The False Claims Act is a federal law that was originally passed during the administration of President Abraham Lincoln. Over the past 150 years, the law has been revised several times.In the past few years, money recovered under the FCA has become big business for the government. In the fiscal year ending September 30, 2014, the federal government recovered a total of $5.7 billion. In addition, each year the number of new cases has increased. Much of the increase is as a result whistleblower lawsuits, also referred to as qui tam matters. Qui tam refers to an action brought by an individual who prosecutes a fraud case on behalf of the government and receives part of the final recovery. In 2014, whistleblowers received a total of $435 million, over $100 million more than in 2013.
The industry hit hardest by whistleblower lawsuits under the FCA in 2014 was banking with $3.1 billion in penalties and recoveries. But the healthcare industry continues to be a target for the government, to the tune of $2.3 billion recovered. This is the fifth year in a row that healthcare has paid back more than $2 billion under the FCA. Hospitals, pharmaceutical companies, medical device companies, physician groups, insurance companies, clinics – all sectors of health care have been the subject of FCA enforcement. For example, one pharmaceutical corporation alone had to pay $2.2 billion to settle allegations of kickbacks and promotion of off-label uses of medications in early 2014. A dialysis center had to pay $350 million in penalties for giving kickbacks for patient referrals. A medical device company paid out $30 million for marketing defective devices. A large home health service provider settled with the government for $150 million for charging Medicare for services not rendered, overcharging, and billing for medically unnecessary procedures.
With all this money being recovered, more and more whistleblowers are filing lawsuits. And whistleblowers are not just disgruntled current or former employees. In recent years, many qui tam matters have been initiated by competitors or consultants with inside information. Health care companies need to monitor their billing more carefully, and develop protocols to prevent the types of abuses for which the FCA collects billions.
Contact the law offices of Brownstein & Nguyen if you suspect that you might have information about healthcare or other government fraud. Our experienced team of legal professionals will answer questions and guide you in the steps to take as a potential whistleblower.