Of the $3 billion total recovery for fiscal year 2011, $2.8 billion was secured under the whistleblower provisions of the False Claims Act. And $2.4 billion of the total annual recovery was attributable to fraud committed against federal health care programs, such as Medicare and Medicaid. Since January 2009, the Department of Justice has used the False Claims Act to recover more than $6.6 billion in federal health care dollars.
At the end of last year, Assistant Attorney General Tony West thanked the “courageous citizens” who reported fraud under the whistleblower provisions of the False Claims Act: “We are tremendously grateful to whistleblowers who have brought fraud allegations to the government’s attention and assisted us in the public-private partnership to fight fraud.”
Many of the 2011 False Claims Act cases based on health care fraud were accompanied by criminal investigations. The Department of Justice obtained 21 criminal convictions and approximately $1.3 billion in criminal fines, forfeitures, restitution, and disgorgement under the Food, Drug and Cosmetic Act during 2011.
Fiscal year 2010 saw similarly impressive recoveries. The government secured approximately $2.5 billion in health care fraud settlements/judgments. According to the Department of Justice, “most of the cases resulting in recoveries were brought to the government by whistleblowers under the False Claims Act, the federal government’s primary weapon in the battle against fraud.”
The Department of Justice believes that the 2010 spike in recoveries for health care fraud was fueled, at least in part, by the creation of a new interagency task force, the Health Care Fraud Prevention and Enforcement Action Team, which was designed to increase coordination and optimize criminal and civil enforcement among the Department of Health and Human Services and the Department of Justice.
If the trend continues, 2012 could be a year of unprecedented False Claims Act recoveries.
