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Whistleblower’s $1 Million Medicare Fraud Win Reversed on Appeal

May 3, 2021, 4:13 PM

A whistleblower shouldn’t have received a $1 million share of the $3.5 million the federal government recovered in audits of Renown Health for improper Medicare inpatient billing because she didn’t satisfy requirements for an “alternate remedy” under the False Claims Act, the Ninth Circuit ruled.

The FCA’s alternate remedy provision allows the government to seek monetary recoveries in administrative proceedings, and whistleblowers may recover shares of proceeds.

For a proceeding to be an alternate remedy, the government must select that proceeding after a whistleblower files an FCA complaint.

But if the government chooses to recoup money in a proceeding before...

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