Opinion ID: 78568
Heading Depth: 1
Heading Rank: 1

Heading: Fraudulent Billing Claims

Text: To state a claim premised on fraud, Sanchez needed to state with particularity the circumstances constituting [the] fraud. Fed.R.Civ.P. 9(b); see also United States ex rel. Clausen v. Lab. Corp. of Am., 290 F.3d 1301, 1308 (11th Cir.2002) (Rule 9(b) does apply to actions under the False Claims Act.). In her complaint, Sanchez alleged that the defendants had knowingly submitted false claims to Medicare for lymphedema treatments performed by massage therapists. [2] Sanchez further alleged that the defendants had intentionally billed Medicare for services they did not provide and that she had gained personal knowledge of these billing practices through her employment as Lymphatx's office manager. [3] In addition to her general accusations of false billing, Sanchez needed to plead facts as to time, place, and substance of the defendants' alleged fraud, specifically, the details of the defendants' allegedly fraudulent acts, when they occurred, and who engaged in them. Clausen, 290 F.3d at 1310 (quotation marks and citation omitted). Despite her assertion that she had direct knowledge of the defendants' billing and patient records, however, Sanchez failed to provide any specific details regarding either the dates on or the frequency with which the defendants submitted false claims, the amounts of those claims, or the patients whose treatment served as the basis for the claims. Without these or similar details, Sanchez's complaint lacks the indicia of reliability necessary under Rule 9(b) to support her conclusory allegations of wrongdoing. See Clausen, 290 F.3d at 1311-12. In other words, because she failed to allege at least some examples of actual false claims, Sanchez could not lay a complete foundation for the rest of [her] allegations. Id. at 1314 n. 25. The district court therefore appropriately dismissed the four claims alleging fraudulent billing. [4] We reject Sanchez's argument that the district court should have allowed her to amend her complaint before dismissing these claims. A district court is not required to grant a plaintiff leave to amend his complaint sua sponte when the plaintiff, who is represented by counsel, never filed a motion to amend [ ]or requested leave to amend before the district court. Wagner v. Daewoo Heavy Indus. Am. Corp., 314 F.3d 541, 542 (11th Cir. 2002) ( en banc ). Sanchez was represented by counsel but did not move for leave to amend, and we cannot conclude that the district court abused its discretion by failing to grant leave that was never requested. Burger King Corp. v. Weaver, 169 F.3d 1310, 1318 (11th Cir.1999).