United States District Court, D. Idaho
MEMORANDUM DECISION AND ORDER
LYNN WINMILL U.S. DISTRICT COURT JUDGE
Court has before it a motion for partial summary judgment
filed by the Government. The motion is fully briefed and at
issue. For the reasons explained below, the Court will grant
in part and deny in part the motion.
Government has brought this lawsuit against Cherie Dillon and
Dental Health Care with Heart, P.C. under the False Claims
Act (FCA) alleging that the defendants committed health care
fraud and seeking civil penalties. In a separate criminal
proceeding in this Court, Dillon pled guilty to 24 counts of
health care fraud. Dillon's plea, the Government argues,
estops her from contesting civil liability in this FCA
Government's motion is directed only against Cherie
Dillon and only seeks summary judgment on one of the fraud
theories alleged in the complaint, i.e., false claims for
dentist-only procedures that were not performed by a dentist.
More specifically, the Government asks the Court to (1) find
that Dillon submitted 492 false and fraudulent claims for
Medicaid payment for dentist-only procedures that were not
performed by a dentist and (2) impose a civil penalty of
$550, 000 on Dillon for that conduct. The Government argues
that Dillon is collaterally estopped from challenging this
motion because she admitted to this conduct when she entered
her plea of guilty in the criminal case.
criminal case, Dillon was charged with 24 counts of health
care fraud and 24 counts of aggravated identity theft.
See U.S. v Dillon, 1:16-cr-037-BLW. The case went to
trial, and after the Government rested its case, Dillon pled
guilty to all counts, and she was later sentenced to 60
months incarceration. Following a hearing, the Court imposed
forfeiture of $847, 016, and ordered restitution in the sum
of $139, 769.80. On appeal, the Ninth Circuit held that (1)
Dillon's plea was “knowing and voluntary”;
and (2) the Court, in calculating the restitution amount,
should not have deducted billings for hygiene services Dillon
performed. See U.S. v. Dillon, 749 Fed.Appx. 541
(9th Cir. 2018). On remand, the Court held a hearing and
increased the restitution amount to $316, 778.25. See
Order (Dkt No. 168 in U.S. v. Dillon, 1:16-cr-037-BLW).
her guilty plea hearing, Dillon stipulated that the evidence
at trial and the allegations in the Superseding Indictment
constituted the factual basis of her guilty plea. See
Transcript (Dkt. No. 53) at pp. 23-24. Thus, Dillon has
admitted the following:
1. That she violated 18 U.S.C. § 1347 by
“knowingly and willfully . . . execut[ing] a scheme and
artifice to defraud health care benefit programs as to
material matters, and to obtain by means of materially false
or fraudulent pretenses, representations, or promises, any of
the money or property owned by, or under the custody or
control of, any health care benefit program.”
See 18 U.S.C. § 1347.
2. That she “submit[ed], or caus[ed] to be submitted,
claims for payment to health care benefit programs for
various Dental Services, falsely and fraudulently
representing that the treatments were performed by a
qualified dentist, when in truth and in fact treatments were
performed by CHERIE R. DILLON, a dental hygienist, or not
performed at all.” See Superseding Indictment (Dkt.
No. 16) at ¶ 7.
3. That she “performed Dental Services and received
payment for those services from health care benefit programs
while fraudulently misrepresenting that the services had been
performed by a dentist, and while fraudulently billing health
care benefit plans under [the dentist's] credentials for
such services.” Id. at ¶ 19.
4. That she defrauded Medicaid. Id. at ¶ 22.
conduct, as admitted to in her guilty plea hearing,
constitute violations of the FCA, as alleged in the complaint
in this case. More specifically, Dillon has admitted
violating 31 U.S.C. § 3729(a)(1)(A) of the FCA by
knowingly submitting, or causing to be submitted, false
Medicaid claims for payment. She has also admitted violating
31 U.S.C. § 3729(a)(1)(B) of the FCA by knowingly making
or using, or causing to be made or used, a false statement or
record material to a false or fraudulent claim.
these admissions establish all the elements required for the
FCA claims in this case, Dillon is collaterally estopped from
denying civil liability for those particular claims. The