UNITED STATES COURT OF APPEALS FOR THE SIXTH CIRCUIT

┐ IN RE: KING’S DAUGHTERS HEALTH SYSTEM, INC., a │ corporation dba King’s Daughters Medical Center, > No. 22-5071 │ Petitioner. ┘

On Petition for Writ of Mandamus. United States District Court for the Eastern District of Kentucky at Ashland; No. 0:15-cr-00015-1—David L. Bunning, District Judge.

Decided and Filed: April 15, 2022

Before: BATCHELDER, McKEAGUE, and GRIFFIN, Circuit Judges. _________________

COUNSEL ON PETITION FOR WRIT OF MANDAMUS: Ashley M. Ward, STITES & HARBISON, PLLC, Lexington, Kentucky, Michael D. Risley, STITES & HARBISON, PLLC, Louisville, Kentucky, for Petitioner.

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ORDER _________________

King’s Daughters Health System, Inc., doing business as King’s Daughters Medical Center (“KDMC”), petitions for a writ of mandamus, asking that we compel the district court to vacate its order granting a motion to compel and, further, that we compel the court to deny the motion to compel. For the following reasons, we deny KDMC’s petition for a writ of mandamus.

I.

This petition for a writ of mandamus is another chapter in the federal government’s prosecution of Dr. Richard Paulus for healthcare fraud. We have recounted the background of No. 22-5071 In re King’s Daughters Health Sys. Page 2

this case in three opinions. See United States v. Paulus, 894 F.3d 267 (6th Cir. 2018) (Paulus I); United States v. Paulus, 952 F.3d 717 (6th Cir. 2020) (Paulus II); United States v. Paulus, No. 20-6017, 2021 WL 3620445 (6th Cir. Aug. 16, 2021) (Paulus III).

Our opinion in Paulus II recounts the background relevant to this mandamus petition:

A.

For years Paulus was a successful cardiologist at King’s Daughters Medical Center (KDMC). He performed an incredible number of angiograms and was “first in the nation for the total amount billed to Medicare for these procedures.” But not all was well. Complaints emerged that Paulus was performing medically unnecessary procedures. And several audits indicated that in multiple cases Paulus had reported a higher degree of blockage in his patients’ arteries than their angiograms reflected. Meaning, in some cases, the patient’s angiogram showed a low degree of blockage and thus that the patient didn’t need a stent inserted. Yet Paulus reported a much more severe blockage, inserted a stent, and then billed patients and their insurance companies for the stent procedure. Eventually, these allegations reached the federal government. At first, the government considered entering into a civil settlement with Paulus. In a letter setting forth its demands, the government stated that its consultants had reviewed 496 of Paulus’s procedures and concluded that 146 of them (or about 30%) were unnecessary because the patients’ angiograms showed minimal arterial blockage. The government further noted that its experts weren’t the only ones who found Paulus’s procedures to be problematic: the letter explained that KDMC’s “consultants [had] also reviewed a random selection of Dr. Paulus’ procedures, and found 75 angiographic films with [minimal blockage] in the artery he stented