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Taxpayers Against Fraud Conference
2005

Taxpayer’s Against Fraud Seminar-Recent Developments in the Law

Team led by David Stone of BSF joins government's False Claims Act case against Medco

October 14, 2004: David Stone addresses the annual convention of Taxpayers Against Fraud (TAF).

Taxpayer’s Against Fraud Seminar

Recent Developments in the Law

The Public Disclosure Bar and the Original Source Exception

William Louis Hurlock

I. Public Disclosure Bar

No court shall have jurisdiction over an action under this section based upon the public disclosure of allegations or transactions in a criminal, civil, or administrative hearing, in a congressional, administrative, or Government Accounting Office report, hearing, audit, or investigation, or from the news media, unless the action is brought by the Attorney General or the person bringing the action is an original source of the information. 31 U.S.C. § 3730 (e)(4)(A).




II. Original Source Exception

For purposes of this paragraph, “original source” means an individual who has direct and independent knowledge of the information on which the allegations are based and has voluntarily provided the information to the Government before filing an action under this section which is based on the information.
31 U.S.C. § 3730 (e)(4)(B).



III.

Recent Cases Analyzing the Public Disclosure Bar/Original Source Exception
(October 1, 2005 – Present)

A.

District Court Cases

United States ex rel. Bannon v. Edgewater Hosp., Inc., 2005 WL 991757 (N.D. Ill. Apr. 14, 2005) (Rule 9(b) does not require that relator’s averments as to public disclosure be stated with particularity since information indicating the original source of fraudulent claims is not an averment of fraud. However, court dismisses complaint, with leave to amend, under Rule 9(b) because relator failed to state with particularity the underlying fraudulent conduct to support the claim, such as when misrepresentations were made and which defendant submitted fraudulent claims.)

United States ex rel. Englund v. L.A. County, 2005 WL 2089216 (E.D. Cal. Aug. 30, 2005) (Relator files FCA complaint alleging Los Angeles County made false claims to receive unwarranted Federal Medicaid funds via intergovernmental transfers, court becomes irritated with defendant’s counsel failure to cite to specific instances of the alleged disclosure in numerous, lengthy exhibits - “Judges are not like pigs, hunting for truffles buried in briefs.” Court denies defendant’s motion to dismiss finding no public disclosure of relator’s claims.)

United States ex rel. Ernst v. Tenet Healthcare Corp., 2005 WL 474244 (N.D. Cal. Mar. 1, 2005) (Relator files FCA complaint regarding fraudulent payments for certain medical claims. After granting defendant’s motion to dismiss because of a public disclosure, court permits relator to amend complaint where relator claims that he is an original source, but failed to plead allegations to support the claim in the amended complaint.)

United States ex rel. Ervin v. Hamilton Sec. Group, Inc., 370 F. Supp. 2d 18 (D.D.C. 2005) (Relator files complaint alleging reverse false claim relating to HUD receiving less for a mortgage note sale. Court analyzed whether relator was an original source following the public disclosure of allegations and found that relator was an original source because he had direct and independent knowledge of the fraud alleged and provided the information voluntarily to the Government.)

United States ex rel. Farmer v. Houston, 2005 WL 1155111 (S.D. Tex. May 5, 2005) (Relator brings FCA complaint alleging over billing for repairs to roof after tropical storm Allison. Court finds that while relator relied heavily upon public information, she was an original source because of the knowledge gleaned from similar repair to roof made years earlier.)

United States ex rel. Gear v. Emergency Med. Assoc. of Ill. Inc., 2005 WL 991789 (N.D. Ill. Apr. 13, 2005) (Relator, a senior resident who worked as an attending physician during residency hours, alleges  double billing and upcoding. Court held relator’s allegations were publicly disclosed and relator was not an original source where, among other things, relator was the editor of publication noting billing irregularities and admitted to never speaking to the Government prior to filing suit.)

United States ex rel. Smith v. Yale-New Haven Hospital, Inc., 2005 WL 2072514 (D.Conn. Aug. 25, 2005) (Relator files FCA complaint alleging false billing for radiological procedures. Defendant files a motion to dismiss pursuant to Fed. R. Civ. P. 12(b)(1) arguing that relator’s allegations were publicly disclosed. Court recognizes: (1) that it is possible, in principle, to resolve public disclosure issue pursuant to Fed. R. Civ. P. 12(b)(1), however the factual record in the case precluded such a determination; and (2) it is within a court’s discretion to order discovery on the issue of disclosure however, relator’s complaint is dismissed because relator was not the first to file.)


B. United States Court of Appeals Cases

United States ex re. Campbell v. Redding Med. Ctr., 421 F.3d 817 (9th Cir. 2005) (First pair of patient relators files FCA case against medical center alleging fraudulently billing of “thousands” of unnecessary invasive cardiac procedures, second physician relator then files FCA claims against same defendants alleging fraudulent billing for unnecessary cardiac procedures. Government moves to dismiss second complaint of physician because of the first-to-file bar and District Court grants dismissal. Physician appeals decision asserting that patients were not original sources. Court of Appeals remands to District Court to determine if patients were original sources, in so doing, court recognizes that when public disclosure is an issue, the first-to-file rule bars only subsequent complaints filed after a complaint that fulfills the jurisdictional requirements of section 3730(e)(4).)

United States ex rel. Dingle v. Bioport Corp., 388 F.3d 209 (6th Cir. 2004) (Relator files FCA complaint alleging drug company made false statements relating to proper manufacture of anthrax vaccines. Court affirms district court dismissal stating that relator’s claims were publicly disclosed and relator was not an original source. In so doing, court declined to reevaluate the “based upon” language of section 3730 (e)(4)(b) (original source) adopted by prior Court of Appeals panel that stated “based upon” meant “supported by.”)

United States ex rel. Gilligan v. Medtronic, Inc., 403 F.3d 386 (6th Cir. 2005) (Relators file FCA complaint alleging fraud relating to pacemaker leads, and acknowledged that they were not original sources. Court recognizes two types of disclosures to put Government on notice of fraud: (1) information of a false state of facts and a true set of facts has been disclosed and; (2) a public allegation of fraud, despite the specificity of the allegation. Thus, there need not be a specific disclosure of fraud to find public disclosure if the information publicly available as to the true state of facts and the false state of facts underlying alleged fraud warrants dismissal as a public disclosure. Prior product liability lawsuits against manufacturer defeated FCA claims.)

United States ex rel. Gross v. AIDS Research Alliance-Chicago, 415 F.3d 601 (7th Cir. 2005) (Relator files FCA complaint alleging mismanagement and negligence relating to AIDS study. Court dismisses plaintiff’s complaint because, among other deficiencies, relator’s claims were based on a public disclosure and relator did not allege that he was an original source.)

United States ex rel. Grynberg v. Praxair, Inc., 389 F.3d 1038 (10th Cir. 2004), cert. denied, 125 S.Ct. 2964 (2005) (Relator files FCA complaint alleging reverse false claims for royalty payments due to Government. Court finds that information used by relator was publicly disclosed, complaint was based on publicly disclosed transaction, and relator did not satisfy the direct and independent knowledge element.)

United States ex rel. Paranich v. Sorgnard, 396 F.3d 326 (3d Cir. 2005) (Relator files FCA complaint alleging over billing for electrical nerve stimulation devices. Defendant establishes that there was a public disclosure of the alleged fraud, and court found that relator was not an original source for providing information in addition to that requested by the Government in a subpoena.)


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