February 7, 2013 Healthcare Fraud
Year of the Whistleblower: How the Department of Justice Recovered $4.9 Billion in 2012
On December 4, 2012, Acting Associate Attorney General Tony West announced that during the fiscal year 2012, The Department of Justice (DOJ) recovered a record $4.9 billion in settlements and judgments as a result of fraud prosecuted under the False Claims Act (FCA).
During 2012, there were about 650 whistleblower, or qui tam, cases filed and around one-fourth of those 650 cases were eventually settled by the Department of Justice. Throughout 2012, whistleblowers were responsible for filing cases that ultimately led to the total recovery of $3.3 billion of the total $4.9 billion. The DOJ recovered $1.4 billion in housing/mortgage cases, including a portion of the $26 billion settlement agreed upon by the government and the five largest mortgage brokers. Acting Associate Attorney General West described the FCA as the “most powerful tool in the government’s legal arsenal for protecting the integrity of government programs such as Medicare and Defense Spending.”
The monies recovered through False Claims Act lawsuits are especially impressive within the area of healthcare fraud. From January 2009 throughout the 2012 fiscal year under the False Claims Act, the DOJ recovered more than $9.5 billion in federal health care dollars alone. That produced another record, along with a clear warning for employers within the healthcare industry to take heed, review their policies, practices and compliance programs. The top two False Claims Act cases involving drugs and medical devices in 2012 were:
GlaxoSmithKline (“GSK”), a global pharmaceutical giant, agreed to enter a plea of guilty to a criminal charge, and to pay a total of $3 billion to resolve both the FCA and the criminal charge. The plea resolved GSK’s criminal liability resulting from unlawful promotion of certain prescription drugs, failure to report important safety data and false price reporting practices. A copy of the United States complaint against GlaxoSmithKline LLC can be found here.
Why the Whistleblowers are Key to Success
The whistleblowers who step forward to expose wrongdoing are crucial in preserving the integrity of government programs and protecting United States citizens from the costs of fraud, according to Principal Deputy Assistant Attorney, General Stuart F. Delery. “We are extremely grateful for the sacrifices they make to do the right thing.” Without the courage and strength of whistleblowers, and the qui tam cases they file, the vast majority of fraud against U.S. government programs would never be exposed.
“The Justice Department’s official recognition of the importance of whistleblowers in fraud detection is an important step forward,” stated Stephen Kohn, Executive Director of the National Whistleblowers Center, in response to the DOJ release. Kohn elaborated saying, “Whistleblower reward laws are the single most effective mechanism to induce employees with knowledge of fraud to risk their careers in serving the public interest.” It is this kind of protection and incentive that ultimately helps whistleblowers make a sound decision to report fraudulent acts within their own workplace.
Since the beginning of fiscal year 2009, the DOJ has recovered $13.3 billion in False Claims Act cases, which is the largest four-year recovery total in DOJ history. And, of the roughly 8,500 qui tam suits filed since the FCA was amended in 1986, , 2,200 of those were filed after January 2009. With the promise of whistleblower protection and the possibility of sharing in the recovery monies, expect to see more and more False Claims Act cases filed by qui tam whistleblowers for years to come.
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