MIRANDA M. DU, District Judge.
This action involves claims of insurance fraud in connection with the medical treatment of individuals injured in auto accidents. Before the Court is Defendants'
In addition, Plaintiffs filed a motion for sanctions pursuant to Fed. R. Civ. P. 11 ("Plaintiff's Motion"). (ECF No. 285.) The Court has reviewed Defendants' response (ECF No. 298) and Plaintiffs' reply (ECF No. 309) and denies Plaintiffs' Motion.
The following background facts are taken from the Complaint (ECF No. 1), which Defendants assume are true for purposes of their Motion. (ECF No. 222 at 5 n.5.)
Allstate alleges that the Doctors are treating physicians who violated federal and state RICO laws and committed a series of related torts by fraudulently inflating the medical bills of patients who have presented personal injury claims to Plaintiffs in order to leverage settlements from Plaintiffs. (ECF No. 1 at 5.) Plaintiffs made payments to over 300 claimants ("Claimants")—some were insured with Plaintiffs and others had claims against Plaintiffs' insureds—who were involved in automobile accidents based on medical bills for services allegedly provided by Defendants between 2006 and 2014. (Id. at 4-5; see also ECF No. 1-1.) Defendants caused these bills to be presented to Plaintiffs for payment knowing they were grossly exaggerated and were for services that were not medically necessary for the Claimants. (ECF No. 1 at 5.) Plaintiffs allege that Defendants rendered treatment to the Claimants based on a standardized patterned developed by Dr. Belsky and Dr. Tarquino "with the express purpose of creating inflated medical bills that would be used to leverage artificially enhanced settlement values to be paid by insurance companies rather than providing patient-centered treatment with the goal of actually treating or healing injuries." (Id.) This pattern involved Defendants allegedly generating "medical reports and billing records [that were presented to Plaintiffs] that falsely reported [the Claimants'] symptoms, complaints, and injuries . . . which were either exaggerated or not supported at all by the facts of the accident, that made pre-programmed, unsubstantiated findings and diagnoses and which prescribed treatment plans which were more consistent with generating large medical bills rather than patient-centered and evidence-based treatment of the patients' actual clinical conditions." (Id. at 7.) These medical bills and reports were presented to Plaintiffs by the Claimants' attorneys to demand payment or obtain settlement. (Id. at 10-11.) Upon each Claimant's initiation of treatment, Defendants would require them to execute a lien to secure payment for medical services to be made out of any settlement or judgment proceeds that would ultimately be paid by Plaintiffs. (Id. at 8.)
Plaintiffs assert the following claims: (1) violation of the Racketeer Influenced and Corrupt Organization Act ("RICO"), 18 U.S.C. § 1962(c); (2) violation of RICO, § 1962(d); (3) fraud and intentional misrepresentation; (4) conspiracy to defraud; (5) violation of Nevada RICO, NRS § 207.400, and (6) constructive trust and unjust enrichment.
Defendants' Motion presents the legal issues of the scope of the litigation privilege and witness immunity doctrines. Defendants present overlapping arguments on both doctrines in their Motion but conceded in their reply and at the Hearing that they rely on Nevada's litigation privilege to bar Plaintiffs' state law claims and the witness immunity doctrine to bar Plaintiffs' federal RICO claims and state law claims.
Defendants raise a threshold argument—issue preclusion—at the end of their Motion to contend that Plaintiffs are barred from relitigating the application of the litigation privilege. The Court will address issue preclusion first.
Defendants rely on People ex. rel. Allstate Ins. v. Berg, No. A139054, 2016 WL 661736 (Cal. Ct. App. Feb. 18, 2016), to argue that Plaintiffs should be estopped from relitigating the application of the litigation privilege in this case. (ECF No. 222 at 15-17; ECF No. 252 at 18-19.) Plaintiffs respond that the issue decided in Berg is not identical. The Court agrees with Plaintiffs.
"The doctrine of issue preclusion prevents relitigation of all `issues of fact or law that were actually litigated and necessarily decided' in a prior proceeding." Robi v. Five Platters, Inc., 838 F.2d 318, 322 (9th Cir. 1988) (quoting Segal v. Am. Tel. & Tel. Co., 606 F.2d 842, 845 (9th Cir. 1979)). Under California law,
In Berg, Allstate alleged the existence of an insurance fraud ring, claiming that certain defendant lawyers referred their clients to certain medical providers who would recommend unnecessary surgical procedures to allow the defendants to inflate their demands for payment under the insurance policies. 2016 WL 661736, at *1. Allstate sued the lawyers and the medical providers. The lawyer defendants filed a special motion to strike under California's anti-SLAPP statute, which the trial court denied. Id. at *2-3. The court of appeals reversed, finding that the trial court erred in concluding that Allstate demonstrated a probability of prevailing on the merits because the lawyer defendants failed to show their demand letters were protected by the litigation privilege, as codified by Civil Code section 47(b). Id. at *9. The court of appeals found that the gist of Allstate's claims against the lawyer defendants was that they committed insurance fraud through their sending of the prelitigation demand letters, and "[a]ttorney demand letters such as these are a `classic example' of communicative conduct to which the litigation privilege applies." Id.
The issue decided in Berg—whether the litigation privilege protects the lawyers who sent demand letters—is not identical to the issue presented in this case. Here, Plaintiffs are suing Defendants in their role as medical providers, and Defendants assert the litigation privilege protects their purportedly inflated bills and false medical reports. While the lawyers in Berg based their demand letters on the medical providers' treatment recommendations, demand letters are a "classic example" of privileged communicative conduct and a key component of legal process. Medical bills and reports are not. Because the issues are clearly dissimilar, the Court finds that Plaintiffs are not precluded from arguing that the litigation privilege does not apply here.
Nevada courts have recognized "the long-standing common law rule that communications uttered or published in the course of judicial proceedings are absolutely privileged" so long as they are "in some way pertinent to the subject of controversy." Fink v. Oshins, 49 P.3d 640, 643-44 (Nev. 2002) (quoting Circus Circus Hotels, Inc. v. Witherspoon, 657 P.2d 101, 104 (Nev. 1983)). "The litigation privilege immunizes from civil liability communicative acts occurring in the course of judicial proceedings, even if those acts would otherwise be tortious." Greenberg Traurig v. Frias Holding Co., 331 P.3d 901, 902 (Nev. 2014). The privilege extends to "statements made with knowledge of falsity and malice." Blaurock v. Mattice Law Offices, No. 64494, 2015 WL 3540903, at *1 (Nev. App. May 27, 2015). Though the privilege originally formed as a defense to defamation, it has been expanded to cover a variety of torts. "The scope of the absolute privilege is quite broad," and "courts should apply the absolute privilege liberally, resolving any doubt in favor of its relevancy or pertinency." Fink, 49 P.3d at 644 (quoting Club Valencia Homeowners v. Valencia Assoc., 712 P.2d 1024, 1027 (Colo. Ct. App. 1985)).
Defendants argue that their medical reports and invoices are protected by the litigation privilege because they were attached to demand letters that constitute communicative acts. (ECF No. 222 at 13-14.) Defendants offer no relevant Nevada case law to support a definition of "communicative acts" broad enough to cover purportedly fraudulent medical reports and invoices described in and attached to demand letters.
The Court agrees with Plaintiffs that Defendants' medical reports and invoices are not communicative acts protected under the litigation privilege. These documents were forwarded to the lawyers who ultimately communicated with Plaintiffs via demands made in connection with each of the Claimants. However, they were not Defendants' communications. The medical reports recorded Defendants' treatment of the Claimants who were their patients, and the bills and invoices were generated to charge for such treatment. They bear no resemblance to the prelitigation demand letters in Defendants' cited cases, which courts have found to constitute communicative acts within the ambit of the litigation privilege.
In sum, the Court finds that the litigation privilege does not apply to bar Plaintiffs' claims.
Defendants rely on the witness immunity doctrine established under Nevada law to protect from the state law claims and the same doctrine under federal common law to protect from the federal RICO claims. At the Hearing, Defendants conceded that application of the doctrine varies little under federal and state law. In fact, Nevada follows the standard that the Supreme Court applied in Briscoe v. LaHue, 460 U.S. 325 (1983). See Harrison v. Roitman, 362 P.3d 1138, 1140 (Nev. 2015) ("We similarly employ the functional approach [utilized in Briscoe] to determine whether the social utility of recognizing absolute immunity for party-retained experts is sufficiently great to justify their pardon from the burdens of litigation."); State v. Second Jud. Dist. Ct., 55 P.3d 420, 426 (Nev. 2002) (applying the Supreme Court's functional approach to find that child protective service agents are protected under the absolute immunity doctrine when they provide information to the court).
In Briscoe, the Supreme Court addressed absolute immunity protection for police officers sued under 42 U.S.C. § 1983 for allegedly committing perjury in their trial testimony in connection with two cases. 460 U.S. at 326. The Court reiterated that the "immunity analysis rests on functional categories, not on the status of the defendant."
Id. at 335-336.
In Franklin v. Terr, 201 F.3d 1098 (9th Cir. 2000), the Ninth Circuit found that the witness immunity doctrine barred a claim for conspiracy to commit perjury against a psychiatrist who had testified as an expert, reasoning that doing so would permit a plaintiff to circumvent the absolute immunity protection for witnesses and undermine its purposes. Id. at 1101-02. "Absolute witness immunity is based on the policy of protecting the judicial process and is `necessary to assure that judges, advocates, and witnesses can perform their respective functions without harassment or intimidation.'" Id. at 1102 (quoting Briscoe, 460 U.S. at 334-35). The witness immunity doctrine thus protects testimony or statement that is the equivalent of testimony given in the course of a judicial proceeding. See Rehberg v. Paulk, 566 U.S. 356, 369-71 (2012) (testimony before a grand jury entitles the witness to the same immunity protection as testimony at trial in actions filed under 42 U.S.C. § 1983 because of the distinctive function performed in both proceedings, which is unlike the function performed by an officer who submitted an affidavit in support of an application for arrest warrant).
However, witness immunity has its limits. Paine v. City of Lompoc, 265 F.3d 975, 981 (9th Cir. 2001). Such "immunity does not shield non-testimonial conduct" nor does it shield "from liability for any conspiratorial conduct not `inextricably tied' to [the witness's] testimony." Id. at 981-82 (affirming the district court's finding that "absolute witness immunity does not shield an out-of-court, pretrial conspiracy to engage in non-testimonial acts such as fabricating or suppressing physical or documentary evidence or suppressing the identities of potential witnesses"); see Cunningham v. Gates, 229 F.3d 1271, 1291 (9th Cir. 2000) ("Obviously, testimonial immunity does not encompass non-testimonial acts such as fabricating evidence."). Moreover, the burden is on the party seeking witness immunity to establish entitlement to immunity. See Genzler v. Longanbach, 410 F.3d 630, 636 (9th Cir. 2005) (quoting Burns v. Reed, 500 U.S. 478, 486 (1991)) ("The Supreme Court has consistently `emphasized that the official seeking absolute immunity bears the burden of showing that such immunity is justified for the function in question.'").
Defendants argue that as treating physicians their role was to serve as witnesses in the Claimants' personal injury disputes, and the conduct that served as the basis of Plaintiffs' claims—Defendants' statements relating to the medical reports and billings for medical treatment—would have been part of their eventual testimony in the Claimants' personal injury disputes. (ECF No. 222 at 10-11.) They reason that because the Doctors would have been expected to testify in the litigation involving the Claimants—including the negotiation and settlement of claims—their role as witnesses entitles them to absolute immunity. (Id.) Plaintiffs counter that the conduct about which they complained does not amount to testimony but instead involved non-testimonial evidence (i.e., "medical records, reports, bills, and invoices"), which they allege Defendants fabricated to inflate the settlement value of the claims. (ECF No. 242 at 3-4, 18-19.) Plaintiffs assert that Defendants' "medical record keeping, production of medical treatment reports and recommendations, and production of bills and invoices for services rendered are not transformed into communicative or testimonial acts for the purposes of a judicial proceeding merely because they may be called as deposition or trial witnesses in personal injury lawsuits." (Id. at 12.) The Court agrees with Plaintiffs.
The claims asserted here are based on allegations that Defendants falsified information in their role as treating physicians—either Defendants overtreated or falsified treatment records to obtain higher payments from Plaintiffs. Defendants' alleged conduct goes to their role as treating physicians, not as witnesses as Defendants assert. Moreover, even accepting Defendants' characterization that the challenged conduct consists of statements they made relating to the Claimants' medical treatment as reflected in the medical reports and invoices, such statements are not the functional equivalent of testimony given in the course of judicial proceedings based on Plaintiffs' allegations. They are statements reflecting treatment, both lack of treatment in some cases and overtreatment in other cases according to Plaintiffs. Indeed, Defendants' conduct is analogous to "pretrial conspiracy to engage in non-testimonial acts such as fabricating . . . evidence" that the Ninth Circuit has found to be outside the protection of witness immunity. See Paine, 265 F.3d at 983. The fact that Defendants may expect to testify consistently with their purportedly fabricated evidence in proceedings involving the Claimants is not a shield to protect from liability for alleged conduct that they engaged in pre-litigation to manipulate evidence before they testified.
Defendants argue that "eventual testimony" is protected and "anything done in preparation of providing such testimony is protected as well." (ECF No. 252 at 5 (emphasis in original) (citing Buckley, 919 F.2d at 1245).) Defendants reason that the medical reports and invoices "were written versions of their future testimony." (Id. at 7.) But the cases they rely on involved expert witnesses and the work they performed in preparing for their testimony.
Finally, Defendants insist that applying the litigation privilege and witness immunity doctrines to bar Plaintiffs' claim advances important public policy. These doctrines are based on the same public policy. (ECF No. 222 at 17-19.) "The policy underlying the [litigation] privilege is that in certain situations the public interest in having people speak freely outweighs the risk that individuals will occasionally abuse the privilege by making false and malicious statements." Circus Circus Hotels, 657 P.2d at 104. "The purpose of [witness] immunity is to encourage witnesses to come forward and speak freely in court by relieving the potential defendant of any fear that he will later have the burden of litigating the propriety of his conduct as a witness." Paine, 265 F.3d at 980 (9th Cir. 2001) (citing Briscoe, 460 U.S. at 335-36).) Extending the litigation privilege and witness immunity to the conduct alleged here would not serve the purpose of promoting those involved in judicial proceedings to "speak freely." To the contrary, it would encourage the fabrication of evidence in an attempt to leverage settlement, and fabrication of evidence is unsurprisingly not entitled to protection. Cunningham, 229 F.3d at 1291.
Plaintiffs seek sanctions pursuant to Rule 11, contending that Defendants' Motion presents frivolous arguments that are not legally supported and are contrary to established law.
The Court notes that the parties made several arguments and cited to several cases not discussed above. The Court has reviewed these arguments and cases and determines that they do not warrant discussion as they do not affect the outcome of the parties' motions.
It is therefore ordered that Defendants' motion for summary judgment (ECF No. 222) is denied.
It is further ordered that Plaintiffs' motion for sanctions (ECF No. 285) is denied.