ZOBEL, UNITED STATES DISTRICT JUDGE.
Plaintiff-Relator Jeffrey Bierman has alleged that DJO
DJO has moved for summary judgment and to exclude the testimony of both experts. DJO's motion for summary judgment is allowed, and its motions to exclude are denied as moot.
Previous opinions have already offered a detailed description of the facts underlying litigation. See United States ex rel. Bierman v. Orthofix Int'l, N.V., 748 F.Supp.2d 123, 125-27 (D.Mass.2010). I therefore recite here only those facts relevant to DJO's motion for summary judgment in the light most favorable to Bierman, see Prescott v. Higgins, 538 F.3d 32, 39 (1st Cir.2008).
According to Bierman, DJO, between 2004 and 2009, coached prescribing physicians when marketing its bone-growth stimulation devices. These devices, which DJO — and all other manufacturers of comparable devices — offered for purchase, not for rental,
From these statistics, Bierman infers that DJO has coached physicians to unreflectively estimate a nine-month length of need in lieu of exercising their medical judgment. By coaching physicians to list a nine-month estimated length of need on the CMNs for its devices and sending them alongside its claims to Medicare, Bierman claims, DJO has submitted to Medicare false claims for device payments. DJO did instruct its employees that it preferred CMNs to state a nine-month estimated length of need, though it argues that estimated lengths of need are immaterial to its Medicare compensation given that (1) Medicare purchases DJO devices instead of renting them; and (2) applicable Medicare guidance makes no mention of estimated length of need as relevant to its decision to pay.
Courts "shall grant summary judgment" absent any "genuine dispute as to any material fact." Fed. R. Civ. P. 56(a). Summary judgment is inappropriate when "the evidence is such that a reasonable jury could return a verdict for the nonmoving party." Anderson, v. Liberty Lobby, Inc., 477 U.S. 242, 248, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986).
DJO has argued, persuasively, that estimated lengths of need on the CMNs are immaterial to Medicare's decision to pay and are thus not actionable under the False Claims Act. The crux of this argument is that DJO and all of its relevant competitors sell devices to patients with no option for rental, rendering the physician's estimated length of need irrelevant to Medicare's decision to purchase — or not purchase — a device for a given patient.
The False Claims Act imposes liability upon "any person who ... knowingly presents ... a false or fraudulent claim for payment or approval." 31 U.S.C. § 3729(a)(1)(A) (2012).
DJO's decision to sell its devices instead of renting them leaves physicians' estimated lengths of need incapable of influencing Medicare's decision to pay for those devices. Medicare purchases devices at a flat rate that does not depend whatsoever on that device's estimated length of need. See 42 C.F.R. § 414.220(b)(1) (2016).
Bierman offers several arguments against this conclusion, none of which disturb it. First, Bierman relies on the CMN itself, arguing that Medicare would not request — and would not require physicians to certify the truth of — information immaterial to its payment decisions. Because estimated length of need appears on the CMN, the argument goes, it must be material. This, however, ignores two facts: CMS uses the same form for rented and purchased devices, and CMS pays a flat rate when it purchased devices. This means — and DJO agrees — that estimated length of need may well be material to Medicare when determining whether or not to cover device rental, but not device purchase. As it relates to device rental, the estimated length of need determines the price that Medicare will pay, and price is an unambiguously material condition under the FCA. See United States ex rel. Shemesh v. CA, Inc., 89 F.Supp.3d 36, 51 (D.D.C.2015). As to device purchase, however, estimated length of need is irrelevant: during the period at issue, Medicare had no option to rent DJO or other bonegrowth stimulators, making estimated length of need incapable of influencing Medicare's decision to rent instead of purchase. Nor could estimated length of need determine the price Medicare paid to purchase the device, as regulations specify that Medicare must purchase devices for a flat fee. See 42 C.F.R. § 414.220(b)(1).
Second, Bierman argues that DJO's policy of coaching physicians to request nine-month estimated lengths of need demonstrates that Medicare considered lengths of need to be material. This is incorrect: although the record suggests that DJO did have such a policy, that has no bearing on Medicare's position as to the relevance of estimated lengths of need. Further, DJO's coaching policy does not even demonstrate conclusively its own belief as to materiality: it is equally consistent with confusion over a query it believed irrelevant given both the purchase-only marketplace and Medicare reimbursement regime.
Third, Bierman points to a charging document against Orthofix — formerly a defendant in this case — in which the Department of Justice stated its belief that Orthofix's alleged coaching of physicians to list a nine-month estimated length of need was material to Medicare's decision to pay for those devices. Setting aside concerns of admissibility, this has no bearing on Bierman's arguments: the Department of Justice's position in a criminal information
Finally, Bierman has gestured to the government's pending investigation as to whether or not Medicare could save money by renting bone-growth stimulators instead of purchasing them. Whether or not such an investigation confirms the government's current interest in the estimated lengths of need for such devices — which may influence decisions to cover rentals, but not purchases, for certain patients — it has no bearing on the materiality of estimated lengths of need from 2004 until 2009, the time at issue in this litigation.
Because Bierman cannot point to any fact in this record to show that estimated lengths of need are material to Medicare's decision to purchase DJO's bone-growth devices, Bierman cannot sustain his False Claims Act action under this theory. Since materiality is also a condition of the state and local False Claims Act analogs under which Bierman has sued, Bierman likewise cannot sustain claims under those statutes.
Accordingly, DJO's Motion for Summary Judgment (Docket # 382) is ALLOWED, and its remaining motions (Docket # # 380 and 384) are DENIED AS MOOT. Given that the other remaining defendants are in the final stages of settlement, see Docket # 408, there is no just reason for delaying judgment for DJO. Judgment may be entered for DJO.