On February 7, 2023, the Department of Justice (DOJ) announced its annual False Claims Act (FCA) recoveries for fiscal year 2022. DOJ recovered $2.2 billion from a total of 351 settlements and judgments—the second-highest number of settlements and judgments in a single year. Of the $2.2 billion, more than $1.7 billion—or roughly 77%—in settlements and judgments related to matters that involved the healthcare industry. Whistleblower cases continued to comprise the vast majority of the FCA cases filed. In fiscal year 2022, whistleblowers filed 652 qui tam suits and recovered over $488 million. Over $1.9 billion of the $2.2 billion in settlements and judgments arose from lawsuits that were filed under the qui tam provisions of the FCA.

Healthcare Industry Recoveries

Although the recovery of $2.2 billion is a significant drop from the previous year’s recovery of $5.7 billion, which was an aberration, the near-record number of 351 settlements and judgments in one year indicates that FCA enforcement activity has not slowed down. Significantly, healthcare fraud remained a leading source of FCA settlements and judgments. The $1.7 billion in healthcare industry recoveries included drug and medical device manufacturers, durable medical equipment, home health and managed care providers, hospitals, pharmacies, hospice providers, and physicians. DOJ noted that the $1.7 billion reflects recoveries arising only from federal losses and does not include the amounts recovered for states in Medicaid cases.

Enforcement Areas

DOJ highlighted its continued focus on the traditional enforcement areas such as Medicaid fraud, the Anti-Kickback Statute, the Stark Law, medically unnecessary services, substandard care, and managed care billing. Of the $1.7 billion recovered from the healthcare industry, $843.8 million—or almost half—was recovered from a pharmaceutical company to resolve allegations that the company paid kickbacks to physicians in the form speaker programs. Other recoveries in the healthcare industry reflected DOJ’s new enforcement areas, such as COVID-related fraud and cybersecurity.

Holding Individuals Accountable

DOJ noted that it continues to be committed to holding individuals, as well as corporations, accountable by incentivizing changes in both corporate and individual behaviors. DOJ also noted that many of its enforcement actions in fiscal year 2022 involved claims against individuals. For example, an individual physician paid $9.5 million to resolve allegations that he submitted false claims to Medicare and Medi-Cal for tests that he never performed.

The DOJ press release is available here.