Settlements and claims under the federal False Claims Act topped $6.8 billion in the fiscal year that ended on September 30, which was the highest annual amount in the history of the act.
“Stopping rampant fraud is a top priority, and this record-breaking year proves the False Claims Act remains one of the government’s most powerful weapons against fraud,” Deputy Attorney General Todd Blanche said. “We will continue to aggressively deploy it to protect taxpayer dollars and hold all fraudsters accountable.”
The False Claims Act imposes triple damages and penalties on people who knowingly and falsely claim money or knowingly fail to pay money owed to the United States. It safeguards government programs and operations that provide access to medical care; supports the military and first responders; protects U.S. businesses and workers; helps build and repair infrastructure; offers disaster and other emergency relief; and provides many other critical services and benefits, according to the Justice Department.
Health care fraud remained a leading source of settlements and judgments. More than $5.7 billion of the total settlements and judgments last year were related to matters involving the health care industry. These recoveries restore funds to federal programs such as Medicare, Medicaid and TRICARE, the health care program for service members and their families. Just as importantly, in many cases, enforcement of the False Claims Act also protects patients from medically unnecessary or potentially harmful conduct.
As in years past, the act was used to pursue matters involving a wide array of health care providers, goods and services. Most notably, the agency continued and expanded its success in three major areas:
- Managed care. The department continued to pursue cases alleging false claims in managed care, particularly the Medicare Advantage (or Medicare Part C) program. Because Plan C is now the largest component of Medicare, both in terms of federal dollars spent and the number of beneficiaries affected, work in this area is of critical importance.
- Prescription drugs. The agency continued to pursue entities that engaged in misconduct related to drug pricing, drug dispensing and illegal kickbacks that risk injecting improper financial motivations into the drugs prescribed to beneficiaries. These include matters that hold accountable actors who contributed to and exacerbated the opioid crisis.
- Unnecessary services and substandard care. The department also pursued and resolved matters in which providers billed federal health care programs for medically unnecessary services and substandard care that risk the health and safety of vulnerable patient populations.
“The results of the past fiscal year are the product of a talented team of civil servants who pursue righteous False Claims Act cases and return funds to American taxpayers,” said Brenna Jenny, deputy assistant attorney general.
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.