US DOJ Sets New Record for Fraud and False Claims Recoveries in FY2014

As 2014 comes to a close, the United States Department of Justice (“DOJ”) has many reasons to celebrate as it reflects on the year that was. In FY2014, the DOJ recovered $5.69 billion in settlements and judgments resulting from civil fraud and false claims cases, with $2.3 billion in health care fraud recoveries alone.

This marks the first time the DOJ has recouped more than $5 billion annually under the False Claims Act and the fifth straight year that the DOJ has recovered more than $2 billion in cases involving false claims against federal health care programs such as Medicare, Medicaid, and TRICARE. While the pharmaceutical industry accounts for what the DOJ calls a “substantial part” of these recoveries, cases also involved large hospital chains, home health providers, and device manufacturers.

“It has been an extraordinary year for civil fraud recoveries, but the true significance is not in breaking records or making history; it is in the billions of dollars restored to the federal treasury,” said Acting Assistant Attorney General Branda. “The False Claims Act was enacted both to protect vital taxpayer dollars and deter those who would misuse public funds. The department will continue to enforce the law aggressively to ensure the integrity of government programs designed to keep us safer, healthier and economically more prosperous.”

Qui tam, or whistleblower, actions under the False Claims Act have proved to be a driving force behind the DOJ’s record-breaking year. For the second year in a row, whistleblowers filed more than 700 suits on behalf of the federal government. FY 2014 recoveries from qui tam cases totaled nearly $3 billion.

“We acknowledge the men and women who have come forward to blow the whistle on those who would commit fraud on our government programs,” said Acting Assistant Attorney General Branda. Often, those individuals who bring qui tam law suits in order to expose fraud and false claims do so at great risk to their careers.

The DOJ press release may be found here.

For more information, please contact the author, David R. Ross, who served as Acting New York State Medicaid Inspector General under governors Pataki and Spitzer, as well as General Counsel, Deputy Medicaid Inspector General, and Director of Audits and Investigations for the Office of the Medicaid Inspector General (OMIG). He can be reached at (518) 462-5601 or via e-mail at dross@oalaw.com.


David Ross

About David Ross

David is Partner and concentrates his practice on Medicaid, Medicare and private insurance audits & investigations, Health Law including fraud and abuse, governmental investigations of all kinds, Medicaid compliance plans and Article 78 cases. He is head of our Government Investigations practice and also works in Healthcare Fraud & Abuse.