JAMES C. FOX, Senior District Judge.
On July 24, 2012, Plaintiff United States of America ("government") filed a complaint [DE-1] in this court, asserting a claim pursuant to the False Claims Act ("FCA"), 31 U.S.C. § 3729, et seq., as well as state law claims of unjust enrichment and payment under mistake of fact against, among others, Defendants Valerie Jurik ("Jurik") and At Home Assessments, LLC ("AHA") (collectively, "Defendants").
The purpose of a motion to dismiss under Rule 12(b)(6) is to test the legal sufficiency of a complaint, not to resolve conflicts of fact or to decide the merits of the action. Edwards v. City of Goldsboro, 178 F.3d 231, 243-44 (4th Cir.1999). In considering
When addressing a motion to dismiss under Rule 12(b)(6), a court generally may not look outside the complaint unless it treats the motion to dismiss as a motion for summary judgment. Witthohn v. Fed. Ins. Co., 164 Fed.Appx. 395, 396 (4th Cir. 2006). A court may, however, take judicial notice of matters of public record, and may also "consider documents attached to the complaint, as well as those attached to the motion to dismiss, so long as they are integral to the complaint and authentic." Philips v. Pitt Cnty. Mem'l Hosp., 572 F.3d 176, 180 (4th Cir.2009) (citations omitted); see also Witthohn, 164 Fed.Appx. at 396 (stating that "a court may consider official public records, documents central to plaintiffs claim, and documents sufficiently referred to in the complaint so long as the authenticity of these documents is not disputed").
The elements of a FCA claim "are predicated on fraudulent conduct...." United States ex rel. Davis v. U.S. Training Ctr. Inc., 498 Fed.Appx. 308, 314-15 (4th Cir.2012) (citation omitted); see also United States ex rel. Totten v. Bombardier Corp., 286 F.3d 542, 551-52 (D.C.Cir.2002) (noting that every circuit to consider the issue has held that Rule 9(b) applies to FCA complaints). In pleading fraud or mistake, although "[m]alice, intent, knowledge, and other conditions of a person's mind may be alleged generally," a plaintiff "must state with particularity the circumstances constituting fraud or mistake." Fed.R.Civ.P. 9(b). "[T]he circumstances required to be pled with particularity under Rule 9(b) are the time, place, and contents of the false representations, as well as the identity of the person making the misrepresentation and what he obtained thereby." United States ex rel. Jones v. Collegiate Funding Servs., Inc., 469 Fed.Appx. 244, 258 (4th Cir.2012) (quotation omitted). Those aspects of a fraud claim that may be pled generally "must still be alleged in accordance with Rule 8 — a `plausible' claim for relief must be articulated." Mayfield v. Nat'l Ass'n for Stock Car Auto Racing, Inc., 674 F.3d 369, 377 (4th Cir.2012). "Dismissal under Rule 9(b) is treated as a failure to state a claim
The following facts are alleged in the complaint. The United States Department of Veterans Affairs ("VA") operates several Prosthetics and Sensory Aids Service units, including one at the Durham VA Medical Center ("Durham PSAS"). The Durham PSAS provides prosthetic and orthotic services, sensory aids, medical equipment, and support services for veterans. This includes the VA's Home Improvements and Structural Alternations ("HISA") program, which provides funds to help defray the costs associated with structural modifications of homes to accommodate wheelchairs or other special needs of veterans. Mark Curtis ("Curtis") was the Durham PSAS' HISA program manager during the time period relevant to this action.
The VA utilizes a United States Government Purchase Card ("USGPC"), a type of credit card that allows authorized purchasing representatives to make purchases up to $25,000.00 for HISA and other VA programs. Curtis was authorized to use the USGPC for HISA and other VA program purchases.
The VA prohibits charging the USGPC for HISA home modification work until the work has been completed, which includes submission of a paper invoice, photos of the modification, and a statement of completion signed by the veteran for whom the work was performed.
Defendant Jurik is the president and largest shareholder of Defendant AHA, a company that conducted a large part of its business with the Durham PSAS. The government alleges that, in letters sent to Defendant AHA authorizing agreed work, it was stated that an invoice, a statement of completion of work by the veteran for whom the work was performed, and photos of the completed work would be required prior to payment for the work.
The government alleges that employees of Defendant AHA, at the express direction of Defendant Jurik, often submitted purchase orders and directly charged the USGPC for VA purchases prior to completing the required work. The government alleges that Defendant AHA needed the payments up front to purchase the supplies and equipment and complete the contracted work.
The government generally alleges that Defendants submitted numerous false claims and made, or caused to be made or used, numerous corresponding false records material to these false claims. The government specifically alleges that Defendants obtained at least 32 payments through unauthorized USGPC charges or false invoices for: (1) HISA work in which
The government alleges that a USGPC purchase made before completion of the associated HISA home modification was a false and fraudulent claim. The government further alleges that submission of invoices were often false — due to the fact that such invoices were for work not completed and Defendant AHA was not entitled to payment — and submission of a false invoice was a false and fraudulent claim by Defendants.
The government also alleges that Defendants created or caused to be made or used false records or statements material to these false claims, and that these false records and statements were created to avoid an obligation to repay funds to the VA. It is unclear whether such records or statements are alleged to be false because of the reasons stated above (that is, because they were submitted prior to completion of agreed work), or because some other falsification or manipulation of these records or statements occurred.
The government alleges that Defendants continually failed to notify Durham PSAS that it had received payment for work that it had not completed, and in many cases could not complete because the veteran died or declined the work.
The court also recognizes the sample purchase order attached to the motion to dismiss.
The government asserts three causes of action against Defendants. In count 1, the government asserts a claim pursuant to the FCA. In this regard, the government generally alleges that, by virtue of the
With regard to the government's unjust enrichment claim (count 2), the government alleges that Defendants wrongfully obtained funds from the United States to which they were not entitled. With regard to the government's payment under mistake of fact (count 3), the government alleges that Defendants obtained funds from the United States to which they were not entitled in that the claims submitted constituted misrepresentations of material fact.
Defendants argue that the FCA claim fails to state the elements necessary to maintain such a claim, and also fails to state the alleged fraud with the requisite particularity. Further, Defendants argue that the unjust enrichment and payment under mistake of fact claims fail as a matter of law because a valid contract exists between the parties, making such quasi-contract claims improper. Finally, Defendants argue that the claims asserted against Defendant Jurik individually should be dismissed because the government has not adequately alleged that her actions were performed outside the scope of her employment with Defendant AHA.
The FCA was enacted "to discourage contractor fraud against the federal government." Glynn v. EDO Corp., 710 F.3d 209, 213 (4th Cir.2013) (citation omitted). The FCA creates civil liability for any person who "knowingly presents, or causes to be presented, [to the United States government] a false or fraudulent claim for payment or approval" or "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. 31 U.S.C. § 3729(a). "The requisite intent for FCA liability `is the knowing presentation of what is known to be false,'" United States ex rel. Joslin v. Cmty. Home Health of Md., Inc., 984 F.Supp. 374, 383 (D.Md.1997) (quoting United States ex rel. Kreindler & Kreindler v. United Techs. Corp., 985 F.2d 1148, 1156 (2d Cir.1993)), and to succeed it must be shown that "a false statement be made with actual knowledge, deliberate ignorance, or reckless disregard of the statement's falsity," id. at 384-85. "[T]he term `false or fraudulent claim' includes those instances when the contract or extension of government benefit was obtained originally through false statements or fraudulent conduct." United States ex rel. Wilson v. Kellogg Brown & Root, Inc., 525 F.3d 370, 376 (4th Cir.2008) (quotation omitted).
The FCA is a "fraud prevention statute." United States ex rel. Owens v. First Kuwaiti Gen. Trading & Contracting Co., 612 F.3d 724, 728 (4th Cir.2010) (quotation omitted). It is not intended to "punish honest mistakes or incorrect claims submitted through mere negligence." Id. (quotation omitted). Furthermore, it does not allow a plaintiff to "shoehorn what is, in essence, a breach of contract action into a claim that is cognizable under the False Claims Act." Id. (quotation omitted); see also Wilson, 525 F.3d at 378 (stating that a plaintiff "cannot base a fraud claim on nothing more than his own interpretation of an imprecise contractual provision. To hold otherwise would render meaningless the fundamental distinction between actions for fraud and breach of contract"); United States ex rel. Durcholz v. FKW, Inc., 189 F.3d 542, 545 (7th Cir.1999) ("If the government knows and approves of the particulars of a claim for payment before that claim is presented, the presenter cannot be said to have knowingly presented a fraudulent or false claim.... We decline to hold [a defendant] liable for defrauding the government by following the government's explicit directions."). To state a claim under the FCA, a plaintiff must allege the following elements: "(1) that the defendant made a false statement or engaged
In transactions where the government "conditions payment of a claim upon certification of compliance with a statute or regulation ... a party violates the FCA by falsely certifying compliance with the statute or regulation." Joslin, 984 F.Supp. at 383-84 (citation omitted). Simply failing to comply "with a statute or regulation, in the absence of a false certification, is insufficient to constitute a false statement within the meaning of the FCA." Id. at 383 (citation omitted). To establish liability under a false certification theory, a plaintiff "must show that a government contract or program required compliance with certain conditions as a prerequisite to a government benefit, payment, or program; the defendant failed to comply with those conditions; and the defendant falsely certified that it had complied with the conditions in order to induce the government benefit." Glynn, 710 F.3d at 216 (quotation omitted).
It is unsettled in the Fourth Circuit whether mere "submission of invoices and reimbursement forms," without an affirmative certification of compliance, can constitute an "implied" false certification of compliance with the terms of the particular government program. Harrison v. Westinghouse Savannah River Co. (Harrison I), 176 F.3d 776, 787 n. 8 (4th Cir.1999) (stating that it is "questionable an implied certification claim in the Fourth Circuit" exists); United States ex rel. Berge v. Bd. of Trs. of the Univ. of Ala., 104 F.3d 1453, 1461 (4th Cir.1997) ("There can only be liability under the [FCA] where the defendant has an obligation to disclose the omitted information." (citation omitted)); United States ex rel. McLain v. KBR, Inc., No. 1:08CV499 (GBL/TCB), 2013 WL 710900, at *6 (E.D.Va. Feb. 27, 2013) ("The Fourth Circuit has not adopted this [implied certification] theory."); Joslin, 984 F.Supp. at 384-85 ("To hold that the mere submission of a claim for payment, without more, always constitutes an `implied certification' of compliance with the conditions of the government program seriously undermines [the principle that the FCA is not designed to punish every type of fraud committed upon the government] by permitting FCA liability potentially to attach every time a document or request for payment is submitted to the government, regardless of whether the submitting party is aware of its non-compliance."). Indeed, recent courts to consider the issue in this circuit have indicated a similar theory, fraud by omission, may be more appropriate in some, but not all, circumstances. See, e.g., United States ex rel. Rostholder v. Omnicare, Inc., No. CCB-07-1283, 2012 WL 3399789, at *14 (D.Md. Aug. 14, 2012) (noting that the Fourth Circuit "has not yet adopted the implied certification doctrine," but that "an omission may render an otherwise truthful statement or claim false or fraudulent," creating FCA liability "where the defendant has an obligation to disclose the omitted information" (quotation omitted)).
The court has three concerns with the government's FCA claim as it is currently alleged.
Second, although certain prerequisites to payment are alleged to exist, the government has not sufficiently stated that these prerequisites were pursuant to a government contract or program that required such compliance. Alleging the existence of specific conditions without alleging their specific basis is insufficient to satisfy the government's minimum pleading burden.
Finally, although not a basis for dismissal in this case, the court notes that the above cited case law makes it clear that not all failures to comply with a statute, regulation, or contract constitute available grounds for relief under the FCA. Although the terms of the contract or agreement to which the complaint refers are not alleged to be the basis for relief in this case, without evaluating the terms of the contract or agreement, it is not possible for the court to distinguish between actionable fraud and mere breach of contract. This concern is amplified in this case because the purchase agreement attached to the motion to dismiss is argued by Defendants to permit payment, not when the work is completed, but when the work is ordered. The terms to which the government agreed, therefore, may have created a situation in which Defendants cannot be said to have knowingly presented a false or fraudulent claim. See Durcholz, 189 F.3d at 545.
When the United States enters into a contract, "ordinary principles governing contracts and their interpretation remain applicable." United States v. Bankers Ins. Co., 245 F.3d 315, 321 (4th Cir.2001) (citation omitted). "[W]hen the United States enters into contract relations, its rights and duties therein are governed generally by the law applicable to contracts between private individuals." United States v. Winstar Corp., 518 U.S. 839, 895, 116 S.Ct. 2432, 135 L.Ed.2d 964 (1996) (quotation omitted). Accordingly, although not addressed by either party, it appears the law of North Carolina applies to the government's state law claims.
Under North Carolina law, "[t]he doctrine of unjust enrichment is based on `quasi-contract' or contract `implied in law'...." Atl. & E. Carolina Ry. Co. v. Wheatly Oil Co., 163 N.C. App. 748, 753, 594 S.E.2d 425, 429 (2004) (citation omitted). "Under a claim for unjust enrichment, a plaintiff must establish certain essential elements: (1) a measurable benefit was conferred on the defendant, (2) the defendant consciously accepted that benefit, and (3) the benefit was not conferred officiously or gratuitously." Primerica Life Ins. Co. v. James Massengill & Sons Constr. Co., 211 N.C. App. 252, 259-60, 712 S.E.2d 670, 677 (2011) (citation omitted). Similarly, "when money is paid to another under the influence of a mistake of fact, and it would not have been paid had the person making the payment known that the fact was otherwise, the money may be recovered. The basis of such recovery is that money paid through misapprehension
The government generally argues that, to the extent this is not an action pursuant to a contract, Defendants' arguments fail to address the allegations made in the complaint. However, the complaint, at best, contains a mere recitation of the elements of these quasi-contract claims. Further, even assuming the government is correct in arguing that, under North Carolina law, such quasi-contract claims may be maintained despite the allegation of the existence of a contract between the parties, the terms of the alleged contract and how such terms fail to provide an adequate remedy for the government's quasi-contract claims are not sufficiently alleged or argued by the government. Accordingly, the court will ALLOW the motion to dismiss the quasi-contract claims.
Because the court finds that the complaint fails to state claims under the FCA or of unjust enrichment and payment under mistake of fact, it declines to address at this time Defendants' alternative arguments specifically related to Defendant Jurik in her individual capacity.
For the above stated reasons, it is hereby ORDERED that:
SO ORDERED.