By Kelly A. Briganti, Editorial Director, G2 Intelligence
Given the large False Claims settlements the laboratory sector has seen this year and the major nationwide Takedown initiatives, it’s no surprise to hear the Department of Justice (DOJ) recovered $1.9 billion in health care False Claims Act cases in fiscal year (FY) 2015. That’s more than half of the aggregate $3.5 billion the DOJ reported recovering under all False Claims Act cases for the fiscal year ending Sept. 30. And that’s just the federal recoveries. The Department also took credit for assisting in millions of dollars of state Medicaid recoveries.
This year’s $1.9 billion brings the total health care recoveries under the False Claims Act since January 2009 to almost $16.5 billion. The DOJ credits the collaborative task force, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), for this success. The DOJ highlighted dialysis providers, hospitals, health systems, and pharmaceutical companies for the largest recoveries from organizations. The diagnostics industry took the spotlight, however, when it came to discussing individual accountability. Noting the Yates memo’s call to hold individuals responsible for corporate wrongdoing, the DOJ highlighted the individuals being pursued as a result of the cases against cardiovascular testing laboratories Health Diagnostics Laboratory (HDL) and Singulex. The government settled with HDL and Singulex for $48.5 million and has intervened in qui tam actions brought against individual owners and founders of the entities involved.
Whistleblowers played a key role in these recoveries. The DOJ reports that of the $3.5 billion recovered under the act, $2.8 billion were linked to qui tam actions. In FY 2015, there were 638 whistleblower or qui tam actions filed. Whistleblowers received $597 million in awards for bringing these actions.