DOJ recovered a whopping $3.7 billion in False Claims Act cases in fiscal year 2017, of which $2.4 billion involved health care fraud. Whistleblowers (known as relators) filed the vast majority of the 2017 False Claims Act recoveries ($3.4 billion). And DOJ awarded a total of $392 million to them. For the eighth straight year, recoveries in False Claims Act health care fraud cases exceeded $2 billion. Total recoveries under the FCA since 1986, when Congress substantially strengthened the law, now total more than $56 billion.
Some Notable Themes
The DOJ announcement and 2017 False Claims Act Recoveries statistics reflect and underscore several notable themes:
Whistleblowers Are Key To False Claims Act Recoveries in 2017
Qui tam cases remain vital. DOJ received 669 qui tam cases, an average of more than twelve cases per week. Yet again, whistleblowers filed the vast majority of 2017 FCA recoveries. Under the False Claims Act, if the case succeeds, the whistleblower receives a share in the recovery. As DOJ noted,
“Because those who defraud the government often hide their misconduct from public view, whistleblowers are often essential to uncovering the truth.”
Health Care Fraud Leads 2017 False Claims Act Recoveries
Health care fraud continues to be the number one culprit. Drug companies, hospitals, skilled nursing facilities, pharmacies, laboratories, physicians, and others lead the pack. This has been true for over eight years and the industry shows little sign of relinquishing this dubious distinction. Other forms of fraud persist, as the press release shows, but health care leads the way.
DOJ Intervention is Key
Government intervention is the critical factor for the success of a FCA case. While a whistleblower can proceed on his or her own in a declined case, and whistleblowers have successfully pursued declined cases over the last few years, the overall odds of success are exponentially higher if the government intervenes. Because the government only intervenes in 20%-25% of the qui tam cases it receives, it remains critically important for the whistleblower’s attorneys to secure an intervention decision by the government prosecutors.
Conclusion
We are proud that two of our 2017 False Claims Act Recoveries are among the few singled out in the DOJ press release. These include our Mylan settlement ($465 million) and our settlement against Joseph Bogdan and AMI Monitoring ($13.4 million). The Mylan EpiPen settlement was the largest FCA settlement of the year while the Bogdan/AMI Monitoring/Spectocor settlement involved the rare instance where DOJ has held an individual accountable under the FCA.
For over 15 years, we have been privileged to help whistleblowers bring information about wrongdoing to the government, to work with the government to uncover the truth, and to obtain favorable results that recover money stolen from the taxpayers. We are already well into 2018 and we are excited for another successful year for the FCA and whistleblowers!
