U.S. ex rel. Kathi Holloway, 960 F.3d 836

Relator Kathi Holloway, a former Heartland Hospice employee, alleged a corporate-wide scheme by Heartland/HCR to enroll and retain non-terminal patients in hospice and bill Medicare/Medicaid for ineligible hospice care.
Alleged practices: large bonuses and census targets for admissions/retention; "negative charting" to suggest decline; non-physician staff shaping records; Medical Directors not properly reviewing/examining patients; administrative overrides of physician discharge recommendations; strategic nonresponse to auditors.
Holloway filed a qui tam complaint in 2010; DOJ declined to intervene; she amended in 2018. The district court dismissed for inadequate pleading under Rule 9(b) but found no public-disclosure bar; Holloway appealed.
Defendant pointed to prior public materials, chiefly three qui tam complaints filed and unsealed in 2007 in the D.S.C. against HCR/Heartland entities (the "South Carolina complaints"), and an OIG report; Holloway did not press an original-source argument on appeal (waived).
The Sixth Circuit held Holloway's claims barred by the FCA public-disclosure bar under both the pre-2010 and post-2010 statutory formulations because the South Carolina complaints publicly disclosed substantially the same allegations, and affirmed dismissal without reaching Rule 9(b)/Prather issues.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the FCA public-disclosure bar pre-2010 ("based upon") bars Holloway's suit	Holloway: her complaint adds corporate-wide, sophisticated allegations beyond the South Carolina facility-specific complaints	Heartland: South Carolina complaints (and other materials) publicly disclosed the same scheme, so the suit is at least partly based on prior disclosures	Held: barred — substantial-identity test satisfied; government was on notice; dismissal affirmed
Whether the post-2010 public-disclosure bar ("substantially the same") bars the suit	Holloway: argued differences in degree/kind; challenged applicability in district court	Heartland: amended text still bars suits where prior disclosures are substantially the same; South Carolina complaints disclose same corporate-wide scheme	Held: barred — allegations are substantially the same; dismissal affirmed
Whether Holloway qualifies as an "original source" (post-amendment exception)	Holloway did not argue original-source on appeal (waived)	Heartland: relator did not carry original-source burden	Held: relator waived original-source argument; court did not consider it substantively
Whether complaint met Rule 9(b) / Prather pleading standard for FCA fraud	Holloway: alleged specific corporate policies, incentives, examples	Heartland: alleged fraud insufficiently particular	Held: court did not reach merits of Rule 9(b)/Prather because dismissal on public-disclosure bar was dispositive

U.S. ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., 838 F.3d 750 (6th Cir. 2016) (announced limited pleading exception under Rule 9(b) for FCA claims)
U.S. ex rel. Antoon v. Cleveland Clinic Found., 788 F.3d 605 (6th Cir. 2015) (2010 public-disclosure amendments are not retroactive)
U.S. ex rel. Poteet v. Medtronic, Inc., 552 F.3d 503 (6th Cir. 2009) (public disclosures can be aggregated; describes X+Y=Z approach)
U.S. ex rel. McKenzie v. Bellsouth Telecomm., Inc., 123 F.3d 935 (6th Cir. 1997) (pre-amendment "based upon" interpreted to bar actions based even partly on public disclosures)
U.S. ex rel. Dingle v. BioPort Corp., 388 F.3d 209 (6th Cir. 2004) (prior public disclosures put government on notice; qui tam suits barred when disclosure gives adequate notice)
U.S. ex rel. Advocates for Basic Legal Equality, Inc. v. U.S. Bank, N.A., 816 F.3d 428 (6th Cir. 2016) (post-amendment original-source standard and interplay with public-disclosure bar)
U.S. ex rel. Walburn v. Lockheed Martin Corp., 431 F.3d 966 (6th Cir. 2005) (describing purpose and reach of the public-disclosure bar)
Schindler Elevator Corp. v. U.S. ex rel. Kirk, 563 U.S. 401 (2011) (public-disclosure bar viewed as "wide-reaching")