The Department of Justice has announced it recovered $5.69 billion in civil settlements and judgments under the False Claims Act in fiscal year 2014, with $2.3 billion resulting from false claims cases against federal healthcare programs.
The 2014 fiscal year marked the fifth consecutive year the DOJ has recovered more than $2 billion in false claims cases against federal healthcare programs.
The continually high recoveries are partially attributable to the Obama administration’s focus on fighting healthcare fraud, including the creation of the Health Care Fraud Prevention and Enforcement Action Team — an interagency task force focused criminal and civil enforcement of healthcare fraud cases.
There were many substantial healthcare fraud settlements in FY 2014 involving the pharmaceutical industry, including the $1.1 billion settlement pharmaceutical giant Johnson & Johnson entered into to resolve False Claims Act claims relating to the company’s promotion and marketing of three of its prescription drugs.
False Claims Act cases involving hospitals led to $333 million in recoveries in FY 2014, with Franklin, Tenn.-based Community Health Systems paying $98.15 million to settle allegations it billed Medicare, Medicaid and TRICARE for inpatient care services that should have been provided in an outpatient or observation setting, which was one of the largest false claims settlements of the year.