A recent U.S. District Court decision provides a good example of how federal courts will apply the public disclosure/original source rules in whistleblower cases alleging that health care providers violated the False Claims Act (“FCA”).
On March 22, 2023, the U.S. District Court for the Eastern District of California dismissed a qui tam lawsuit that had been filed by a plaintiff-whistleblower alleging that Envision Healthcare and its subsidiaries (“Envision”) violated the FCA by knowingly submitting false and fraudulent claims to Medicare and TRICARE for anesthesia services that were the result of illegal remuneration, i.e., kickbacks. (U.S. ex. rel. Jack Waters v. Envision Healthcare Corporation, et. al. No. 2:19-cv-00873-TLN-AC). (The whistleblower, who was a CRNA at an Envision ambulatory surgery center ASC, was proceeding with the case after the government had declined to intervene.)
The Court dismissed the complaint concluding that the FCA’s “public disclosure” bar applied.
The public disclosure bar, as set forth in 31 U.S.C. Section 3730(e)(4)(A), mandates that a court dismiss an action or claim under the FCA, unless opposed by the government, if substantially the same allegations or transactions as alleged in the action or claim were publicly disclosed in either:
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