Health Care Fraud Enforcement Lucrative for Federal Government

Attorney General Eric Holder announced on January 9, 2013 that the Justice Department collected $8 billion dollars in civil and criminal actions for the fiscal year ending in September 2013.  In his press release, AG Holder stated that, “It is critical that Congress provide the resources necessary to match the department’s mounting caseload. As these figures show, supporting our federal prosecutors is a sound investment.”

Approximately $3.2 billion was collected in civil cases related to health care fraud. This included the collection of fines and recovery of money lost to fraud.  The fact that health care fraud recovery leads the way should not be surprising given the intense focus on health care dollars and the complex civil and criminal laws at both the federal and state levels.

On the same day these figures were released, the Justice Department announced that CareFusion Corp. would pay the government $40.1 million dollars to settle allegations of False Claims Act violations based on kickbacks paid to one doctor.  The lawsuit was a qui tam action by a former vice president of the company who will receive $3.26 million as her share in the settlement. According to the government press release, “This settlement illustrates the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative….”   Use of the False Claims Act is seen as an essential tool in the fight against health care fraud, with more than $17 billion recovered through False Claims Act cases since January 2009.

These numbers illustrate the government’s commitment to combating health care fraud and the importance of health care providers remaining current on health law and regulatory requirements.

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