152420P.pdf   08/12/2016  Linda Donegan  v.  Anesthesia Associates
   U.S. Court of Appeals Case No:  15-2420
   U.S. District Court for the Western District of Missouri - Kansas City   
   [PUBLISHED] [Loken, Author, with Riley, Chief Judge, and Benton, Circuit 
   Judge] 
   Civil case - False Claims Act. In qui tam action alleging defendant 
   defrauded the government by misbilling anesthesia services because an 
   anesthesiologist was not usually present when the patient "emerged" from 
   anesthesia, the district court did not err in granting defendant summary 
   judgment based on its conclusion that the defendant could not knowingly 
   submit false or fraudulent claims because neither the government agency 
   administering the Medicare and Medicaid programs nor any other relevant 
   governing body has issued guidance on the meaning of "emergence," and 
   defendant's interpretation that the regulations permitted its billing 
   practice was objectively reasonable; as the agency had not clarified an 
   obvious and decades-old ambiguity in its regulations, defendant's failure 
   to obtain a legal opinion or prior agency approval for the billing cannot 
   support a finding of recklessness; the district court did not err in 
   refusing to consider a new theory relator presented for the time at 
   summary judgment.