United States v. State Farm Mutual Automobile Ins., Co., 100110 FED9, 09-35819
|Party Name:||UNITED STATES OF AMERICA, ex rel, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, AKA State Farm Insurance Group, Defendant-Appellee. and EUGENE MASON and PATRICK D. BROWN, Plaintiffs - Appellants,|
|Judge Panel:||Before: HAWKINS, McKEOWN, and BEA, Circuit Judges.|
|Case Date:||October 01, 2010|
|Court:||United States Courts of Appeals, Court of Appeals for the Ninth Circuit|
NOT FOR PUBLICATION
Submitted September 2, 2010 [**]Seattle, Washington
Appeal from the United States District Court for the District of Idaho No. 1:07-cv-00297-EJL Edward J. Lodge, District Judge, Presiding.
Eugene Mason brought suit under the False Claims Act, 31 U.S.C. § 3729(a)(7), against State Farm Mutual Automobile Insurance Company. Mason sought to recover damages on behalf of the U.S. government for an allegedly false statement caused by State Farm: that Medicare owed the costs of Mason's operation to St. Luke's hospital, when it was really State Farm, not Medicare, which owed St. Luke's. Indeed, after St. Luke's invoiced Medicare, State Farm withdrew its claim that there was no coverage, and conceded liability for sixty percent of Mason's hospital bill.
The district court granted State Farm's motion to dismiss, with prejudice, pursuant to Federal Rule of Civil Procedure 12(b)(6). We have jurisdiction over Mason's appeal under 28 U.S.C. § 1291. We affirm.1
We review de novo the grant of a Rule 12(b)(6) motion to dismiss. Knievel v. ESPN, 393 F.3d 1068, 1072 (9th Cir. 2005). "To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face." Ashcroft v. Iqbal, 129 S.Ct. 1937, 1948 (2009) (quotations omitted).
Even if State Farm caused St. Luke's to submit a payment invoice to Medicare, Mason has not stated a claim that State Farm caused to be made a "false statement" as required for liability under the False Claims Act. 31 U.S.C. § 3729(a)(1)(G). The St. Luke's invoice was not false, because it was based on a statutorily-created liability of Medicare. See United States ex rel Hochman v. Nackman, 145 F.3d 1069, 1075 (9th Cir. 1998) (for False Claims Act purposes, a statement authorized by statute is not false). Under the Medicare Secondary Payer statute, 42 U.S.C. § 1395y(b)(2)(B)(i), Medicare is liable as a secondary insurer to a Medicare service provider when it does not appear...
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