did intervene. "[T]he mere existence of some alleged factual dispute between the parties will not defeat an otherwise properly supported mo *663 tion for summary judgment; the requirement is that there be no genuine issue of material fact." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 , 106 S.Ct. 2505 (1986)(italics in original). Section § 3730(d)(1) provides in relevant part: "If the Government proceeds with an action brought by a person under subsection (b), such person shall, subject to the second sentence of this paragraph, receive at least 15 percent but not more than 25 percent of the proceeds of the action or settlement of the claim, depending upon the extent to which the person substantially contributed to the prosecution of the action.Any payment to a person under the first or second sentence of this paragraph shall be made from the proceeds. Any such person shall also receive an amount for reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorneys' fees and costs. All such expenses, fees, and costs shall be awarded against the defendantâ. Section § 3730(d)(2) provides that: "If the Government does not proceed with an action under this section, the person bringing the action or settling the claim shall receive an amount which the court decides is reasonable for collecting the civil penalty and damages. The amount shall be not less than 25 percent and not more than 30 percent of the proceeds of the action or settlement and shall be paid out of such proceeds. Such person shall also receive an amount for reasonable expenses which the court finds to have been necessarily incurred, plus reasonable attorneys' fees and costs. All such expenses, fees, and costs shall be awarded against the defendant... â
Case Information
- Court
- E.D. Ky.
- Decision Date
- March 11, 2003
- Status
- Precedential