The United States Department of Justice (DOJ) again broke a record by recovering approximately $3 billion under the False Claims Act in healthcare fraud and abuse cases in the 2012 fiscal year. This new record shatters the record recovery of $2.4 billion last year, but the DOJ’s total recovery this year received an extra boost from its $1.5 billion settlement with the pharmaceutical company GlaxoSmithKline.
The False Claims Act allows the federal government to impose hefty fines and penalties on providers that improperly submit claims to federal healthcare programs such as Medicare. The majority of the money the DOJ recovered this past year under the False Claims Act was through whistleblower lawsuits. Such lawsuits allow private citizens to file cases on behalf of the government in federal court if they have knowledge of healthcare fraud perpetrated against the government. If the government is successful in recovering money, the whistleblower is entitled to a portion of the recovery.
The record-setting recovery this year by the DOJ is another reminder to healthcare providers to be vigilant for healthcare fraud within their ranks. If providers discover healthcare fraud, they should work with counsel to self-report it quickly to preclude whistleblower lawsuits and further damages.
David Dirr is an attorney at the Northern Kentucky office of Dressman Benzinger LaVelle and is licensed to practice in Ohio, Kentucky, and Indiana. David, a member of the firm’s healthcare and litigation groups, concentrates his practice on the areas of Medicare and Medicaid reimbursement, anti-kickback law, the Stark law, and HIPAA.