Gonzalez v. Planned Parenthood

Under Federal Rule of Civil Procedure 8(a) and 9(b), a claim under the False Claims Act must plausibly suggest an entitlement to relief through factual allegations, and must adequately plead falsity.

P. Victor Gonzalez appealed his dismissed action under the False Claims Act (“FCA”) and the California False Claims Act (“CFCA”). “Gonzalez alleged that Planned Parenthood knowingly and falsely over billed state and federal governments for contraceptives supplied to low-income individuals.” Planned Parenthood is reimbursed for contraceptives that it provides. The reimbursement claims should contain the “at cost” rate for contraceptives, however from 1997 to 2004, Planned Parenthood used its “usual and customary rates.” Beginning in 1997, the California Department of Healthcare Services (“CDHS”) sent letters to Planned Parenthood regarding its billing. After Planned Parenthood explained its reimbursement billing practices, CDHS did not respond, but conducted an audit in 2004. CDHS did not attempt to recover any overcharges made by Planned Parenthood, which as a result of the audit equaled $5,213,645.92. Gonzalez, Chief Financial Officer of Planned Parenthood of Los Angeles from 2002 to 2004, “filed a qui tam suit” in 2005, regarding Planned Parenthood’s “fraudulent billing.” Gonzalez’s third amended complaint was dismissed with prejudice by the district court for “failure to adequately plead falsity under Federal Rule of Civil Procedure 9(b).” Upon review, the Ninth Circuit found on the alternate ground that Gonzalez “did not state plausible claims for relief.” The panel applied “the plausibility requirement” under Federal Rule of Civil Procedure 8(a), and determined that the factual allegations did not “plausibly suggest an entitlement to relief.” The panel based its finding on the letters, which contradicted that Planned Parenthood “knowingly submitted false claims” since CDHS remained silent after Planned Parenthood explained its billing practices. The panel agreed with the district court that Gonzalez’s CFCA claims were beyond the three-year statute of limitations, since reasonable discovery began in 1997 and the complaint was filed in 2005. The panel therefore affirmed the district court’s dismissal. AFFIRMED.