Anderson accused the hospital and its affiliated physician groups of billing federal health programs for "medically unnecessary kidney dialysis and vascular procedures." He also brought a claim under Kentucky law.
The court traced the dispute to a 2017 case filed by James Kent, which alleged a conspiracy between Davita Healthcare Partners and St. Elizabeth to pay kickbacks of "$70,000 per dialysis center per year" for unnecessary dialysis referrals. Kent, himself a dialysis patient, died during the litigation, and the administrator of his estate voluntarily dismissed the case. The government did not intervene.
Anderson's complaint relied on the same core narrative but added two new elements. He identified the leader of the dialysis center group as Dr. Shaughnessy and alleged the hospital used an electronic referral system called the "EPIC system" to steer patients to the scheme.
The Sixth Circuit held that these additions did not provide sufficient new information to overcome the "public-disclosure bar," which prevents whistleblowers from suing on allegations already in the public domain.
On Anderson's separate allegations of fraudulent billing for vascular treatments, the court ruled that he failed to plead with sufficient particularity, offering only "four sentences of vague allegations without specific examples of referrals."
The panel also affirmed dismissal of Anderson's state-law claim, agreeing with the district court that Kentucky's criminal code provisions "do not create a private cause of action for whistleblowers."