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Nature of Suit Code: 890
Nature of Suit: Other Statutory Actions
Cause of Action: 

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United States Court of Appeals

FOR THE DISTRICT OF COLUMBIA CIRCUIT

Argued November 1, 2002 Decided February 7, 2003

No. 01-5265

UNITED STATES OF AMERICA EX REL. MARY R. HAMPTON,

APPELLANT

UNITED STATES OF AMERICA,

APPELLEE

v.

COLUMBIA/HCA HEALTHCARE CORP., ET AL.,

APPELLEES

Appeal from the United States District Court

for the District of Columbia

(99cv03294)

Mike Bothwell argued the cause for appellant. With him

on the briefs was G. Mark Simpson.

Michael D. Granston, Attorney, U.S. Department of Justice, argued the cause for appellee United States of America.

 Bills of costs must be filed within 14 days after entry of judgment.

The court looks with disfavor upon motions to file bills of costs out

of time.

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On the brief were Roscoe C. Howard, Jr., U.S. Attorney,

Douglas N. Letter, Litigation Counsel, U.S. Department of

Justice, and Michael F. Hertz and Jamie Ann Yavelberg,

Attorneys.

Richard P. Bress argued the cause for appellees Columbia/HCA Healthcare Corp, et al. With him on the brief were

Roger S. Goldman, Adam S. Hoffinger, and Robert A. Salerno. Jennifer C. Archie entered an appearance.

Before: RANDOLPH and ROGERS, Circuit Judges, and

WILLIAMS, Senior Circuit Judge.

Opinion for the Court filed by Circuit Judge RANDOLPH.

RANDOLPH, Circuit Judge: Mary Hampton filed a complaint

in the Middle District of Georgia on February 12, 1999, under

the False Claims Act, 31 U.S.C. §§ 3729–3733. The Act

allows a private person (a relator) to bring a qui tam civil

action ‘‘in the name of the Government,’’ id. § 3730(b)(1), and

to receive part of any proceeds of the suit, id. § 3730(d).

Hampton’s complaint alleged that the defendants—Columbia/HCA Healthcare Corp. (‘‘HCA’’), Clinical Arts Comprehensive Services, Inc. d/b/a Clinical Arts Homecare (‘‘Clinical

Arts’’) (a Georgia subsidiary of HCA), several Clinical Arts

employees, and others—had improperly billed the government under the Medicare program for home health services.

In December 1999, the Judicial Panel on Multidistrict Litigation transferred Hampton’s case and twenty-nine others from

various districts to the District of Columbia under 28 U.S.C.

§ 1407 for consolidated pretrial proceedings.

The United States and HCA executed a partial settlement

agreement for thirteen of the complaints, including Hampton’s, on December 14, 2000. HCA agreed to pay the United

States more than $731 million and the United States agreed

to move to dismiss numerous claims against HCA, including

claims about the home health billing practices of more than

six hundred HCA subsidiaries (among them Clinical Arts) in

multiple states.

Pursuant to the agreement, on February 14, 2001, the

United States intervened in Hampton’s case with respect to

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the improper billing claims against HCA and Clinical Arts,

but declined to intervene with respect to the claims against

the individual employees. One month later the government,

invoking the False Claims Act’s first-to-file rule for qui tam

actions, 31 U.S.C. § 3730(b)(5), moved to dismiss the claims in

which it had intervened. The government argued that

Hampton’s complaint against HCA and Clinical Arts was

barred because it was an action related to previously filed qui

tam suits, and that she was therefore not entitled to part of

the proceeds of the settlement. Also relying on the first-tofile rule, HCA moved to dismiss Hampton’s entire complaint.

The district court granted the motions to dismiss, disposing of

the improper billing claims against HCA, Clinical Arts, and

the individual defendants. The court held that another relator had beaten Hampton to the courthouse by about eighteen

months.

There is reason to doubt our jurisdiction over Hampton’s

appeal. In general, a district court decision is final and

appealable within the meaning of 28 U.S.C. § 1291 only if it is

final with respect to all the parties and all their claims. Bldg.

Indus. Ass’n of Superior Cal. v. Babbitt, 161 F.3d 740, 742–43

(D.C. Cir. 1998); Franklin v. Dist. of Columbia, 163 F.3d 625,

628–29 (D.C. Cir. 1998). Some of the cases consolidated with

Hampton’s are still pending. Although FED. R. CIV. P. 54(b)

allows the entry of a final judgment in ‘‘an action’’ on ‘‘one or

more but fewer than all of the claims or parties’’ if the district

court expressly determines ‘‘that there is no just reason for

delay,’’ the court dismissed Hampton’s complaint without

issuing a Rule 54(b) certification.

Whether consolidated cases retain their separate identity

or become one case for purposes of appellate jurisdiction has

divided the courts of appeals, as is thoroughly discussed in

15A CHARLES ALAN WRIGHT, ARTHUR R. MILLER, & EDWARD H.

COOPER, FEDERAL PRACTICE AND PROCEDURE § 3914.7, at 602–08

(2d ed. 1992 & Supp. 2002), from which we borrow. Some

circuits hold that consolidated cases remain separate actions

and no Rule 54(b) certification is needed to appeal the dismissal of any one of them. See Beil v. Lakewood Eng’g &

Mfg. Co., 15 F.3d 546, 551 (6th Cir. 1994); Albert v. Maine

USCA Case #01-5265 Document #730745 Filed: 02/07/2003 Page 3 of 9
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Cent. R.R., 898 F.2d 5, 6–7 (1st Cir. 1990).1

 Others treat

consolidated cases as a single action, see Spraytex, Inc. v.

DJS&T & Homax Corp., 96 F.3d 1377, 1382 (Fed. Cir. 1996);

Huene v. United States, 743 F.2d 703, 705 (9th Cir. 1984);

Trinity Broad. Corp. v. Eller, 827 F.2d 673, 675 (10th Cir.

1987), or presume that they are, Hageman v. City Investing

Co., 851 F.2d 69, 71 (2d Cir. 1988), allowing the presumption

to be overcome ‘‘ ‘[i]n highly unusual circumstances,’ ’’ Kamerman v. Steinberg, 891 F.2d 424, 429 (2d Cir. 1989) (quoting

Hageman, 851 F.2d at 71). Still other circuits apply no hard

and fast rule, but focus on the reasons for the consolidation to

determine whether the actions are one or separate. See Hall

v. Wilkerson, 926 F.2d 311, 314 (3d Cir. 1991); Eggers v.

Clinchfield Coal Co., 11 F.3d 35, 39 (4th Cir. 1993); Road

Sprinkler Fitters Local Union v. Cont’l Sprinkler Co., 967

F.2d 145, 149–51 (5th Cir. 1992); Brown v. United States, 976

F.2d 1104, 1107 (7th Cir. 1992); Tri-State Hotels, Inc. v.

FDIC, 79 F.3d 707, 711–12 (8th Cir. 1996); Lewis Charters,

Inc. v. Huckins Yacht Corp., 871 F.2d 1046, 1048–49 (11th

Cir. 1989).

While our decisions have not foreclosed the issue, they

suggest that our court falls into the last camp. We have held

that when a district court consolidates cases and treats them

as such ‘‘for all purposes,’’ an order deciding fewer than all

the claims of all the parties cannot be appealed without a

Rule 54(b) certification. Phillips v. Heine, 984 F.2d 489, 490

(D.C. Cir. 1993) (internal quotation marks omitted); see also

Cablevision Sys. Dev. Co. v. Motion Picture Ass’n of Am., 808

F.2d 133, 136 & n.3 (D.C. Cir. 1987). The clear implication is

that if the consolidation is not ‘‘for all purposes,’’ a judgment

entirely disposing of any one of the cases might be considered

final and appealable. Although Hampton’s case and twentynine others were consolidated, they were consolidated only

for pretrial proceedings, the extent of consolidation authorized by the statute. See 28 U.S.C. § 1407(a). At the

1 The First Circuit’s position may not be as firm as stated in the

text. See Cablevision Sys. Dev. Co. v. Motion Picture Ass’n of

Am., 808 F.2d 133, 136 n.3 (D.C. Cir. 1987).

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conclusion of pretrial proceedings the cases were to be remanded to the districts from which they were transferred.

Id. When final judgments were then rendered, appeals

would lie in the courts of appeals for their respective districts.

Treating the consolidated cases as one action at this stage

would therefore not ensure only a single appeal—one of the

objectives of the final judgment rule. And to force Hampton

to await the outcome of the remaining cases before appealing

would risk needless complications in the event one or more of

the pending actions was transferred back to the district

where it began. Despite the consolidation, Hampton’s action

thus retained its separate status and the order dismissing it

was a final judgment, appealable without the need for a Rule

54(b) certification. See Brown, 976 F.2d at 1107.

On the merits, the dispute centers on the False Claims

Act’s first-to-file rule: ‘‘When a person brings [a qui tam

action], no person other than the Government may intervene

or bring a related action based on the facts underlying the

pending action.’’ 31 U.S.C. § 3730(b)(5). The district court

held that a qui tam action filed before Hampton’s by a relator

named Randal Boston barred Hampton’s improper billing

claims. Boston had filed his complaint against HCA on

August 8, 1997, in the Northern District of Texas, also

alleging that HCA submitted false claims to Medicare.

Other courts of appeals have interpreted the words of

§ 3730(b)(5)—‘‘related action based on the facts underlying

the pending action’’—to bar ‘‘actions alleging the same material elements of fraud’’ as an earlier suit, even if the allegations ‘‘incorporate somewhat different details.’’ United States

ex rel. Lujan v. Hughes Aircraft Co., 243 F.3d 1181, 1189 (9th

Cir. 2001); see also United States ex rel. LaCorte v. SmithKline Beecham Clinical Labs., Inc., 149 F.3d 227, 232–34 (3d

Cir. 1998). Hampton does not object to this standard, and

there are good reasons for us to adopt it.

Congress added § 3730(b)(5) to the False Claims Act in

1986. We described the purpose of the 1986 amendments to

the Act in United States ex rel. Springfield Terminal Ry. v.

Quinn, 14 F.3d 645 (D.C. Cir. 1994), a decision interpreting

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another provision—31 U.S.C. § 3730(e)(4)(A), which bars qui

tam suits ‘‘based upon the public disclosure of allegations or

transactions’’ in specified types of public proceedings, id.,

including legal proceedings. See Springfield, 14 F.3d at 652.

The history of the False Claims Act ‘‘qui tam provisions

demonstrates repeated congressional efforts to walk a fine

line between encouraging whistle-blowing and discouraging

opportunistic behavior. The 1986 amendments TTT must be

analyzed in the context of these twin goals of rejecting suits

which the government is capable of pursuing itself, while

promoting those which the government is not equipped to

bring on its own.’’ Id. at 651. Cf. United States ex rel.

Findley v. FPC–Boron Employees’ Club, 105 F.3d 675, 686–

88 (D.C. Cir. 1997). The Springfield and Findley decisions

interpreted the words ‘‘based upon TTT allegations or transactions’’ in § 3730(e)(4)(A) to mean ‘‘ ‘material elements of the

fraudulent transaction.’ ’’ Findley, 105 F.3d at 687 (quoting

Springfield, 14 F.3d at 655). The language of § 3730(b)(5)

differs from that of § 3730(e)(4)(A), but the objectives of

§ 3730(b)(5)—encouraging whistle-blowing and discouraging

opportunistic behavior—are the same. The only possibly

relevant difference in the language of the two provisions is

the use of ‘‘facts’’ in § 3730(b)(5) versus ‘‘allegations or transactions’’ in § 3730(e)(4)(A). In this case the difference is of

no consequence, since we are comparing complaints rather

than findings of fact. Cf. Lujan, 243 F.3d at 1189.

We therefore hold that § 3730(b)(5) bars any action incorporating the same material elements of fraud as an action

filed earlier. In doing so we reject another possible test, one

barring claims based on ‘‘identical facts.’’ It might be argued

that a single sentence from the legislative history, which

states that ‘‘private enforcement under the civil False Claims

Act is not meant to produce class actions or multiple separate

suits based on identical facts and circumstances,’’ S. REP. NO.

99–345, at 25 (1986), supports such a test. But § 3730(b)(5)

does not say that the later action must rest on identical facts,

and the purposes of the qui tam provisions are against such a

reading. See Lujan, 243 F.3d at 1188–89; LaCorte, 149 F.3d

at 232–34.

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Even though Hampton does not contest the ‘‘same material

elements’’ standard, she argues that it does not support the

district court’s decision. To evaluate her argument it is

necessary to understand the elements of the fraud in question. Hampton and Boston both alleged violations of § 3729

of the False Claims Act. One way of establishing a violation

of this section is to prove that the defendant presented or

conspired to present a claim to the government, that the

claim was false, and that the defendant knew that the claim

was false. See § 3729(a)(1)-(3);2

 JOHN T. BOESE, CIVIL FALSE

CLAIMS AND QUI TAM ACTIONS § 2.01[A], at 2–8 (2d ed. Supp.

2002).

Hampton thinks her complaint differs significantly from

Boston’s because it named different defendants. Boston sued

only HCA. Hampton sued not only HCA but also HCA’s

subsidiary Clinical Arts and several Clinical Arts employees.

As Hampton sees it, Boston’s complaint cannot possibly have

covered fraud by Clinical Arts and its employees because it

(1) fails to name Clinical Arts or its employees as defendants

and (2) specifically mentions fraud at HCA home health care

subsidiaries in six states that do not include Georgia. But

these are not differences in the material elements of the

fraud. Boston was a senior manager in HCA’s home care

group. He alleged a corporate-wide problem, revealed

2 Section 3729(a) provides, in relevant part:

Any person who—

 (1) knowingly presents, or causes to be presented, to an

officer or employee of the United States Government or a

member of the Armed Forces of the United States a false or

fraudulent claim for payment or approval;

 (2) knowingly makes, uses, or causes to be made or used, a

false record or statement to get a false or fraudulent claim

paid or approved by the Government; [or]

 (3) conspires to defraud the Government by getting a false

or fraudulent claim allowed or paid;

TTTT

is liable to the United States Government for a [specified]

civil penaltyTTTT

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through internal audits, in which HCA perpetrated fraud in

providing home health care services through numerous subsidiaries. It is true that Boston’s complaint mentioned instances of fraud at particular home health agencies in only six

specific states, not including Georgia. But Boston’s complaint

described these as ‘‘examples’’ and ‘‘samplings’’ of ‘‘a huge

number of illegal payments from Medicare TTT received by

Columbia/HCA’s 550 home health locations in 37 states.’’

Given Boston’s broad allegations based on his position as an

HCA insider, Hampton’s naming Clinical Arts—a specific

HCA subsidiary—and naming individual employees of Clinical

Arts were merely variations on the fraud Boston’s complaint

described.

Hampton also distinguishes her suit from Boston’s on the

basis that HCA’s subsidiaries rather than its corporate headquarters perpetrated the fraud (except for concealment of the

subsidiaries’ actions), and that fraud at any given HCA home

health care subsidiary occurred independently of fraud at any

other one. Because of this, the nature and extent of Medicare fraud in the provision of home health services varied

greatly among different subsidiaries, as did the type and

percentage of improperly billed visits.

We see no substantial difference between the claims.

Hampton alleged that she learned of HCA and Clinical Arts’

fraudulent Medicare billing practices while they were providing home health care for her mother beginning in 1994. She

claimed that HCA and Clinical Arts submitted improper bills

for services for her mother and other patients: the companies

billed for services that were miscoded; already paid for;

performed by others; never administered; or supposedly

administered to Hampton’s mother after she died in 1996.

Hampton also claimed that HCA and Clinical Arts submitted

bills for supplies and medications that were unnecessary or

never received; and that they billed for services to patients

who did not qualify under the Medicare guidelines, did not

need treatment, or were not charged required copayments.

The companies submitted false or inaccurate documentation

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to the government and, so she alleged, shredded documents

in order to destroy evidence of the fraud.

Boston’s allegations were along very much the same lines.

He asserted that HCA home health subsidiaries billed the

government for services that did not meet the Medicare

eligibility criteria, for undocumented services, and for services not medically necessary. He also alleged that they

submitted false or inaccurate Medicare documentation and

destroyed documents.

Hampton also raises an issue about the difference in the

time periods covered by the two complaints. Hampton’s

complaint covered Clinical Arts services beginning in 1994.

Boston’s covered Clinical Arts services during its status as a

subsidiary of HCA. Hampton says in her brief that HCA did

not acquire Clinical Arts until 1996. If Hampton is right

about the timing of the acquisition, she might have a valid

argument that part of her complaint covered a different set of

facts: fraud allegedly committed by Clinical Arts before it

became an HCA subsidiary. But nothing in the record

establishes when the acquisition occurred. And in any event,

Hampton did not make this argument to the district court.

Arguments not presented to the district court will not be

heard on appeal absent exceptional circumstances, District of

Columbia v. Air Florida, Inc., 750 F.2d 1077, 1084–85 (D.C.

Cir. 1984), and there are none in this case.

In short, Hampton’s action was related to and based on the

same underlying facts as Boston’s within the meaning of the

first-to-file rule and the district court correctly dismissed it.

Affirmed.

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