2013 Health Care Fraud and Abuse Report Highlights Significant Recoveries Under the FCA

Posted by Kristin Graham Koehler and Monica Groat

On February 26, 2014, the Departments of Justice and Health and Human services released the annual Health Care Fraud and Abuse Control Program report (HCFAC Report).

In fiscal year 2013, the government recovered $4.3 billion through its healthcare fraud prevention and enforcement efforts, up from the $4.2 billion that was recovered in fiscal year 2012. The government also entered into many significant False Claims Act (FCA) settlements with healthcare companies and providers; nearly $325 million of the $4.3 billion recovered was paid to qui tam relators. Several of the significant recoveries involving pharmaceutical and device manufacturers, hospitals, physicians, and other healthcare companies are highlighted in the report.

According to the report, the Justice Department opened 1,083 new civil healthcare fraud investigations in fiscal year 2013, suggesting that FCA actions will continue to represent a significant percentage of the government’s healthcare fraud enforcement activity.