DOJ Breaks Record for Healthcare Recoveries Under False Claims Act

The Justice Department recovered $4.9 billion in settlements and judgments from False Claims Act cases in fiscal year 2012, setting a new record for healthcare fraud recoveries.

From January 2009 through the end of the 2012 fiscal year, the DOJ used the False Claims Act to recover more than $9.5 billion in federal healthcare dollars, mostly Medicare and Medicaid. That figure is a record for any four-year period.

Actions against pharmaceutical companies represented some of the largest recoveries. For instance, GlaxoSmithKline paid $1.5 billion to resolve FCA allegations of off-label marketing for five of its medications.

This year's sum brings the total of all FCA recoveries from 2009 to $13.3 billion — the largest four-year total in the department's history.

The FCA is the government's primary civil remedy to redress false claims for federal money or property. Most actions are filed under the FCA's whistleblower, or qui tam, provisions. These allow private citizens to file suits alleging false claims on behalf of the government. If the government prevails in the action, the whistleblower can receive up to 30 percent of the recovery.

The DOJ saw a record 647 qui tam suits filed and recovered a record $3.3 billion in suits filed by whistleblowers during FY 2012.

More Articles on Healthcare Fraud:

OIG Expects $6.9B in Healthcare Fraud Recoveries
Baylor Health System to Pay $907k for Alleged False Claims
Whistleblower Claims Northwestern Memorial Double-Billed Government


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