Corporate Compliance

DOJ recovers $2.5 billion in healthcare fraud via False Claims Act

Compliance Monitor, December 1, 2010

The Department of Justice (DOJ) recovered $2.5 billion in healthcare fraud recoveries for fiscal year (FY) 2010—the largest in history—and $3 billion in total civil fraud claims, according to a DOJ press release.

The DOJ recovered over $2.3 billion via the False Claims Act’s qui tam provisions. These provisions award whistleblowers between 15% and 30% of the proceeds of a successful suit. In FY 2010, whistleblowers collected $385 million.

The DOJ also entered into a $2.3 billion settlement with Pfizer Inc., which is the largest healthcare fraud settlement in history. The $2.3 billion includes $669 million recovered under the federal False Claims Act, $1.3 billion in criminal fines and forfeitures, and $331 million in recoveries for state Medicaid programs and the District of Columbia.

Pharmaceutical companies and medical device industries accounted for $1.6 billion in settlements, including the $669 million from Pfizer Inc., $302 million from AstraZeneca, and $192.7 from Novartis Pharmaceutical Corporation.

A $108 million settlement with The Health Alliance of Greater Cincinnati and one of its former member hospitals, The Christ Hospital, was the largest Anti-Kickback Statute settlement for the conduct of a single hospital.

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