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U.S. EX REL. ZIZIC v. Q2ADMINISTRATORS, LLC

No. 12-2215.

728 F.3d 228 (2013)

UNITED STATES of America ex rel. Thomas M. ZIZIC, M.D., Appellant v. Q2ADMINISTRATORS, LLC and Rivertrust Solutions, Inc.

United States Court of Appeals, Third Circuit.

Opinion Filed: August 26, 2013.

Attorney(s) appearing for the Case

Brian J. McCormick, Jr. (Argued), Matthew C. Monroe , Sheller, Philadelphia, PA, for Appellant.

Stephanie C. Chomentowski , Blank Rome, Philadelphia, PA, Daniel E. Chudd , James C. Cox , Warren J. DeVecchio (Argued), Marina K. Jenkins , Jenner & Block, Washington, DC, for Q2Administrators, LLC.

James A. Backstrom, Jr. , Philadelphia, PA, Jaime L. Derensis , Gary C. Shockley (Argued), Baker, Donelson, Bearman, Caldwell & Berkowitz, Nashville, NC, for RiverTrust Solutions, Inc.

Before: RENDELL, FISHER and JORDAN, Circuit Judges.

OPINION OF THE COURT

FISHER, Circuit Judge.

Relator Thomas M. Zizic, M.D. ("Zizic") filed this qui tam1 suit under the False Claims Act ("FCA"), 31 U.S.C. §§ 3729-33, alleging that Q2Administrators, LLC ("Q2A") and RiverTrust Solutions, Inc. ("RTS") fraudulently billed the United States for the unperformed review of benefit claim denials that was required by the Medicare Act ("Medicare"), 42 U.S.C. § 1395...

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