Opinion ID: 2972242
Heading Depth: 2
Heading Rank: 2

Heading: Based Upon the Disclosed Fraud

Text: The next question before us is whether the claim is based upon the disclosed fraud. This Court has held that a complaint is “based upon” the public disclosure where it is “supported by [the public disclosure] and includes any action based even partly upon public disclosures.” United States ex rel. Jones v. Horizon Healthcare Corp, 160 F.3d 326, 332 (6th Cir. 1998) (internal quotations omitted); see also Bledsoe, 342 F.3d at 646; McKenzie, 123 F.3d at 938. The district court found that jurisdiction was proper because the qui tam action was not based upon prior allegations of Medicare fraud. Specifically, the district court found that “[d]efendant has not shown a public record which specifically alleges that a particular patient had a Model 4004/M lead implanted and that this procedure and implant were paid for by Medicare.” (emphasis in original). However, the Medicare fraud claim necessarily relies on the FDA fraud claim. Without FDA fraud rendering the leads unapproved, there could not have been Medicare fraud, because the submission of Medicare claims for implantation of the leads would have been valid. Therefore, the Medicare fraud claim is based on the public disclosure of fraud on the FDA and jurisdiction under the False Claims Act was inappropriate.