Opinion ID: 77158
Heading Depth: 2
Heading Rank: 3

Heading: The Denial of the Motion to Dismiss

Text: 35 Finally, LFM cross-appeals, arguing that the district court erred in denying LFM's Federal Rule of Civil Procedure 12(b)(6) motion to dismiss the Amended Complaint. The motion was grounded on the assertion that the Amended Complaint failed to plead fraud with particularity as required by Federal Rule of Civil Procedure 9(b). We find this argument meritless. 36 This is not a case like United States ex rel. Clausen v. Laboratory Corporation of America, Inc., 290 F.3d 1301 (11th Cir.2002), in which a corporate outsider made speculative assertions that claims must have been submitted, were likely submitted or should have been submitted to the Government. 290 F.3d at 1311. Neither is this case like Corsello v. Lincare, Inc., 428 F.3d 1008 (11th Cir.2005), in which we recently affirmed the district court's dismissal on the ground that the relator's complaint was deficient under Rule 9(b) because it failed to explain why he believe[d] fraudulent claims were ultimately submitted. 428 F.3d at 1014. 37 Walker's complaint identifies her as a nurse practitioner who was employed at LFM. Amended Complaint ¶ 7. Walker alleges that, during her employment at LFM, she never had her own UPIN and that she was instructed each day which doctor she would be billing under. Amended Complaint ¶¶ 11, 15. The Amended Complaint also alleges that Walker had at least one personal discussion with LFM's office administrator (identified in the complaint by name) during which the two women discussed that Walker did not have her own UPIN, whether Walker and the other nurse practitioners and physician assistants should have their own UPINs, that (according to the office administrator) LFM billed all nurse practitioner and physician assistant services as rendered incident to the service of a physician, that (also according to the office administrator) LFM had never billed nurse practitioner or physician assistant services in another manner, and the propriety of the billing method. Amended Complaint ¶¶ 10-12. These allegations are sufficient to explain why Walker believed LFM submitted false or fraudulent claims for services rendered by nurse practitioners and physician assistants incident to the service of a physician. Therefore, we affirm the district court's order denying LFM's motion to dismiss Walker's complaint.