U.S. Recovered Over $2 Billion from Health Care Fraud in 2012 Alone

The premier whistleblower advocacy group, Taxpayers Against Fraud (“TAF”), recently released a report detailing that Whistleblower lawsuits brought under the qui tam provisions of the False Claims Act have generated over $3 billion in settlements and judgments in civil cases in 2012 alone. Cases involving pharmaceutical and medical device sales and marketing fraud comprised the largest portion of these recoveries or approximately $2 billion. The TAF report concluded that every dollar invested by the U.S. government to investigate and prosecute health care fraud generates about $16.4 dollars. The report further details that between 2008 and 2012, the U.S. government expended approximately $575 million in cases that recovered approximately $10 Billion.

As noted in the TAF report, the U.S. Department of Justice has embraced cases being brought under the qui tam provisions of the False Claims Act and, in fact, in 2009 created the Health Care Fraud Prevention and Enforcement Action Team (HEAT) which is aimed at enabling closer collaboration between the Department of Justice and the U.S. Department of Health and Human Services. The TAF report emphasized some recent significant recoveries in the pharmaceutical industry under the False Claims Act including cases involving GlaxoSmithKline, Merck, and other Pharma heavyweights.

GSK paid approximately $1.5 Billion to resolve False Claims Act cases involving a number of drugs marketed and sold for uses not approved by the FDA, payment of kick-backs to prescribers, and other false and misleading statements about drug safety and efficacy. Likewise, Merck paid over $300 million for false and misleading claims about some of its drugs.

As noted in the TAF report, the positive impact that False Claims Act qui tam cases have for U.S. taxpayers cannot be fully accounted for. The reported settlement amounts do not include the amount of money saved by government health care programs due to the deterrent effect of False Claims Act cases. These major settlements undoubtedly cause some pharmaceutical companies and others in the healthcare arena to think twice before engaging in widespread sales and marketing fraud at the expense of federal and state health care programs. At the end of the day, whistleblower programs such as those provided for under the qui tam provisions of the False Claims Act are a critical component to our healthcare system self-correcting such  that wide spread fraud and other misconduct can be ferreted out.

Young Law Group is a nationwide leader in whistleblower representation and has successfully represented numerous clients in some of the nation’s largest qui tam cases for over a decade.  For a free confidential consultation, please call Eric L. Young, Esquire at (800) 590-4116 or complete the online form here.