United States of America v. Sentara Healthcare et al

Filing 67

MEMORANDUM OPINION. Signed by Judge Elizabeth K. Dillon on 3/8/2024. (kpa)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF VIRGINIA
CHARLOTTESVILLE DIVISION
UNITED STATES OF AMERICA,
v.

Petitioner,

SENTARA HEALTHCARE,
HOWARD KERN,
MICHAEL DUDLEY, and
JAMES JUILLERAT,
Respondents.

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Civil Case No. 3:23-mc-00007
By: Elizabeth K. Dillon
United States District Judge

MEMORANDUM OPINION
This enforcement matter arises out of an ongoing False Claims Act (FCA) investigation
of Sentara Healthcare (Sentara) by the United States Attorney’s Office and the Department of
Justice. The government is investigating whether Sentara made materially false statements in
health insurance rate filings for the 2018 and 2019 plan years for the Affordable Care Act (ACA)
individual health insurance marketplace in Virginia and submitted false claims for Advanced
Premium Tax Credits (APTCs) to the federal government. (Pet. For Enforcement 1, Dkt. No. 1.)
The United States issued to Sentara a number of Civil Investigative Demands (CIDs) for oral
testimony and documents relating to the market rate filings, and Sentara has generally complied
with these demands. (Id. at 8.) The government claims, however, that Sentara has refused to
comply with four CIDs requesting documents and oral testimony from several former and
current Sentara employees. (Id. at 14–15.) The United States brought this action to compel
Sentara’s responses to these CIDs. (Id.) Sentara opposes the government’s petition and has filed
several motions to seal the pleadings and related exhibits in this matter (Dkt. Nos. 9, 20, and 36).
The court temporarily sealed pleadings and related exhibits pending argument on the same.
Sentara also filed a motion to close the courtroom for a hearing on these matters. (Dkt. No. 46.)

The court held a hearing on these issues, and they are now ripe for resolution. For the
reasons stated on the record at the hearing, 1 the court denied the motion to close the courtroom
generally (Dkt. No. 46), but it took the motion under advisement in part to allow counsel to
request that the courtroom be closed for the discussion of specific exhibits or arguments.
Pursuant to this ruling, the court allowed bench conferences for sensitive matters. For the
following reasons, the court will grant the United States’ petition for enforcement (Dkt. No. 1)
and grant in part and deny in part Sentara’s motions to seal (Dkt. Nos. 9, 20, 36).
I. BACKGROUND
The United States has been investigating Sentara under the FCA since 2021, and Sentara
has provided voluminous documents and many depositions over the course of the investigation.
(Pet. 8.) In May 2021, the government issued CID No. 21-337 for all documents relating to the
2018 and 2019 ACA market rate filings as well as Sentara’s corporate and organizational
structure. (Id. at 7.) Later that year, Sentara named several document custodians including
Michael Dudley, the former president and CEO of Sentara, and James Juillerat, Sentara’s current
chief actuary. (Id. at 8.) As noted at the hearing, Sentara produced many documents in response
to that CID. On March 22, 2022, Sentara represented to the government that all documents had
been produced regarding Juillerat (Exhibit C, Dkt. No. 4-2), and on April 4, 2022, that all
documents had been produced regarding Dudley (Exhibit D, Dkt. No. 4-3). Following Sentara’s
represention in August 2022 that all responsive documents had been produced, the government
issued CIDs for the oral testimony of several custodians, including Dudley and Juillerat. 2 (Pet.

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Many of these reasons also support the court’s ruling regarding the sealing of documents.
CID Nos. 22-1024 and 22-1026, respectively.

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8.) The United States took sworn testimony of Juillerat on December 8, 2022, and of Dudley on
June 12, 2023. (Id.)
In June 2023, the United States noticed that Sentara was relying upon documents that had
not been previously produced to the government. Sentara then began producing thousands of
additional documents (somewhere between 2,100 and 2,800 new documents (about 8,000 pages))
after conducting a “re-review” of its records. While Sentara claims that many of these
documents were not responsive to the government’s original request for documents in CID No.
21-337 but were either duplicative or “relevant to Sentara’s defenses” (Id. at 12; Ex. G 1, Dkt.
No. 4-6), it admitted at the hearing that some of the documents were non-duplicative, relevant,
and responsive to the CIDs. According to the government, the new records contain “important
details requiring further investigation,” including additional sworn testimony from Dudley and
Juillerat. (Pet. 10.) The new documents also make extensive mention of Howard Kern,
Sentara’s president and CEO during the time in question, whom Sentara had not previously
identified as a custodian. (Id. at 11.)
The United States issued two new CIDs for Kern’s responsive documents and sworn
testimony. 3 (Id. at 14.) The government has also requested Dudley and Juillerat’s further
testimony as a continuation of their previous testimony under CID Nos. 22-1024 and 22-1026,
but Sentara has not yet complied. (Id. at 14–15.) In light of Sentara’s noncompliance, the
United States filed a Petition for an Order to Show Cause and for Summary Enforcement of the
CIDs on November 13, 2023. (See generally Pet.) During the pendency of this petition, Sentara
has agreed to comply with the United States’ demands for Kern’s responsive documents and

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CID Nos. 23-1221 and 23-1222, respectively.

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sworn testimony, leaving at issue only the CIDs demanding Dudley and Juillerat’s continued
sworn testimony. (US’s Reply 2, Dkt. No. 43.)
The government also filed a motion to temporarily seal the exhibits attached to the
petition “until such time as the Respondents may note their position on the sealing of the
exhibits.” (US’s Mot. to Seal 1, Dkt. No. 2.) Sentara then filed several motions to seal the
following: (1) the petition and the accompanying exhibits (Dkt. No. 9), 4 (2) Sentara’s own
response to the petition (Dkt. No. 20), and (3) all future briefings in this matter (Dkt. No. 36).
II. DISCUSSION
A. Petition for Enforcement
1. Legal standards
The FCA empowers the Attorney General or his or her designee to issue a CID
requesting documents, responses to interrogatories, or deposition testimony. 31 U.S.C. §
3733(a)(1). When a CID recipient “fails to comply with any civil investigative demand issued
under subsection (a) . . . the Attorney General may file, in the district court of the United States
for any judicial district in which such person resides, is found, or transacts business, and serve
upon such person a petition for an order or such court for the enforcement of the civil
investigative demand.” 31 U.S.C. § 3733(j)(1). Courts treat CIDs as if they were administrative
subpoenas, meaning that the court’s role in enforcing CIDs is “sharply limited.” United States v.
Markwood, 48 F.3d 969, 975 (6th Cir. 1995); EEOC v. City of Norfolk Police Dep’t, 45 F.3d 80,
82 (4th Cir. 1995). A CID will be enforceable if the government can show the investigation has
a “legitimate purpose” and the CID “may be relevant to that purpose.” Markwood, 48 F.3d at
978. Further, courts must enforce CIDs when: (1) the issuing agency has the authority to engage
Sentara designates this as its response to the United States’ request for Sentara’s position on sealing the
petition’s exhibits.
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in the investigation; (2) the issuing agency has complied with the statutory requirements of due
process; (3) the information sought is reasonably relevant to the investigation; and (4) the
information sought is not unduly burdensome. 5 In re Civ. Investigative Demand 15-439, 2016
WL 4275853, at *3 (citing E.E.O.C. v. Ranstad, 685 F.3d 433, 442 (4th Cir. 2012)); EEOC v.
Maryland Cup Corp., 785 F.2d 471, 476 (4th Cir. 1986).
2. Agency authority and undue hardship
While Sentara argued in its briefing that the United States had no authority to issue the
CIDs, it conceded at the hearing that it is not pursuing this argument. (See Sentara’s Resp. 20,
Dkt. No. 19; Hr’g. Tr. 56:23–25, Dkt. No. 64.) Sentara also argued in briefing that the
government’s purported lack of authority somehow causes the CIDs to be “overly broad” and
“unduly burdensome.” (Sentara’s Resp. 20–21.) It is unclear whether Sentara intended to also
concede this point when it made its concession on the government’s authority; regardless, the
court does not accept Sentara’s line of reasoning. As the Fourth Circuit has found, “[t]he burden
of proving that an administrative subpoena is unduly burdensome is not easily met. The party
subject to the subpoena must show that producing the documents would seriously disrupt its
normal business operations.” N.L.R.B. v. Carolina Food Processors, Inc., 81 F.3d 507, 513 (4th
Cir. 1996) (quoting Maryland Cup Corp., 785 F.2d at 477. Sentara has made no such showing.
3. Relevance of the CIDs
The government further contends that the testimony sought is “reasonably relevant to the
United States’ investigation and is necessary because Sentara failed to produce all responsive
records for each witness prior to the government taking their sworn testimony.” (Pet. 21.)

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process.

Sentara does not dispute that the government has complied with the statutory requirements of due

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Generally, “[f]or purposes of an administrative subpoena, the notion of relevancy is a broad
one.” Sandsend Fin. Consultants Ltd. v. Fed. Home Bank Bd., 878 F.2d 875, 882 (5th Cir.
1989). An agency “can investigate merely on the suspicion that the law is being violated, or
even just because it wants assurance that it is not.” United States v. Morton Salt Co., 338 U.S.
632, 642 (1950). “So long as the material requested ‘touches a matter under investigation,’ an
administrative subpoena will survive a challenge that the material is not relevant.” Sandsend,
878 F.2d at 882 (quoting EEOC v. Elrod, 674 F.2d 601, 613 (7th Cir. 1982)).
The United States represents that the newly produced documents “include important
details requiring further investigation” and are “material to the core issues under investigation.”
(Pet.10; US’s Reply 5, Dkt. No. 39.) The government further contends that “over 150 of the
documents Sentara produced after Mr. Dudley’s sworn testimony on June 12 relate to Mr.
Dudley. Similarly[] . . . over 1,200 of these newly produced responsive documents involve Mr.
Juillerat.” (Pet. 14–15.) Sentara conceded at the hearing that some of the newly produced are
non-duplicative, relevant, and responsive. 6 As discussed above, the court in its “sharply limited”
role need merely find that the government’s investigation has a legitimate purpose and that the
CIDs at issue are reasonably relevant to that purpose. Markwood, 48 F.3d at 975. The
information the government is seeking from Dudley and Juillerat certainly “touches a matter
under investigation” as it is material to the insurance rate filings at the center of the
government’s investigation. Sandsend, 878 F.2d at 882. The court finds that the government’s

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Sentara has also provided the government with another reason for not complying with the government’s
CIDs, writing in email correspondence that “[t]he Department has more than sufficient information in its possession
to make [a] decision . . . and it should do so without any more delay or expense to the subjects of this investigation.”
(Ex. M 3, Dkt. No. 4-12.) Sentara did not pursue this argument at the hearing, and, regardless, it is not part of the
court’s inquiry.

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requests for Dudley and Juillerat’s continued oral testimony are reasonably relevant to its
investigation.
4. Procedural concerns
At the hearing, Sentara focused its argument on an alleged government violation of the
CID statute’s (31 U.S.C. § 3773 (a)(2)(G)) requirement that a new civil investigative demand for
oral testimony must be authorized by the Attorney General before oral testimony may be
required of Dudley and Juillerat because they have already been deposed under the CIDs for
which the government seeks enforcement. Sentara states that it would now comply with new
CIDs, if authorized by the Attorney General, but it does not believe that a continuation of
depositions under the previously issued CIDs is allowed.
The government represented that it seeks only to supplement the previous depositions of
Dudley and Juillerat based upon the newly produced documents for the same general purpose
and primary areas of inquiry provided in the previously issued CIDs. The need for additional
testimony arises from the failure of Sentara to produce all of the requested documents prior to the
depositions, despite a representation to the contrary. Sentara insists that the failure to produce all
of the documents was inadvertent in this complex matter and that it has cooperated and produced
many documents. The court has no reason to doubt these representations, but it makes no matter
here. The need for a continuation of the previously held depositions arises from the production
of the new documents.
The decision in United States v. Hines, No. 8:18-mc-83, 2019 WL 4491313 (M.D. Fla.
Aug. 14, 2019), report and recommendation adopted, No. 8:18-mc-83, 2019 WL 4479314 (M.D.
Fla. Sept. 18, 2019), supports the government’s request to enforce the CIDs. In that case, a CID
recipient failed to produce requested documents before his testimony, but the government took

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his testimony anyway and reserved the right to resume the testimony; the recipient eventually
provided the documents. When the government later decided to take additional testimony, it
filed an enforcement petition asking the court to enforce the original CID. Id. at *2. The
magistrate judge found that the government had the authority to issue the CID and that the
information sought from the witness was relevant to that investigation. Id. at *8–9. The district
judge ordered that the original CID be “enforced as issued” and did not require the issuance of a
new CID. United States v. Hines, 2019 WL 4479314 at *1 (M.D. Fla. Sept. 18, 2019) (emphasis
added). The court will follow a similar approach here and not require the government to issue
new CIDs for Dudley’s and Juillerat’s testimony.
The United States has shown, and Sentara has conceded, that it has the authority to
conduct an FCA investigation of Sentara’s rate filing practices in 2018 and 2019, and the court
finds that Dudley and Juillerat’s testimony is reasonably relevant to that purpose and not unduly
burdensome. For these reasons, the court, cognizant of its “sharply limited” role in enforcing
CIDs, will grant the United States’ petition to enforce CIDs 22-1024 and 22-1026 and order that
Dudley and Juillerat comply with the government’s requests for their continued testimony.
B. Motions to Seal
1. Legal standards
Although the district court’s authority and discretion to seal judicial records or documents
is well established in the Fourth Circuit, the court may do so only “if the public’s right of access
is outweighed by competing interests.” Ashcraft v. Conoco, Inc., 218 F.3d 288, 302 (4th Cir.
2000) (quotations omitted). Because public access advances judicial integrity and serves the
public interest, access “may be abrogated only in unusual circumstances.” Stone v. Univ. of Md.
Med. Sys. Corp., 855 F.2d 178, 182 (4th Cir. 1988). See also Doe v. Public Citizen, 749 F.3d

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246, 266 (4th Cir. 2014). The party seeking the sealing of documents bears the burden of
overcoming the right of access to the documents. Va. Dep’t of State Police v. Washington Post,
386 F.3d 567, 578 (4th Cir. 2004).
There are two sources for the public’s right of access to court documents – the common
law and the First Amendment. Id. at 575. “The common law presumes a right to inspect and
copy judicial records and documents.” Stone v. Univ. of Md. Med. Sys. Corp., 855 F2d 178, 180
(4th Cir. 1988) (citing Nixon v. Warner Commc’ns., Inc., 435 U.S. 589, 597 (1978)). This
presumptive right to judicial documents can be “rebutted only by showing that countervailing
interests heavily outweigh the public interests in access.” Doe v. Public Citizen, 749 F.3d 246,
264 (4th Cir. 2014). Courts have also noted that the public interest is at its apex when the
government is a party to the action. Id. at 271. Likewise, the First Amendment guarantees access
but only “to particular judicial records and documents.” Id. at 180; see, e.g., In re Washington
Post Co., 807 F.2d 383, 390 (4th Cir. 1986) (First Amendment right of access applies to criminal
plea and sentencing hearings); Rushford v. New Yorker Magazine, Inc., 846 F.2d 249, 252–53
(4th Cir. 1988) (same as to filings related to summary judgment); but see Craddock v.
LeClairRyan, No. 3:16-cv-11, 2019 WL 2437460, at *6–7 (E.D. Va. June 11, 2019) (First
Amendment right of access does not apply to arbitration awards, but common law right does). In
the civil context, there is very little caselaw about application of the First Amendment right of
access other than summary judgment motions. When the First Amendment provides a right of
access to records, that right may only be overcome by a “compelling government interest” and
only if the denial of access is “narrowly tailored to serve that interest.” Doe, 749 F.3d at 266.
Usually, the distinction between the rights of access afforded by the common law and the
First Amendment is “significant” because the common law “does not afford as much substantive

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protection to the interests of the press and the public as does the First Amendment.” In re
Baltimore Sun Co., 886 F.2d 60, 64 (4th Cir. 1989); Rushford v. New Yorker Magazine, Inc., 846
F.2d 249, 253 (4th Cir. 1988). Because of this distinction, the district court is generally directed
to first “determine the source of the right of access with respect to each document . . . [so it] then
can it accurately weigh the competing interests at stake.” Stone v. Univ. of Md. Med. Sys. Corp.,
855 F.2d 178, 181 (4th Cir. 1988).
Upon determining the source of the right of access, a district court may seal court
documents once it has “(1) provided public notice of the request to seal and allow[ed] interested
parties a reasonable opportunity to object, (2) consider[ed] less drastic alternatives to sealing the
documents, and (3) provide[ed] specific reasons and factual findings supporting its decision to
seal the documents and for rejecting the alternatives.” 7 Ashcraft, 218 F.3d at 302.
2. Source of the right of access
The government argues that the First Amendment provides the source of the right of
access because the government is a party. It further argues that the court need not decide this
constitutional issue because Sentara cannot overcome its burden under the less demanding
common law standard. Sentara makes no argument regarding the source of the right of access.
Because there is no caselaw applying the First Amendment as a source of access in CID
matters and in accordance with the doctrine of constitutional avoidance, the court first analyzes
the matter under the common law standard. As noted below, because Sentara cannot meet the
common law standard for most of the documents, the court has no need to analyze the matter
under the more demanding First Amendment standard. 8

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The docket in this case provided public notice.

As the Supreme Court has recognized, “It is a well[-]established principle governing the prudent exercise
of . . . jurisdiction that normally [a federal court] will not decide a constitutional question if there is some other
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3. Sentara has not presented countervailing interests that heavily outweigh the
public interests in access that would justify Sentara’s broad sealing request
Sentara asks that the court seal the government’s petition, all exhibits to the petition,
Sentara’s response and exhibits thereto, and the government’s reply to Sentara’s response. It
argues that without the sealing of the documents it will suffer reputational damage and that the
Federal Claims Act supports the sealing of documents. It further argues that the petition is
overly broad in certain of its disclosures and that at least some of the exhibits should be sealed.
Sentara first contends that making the pleadings here publicly available would have
“damaging implications” and that the petition causes harm “by alerting the public and the press
to damaging allegations that the Government maintains it has not yet fully investigated.”
(Sentara’s Mem. in Supp. of First Mot. to Seal 4–5, Dkt. No. 10.) Courts have found several
factors associated with reputational damage that weigh in favor of sealing court documents: “(1)
where disclosure may be used to gratify private spite or promote public scandal, (2) where
disclosed records may serve as reservoirs of libelous statements for press consumption, or (3)
where disclosure might reveal trade secrets[.]” Under Seal v. Under Seal, 326 F.3d 479, 485–86
(4th Cir. 2003) (citing Nixon, 435 U.S. at 598–99). Sentara claims that the petition includes
sensitive business information and that government is using the petition to stir up public
sentiment against Sentara. (Id. at 6.) The United States responds that the petition does not
contain any trade secrets or otherwise confidential information that would disadvantage Sentara
in the market. (US’s Resp. to First Mot. to Seal 6, Dkt. No. 23.) The government further
contends that the circumstances surrounding the rate filings at issue here are already well-known

ground upon which to dispose of the case.” Escambia Cnty. v. McMillan, 466 U.S. 48, 51 (1984) (citing Ashwander
v. Tenn. Valley Auth., 297 U.S. 288, 347 (1936) (Brandeis, J., concurring)).

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to the public and have been covered by the press. 9 (Id. at 7.) The court agrees that the unsealing
of this matter would not reveal trade secrets, cause further damage to Sentara’s reputation, or stir
up any public scandal. Given that the issues have already been publicized, it appears whatever
damage that may come from the disclosure of the United States’ investigation has already been
done. Moreover, most of the disclosures were necessary for the United States to seek the relief
requested.
Sentara also supports its arguments regarding possible reputational harm by pointing to
the routine sealing of qui tam cases, noting that the seal is used “to [both] permit the United
States to investigate the allegations” and “to protect the reputation of a defendant in that the
defendant is named in a fraud action brought in the name of the United States, but the United
States has not yet decided whether to intervene.” ACLU v. Holder, 673 F.3d 245, 250 (4th Cir.
2011). But qui tam actions and CID proceedings are statutorily distinct. Qui tam actions are
brought under the FCA, 10 while 31 U.S.C. § 3733 sets forth the CID regulations. This is not a
qui tam action. It is a procedure to enforce CIDs, and the CID regulations do not include any
confidentiality requirement. Rather, the statute specifically provides for the public use of
material obtained from a CID in enforcement proceedings.
Indeed, the “official use” provision of the CID statute—which the United States relies
upon—authorizes the government to introduce CID documents and transcripts “into the record of
a case or proceeding; applications, motions, memoranda and briefs submitted to a court or other
tribunal” and “in connection with any such case or proceeding as such [DOJ] attorney determines

9
See, e.g., Sandy Hausman, Consumers Complain of Massive Health Insurance Hikes, WTVF (Apr. 12,
2018, 4:24 PM), https://www.wvtf.org/news/2018-04-12/consumers-complain-of-massive-health-insurance-hikes;
Lisa Provence, Out of pocket, C-VILLE WEEKLY (Dec. 6, 2023, 5:00 AM), https://www.c-ville.com/out-of-pocket.
10

See 31 U.S.C. § 3730(b).

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to be required.” 31 U.S.C. § 3733(l)(8); § 3733(i)(3). The United States contends that the
transcript excerpts included in the petition satisfy the “official use” exception because the
excerpts “directly addressed the issue underpinning the Petition to Enforce: the relevance of
Howard Kern’s documents and testimony[.]” (US’s Opp’n to First Mot. to Seal at 8, Dkt. No
23.)
In a similar case, United States v. Bechtold, No. 3:22-MC-18, 2022 WL 3137950 (N.D.
Fla. June 13, 2022), the respondents filed a motion to strike or seal a portion of the government’s
enforcement petition that purportedly conveyed the government’s opinions of the merits of its
FCA investigation in a way that put the respondents in a negative light and included purportedly
confidential information. Id. at *2. The government opposed this request, asserting, as the
United States does here, that nothing in the CID statute prohibits the government from simply
explaining its investigation and “judicial opinions resolving disputes over CIDs routinely include
a summary of the Government’s allegations and the basis for the FCA investigation.” 11 Id. The
court ultimately denied the motion to strike/seal. Id. at 3. Though the government in Bechtold
did not explicitly invoke the “official use” exception as it does here, Bechtold is analogous to the
present matter. Here, the petition contains information that Sentara considers negative and
confidential but that the government contends is simply being used to explain the reason for the
petition. The United States’ inclusion in the petition of excerpts from Dudley’s testimony and
other information obtained from CIDs was done to demonstrate the need for the enforcement
measures for which it has petitioned. Thus, with only a few exceptions addressed later, the court
finds that the information falls under the “official use” exception and need not be kept under
seal.
See, e.g., United States v. Kamal Kabakibou, MD, PC, 522 F. Supp. 3d 1307, 1309 (N.D. Ga. 2020);
United States v. Witmer, 835 F. Supp. 208, 211–12 (M.D. Pa. 1993).
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2. Sentara’s arguments regarding negotiations between the parties
Sentara next contends that the petition “implicates information covered by settlement
discussions” in violation of Federal Rule of Evidence 408. Sentara points to Exhibit G (Dkt. No.
4-6), an email chain referencing negotiations, as particularly violative of Rule 408. (Sentara’s
First Mot. to Seal 6.) The government asserts that the petition does not violate Rule 408 since it
“at no point seeks to use the evidence to prove or dispute the validity or amount of a disputed
claim, or to impeach Sentara’s witnesses.” (US’s Resp. to First Mot. to Seal at 12.) The court
finds that disclosures of exhibits regarding negotiations does not violate Rule 408. However, the
court also finds that disclosures of the particulars of any negotiations, other than mere references
to negotiations, would reveal sensitive matters that should be kept confidential and are not
necessary to the court’s determination of the issues before it. The parties’ interests in
confidential negotiations outweigh the public interest in access to these documents. Therefore,
the court will maintain the seal, and/or redact, certain of the documents listed below.
3. Assessment of countervailing interests and sealing factors
The determination of whether countervailing interests heavily outweigh the public’s
interests in access to judicial records is up to “the sound discretion of the court [considering] the
relevant facts and circumstances of the particular case.” Washington Post, 386 F.3d at 575
(quoting Nixon, 435 U.S. at 598–99). The court finds Sentara has not shown that its interests
regarding sealing all requested documents wholly outweigh the public’s right of access to this
matter. Regarding certain exhibits, or portions thereof, however, countervailing interests do
outweigh the public’s interest. Exhibits containing the content of the government’s
investigation, and not the mere logistics of requesting and receiving information, are properly
sealed. While the exhibits were appropriately attached to the various pleadings, some of them

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contain detailed information revealed in the investigation comingled with the logistics of
producing the same. For the most part, it is the logistics that are key to the petition before the
court. The substance of the pending investigation, however, should remained sealed because of
the harm that could result to all parties if disclosed now. The substance of the investigation
includes the testimony witnesses (other than the brief excerpt included in the petition),
interrogatories and other questions posed by the government, and Sentara’s responses thereto.
When deciding whether to grant a motion to seal, the court also must determine whether
there are less drastic alternatives to sealing. Here, the court has reviewed each document that has
been filed under seal. Only a few documents will remain entirely sealed because redaction is not
an appropriate alternative to sealing. The remaining documents that contain, in part, matters that
should be sealed will be redacted as an alternative to sealing the documents.
Thus, for the foregoing reasons, the court will grant Sentara’s motions to seal (Dkt. Nos.
9, 20, 36) in part and deny the motions in part. All documents except those listed below shall be
public documents on the court’s docket and shall be unsealed:
Dkt. No. 4-8, Exhibit I – 2023 email thread – REDACT (regarding negotiations and
specific document requests)
Dkt. No. 4-14, Exhibit O – Dudley deposition transcript excerpt – SEAL
Dkt. No. 19-2, Exhibit 1 – 2021 email thread – REDACT (regarding data extraction
information, current set, and term revisions)
Dkt. No. 19-5, Exhibit 4 – 2022 email thread – REDACT (regarding specifically
requested information and answers thereto)
Dkt. No. 19-8, Exhibit 7 – 2022 email thread – REDACT (regarding testimony and
specifically requested information)

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Dkt. No. 19-10, Exhibit 9 – 2023 emails re negotiations – SEAL
Dkt. No. 19-11, Exhibit 10 – CID No. 23-1222 and interrogatories – REDACT (regarding
interrogatories)
Dkt. No. 19-13, Exhibit 12 – 2023 email thread – REDACT (regarding negotiations and
specific areas of questioning for witnesses)
Dkt. No. 19-14, Exhibit 13 – Responses to interrogatories – SEAL
III. CONCLUSION
For the foregoing reasons, the court will grant the United States’ petition for enforcement
and grant in part and deny in part Sentara’s motions to seal. An appropriate order will be
entered.
Entered: March 8, 2024.

/s/ Elizabeth K. Dillon
Elizabeth K. Dillon
United States District Judge

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