Posted on February 21, 2011 by Debra A. McCurdy

Interesting health care fraud prosecution data contained in letter to Senator Charles Grassley

This post was written by Scot T. Hasselman.

In response to a letter dated December 17, 2010, the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) have outlined statistics associated with health care fraud prosecutions.  In the letter, dated January 24, 2011, DOJ and HHS detail criminal and civil prosecutions for health care fraud.  Among the highlights:

  • As of January 4, 2011, there were 1,341 FCA cases under seal. Of those, 885 cases allege health care fraud. Of those 180 involve pharmaceutical pricing or marketing, and 80 cases involve hospitals.
  • Since the end of fiscal year 2006 (October 1, 2006) DOJ has resolved 716 cases (541 in qui tam cases and 175 in direct actions). In addition, 1,244 qui tam cases have been declined. The average length of time a case is under seal is 13 months (during the same period of time).
  • DOJ has intervened in 22.20 percent of qui tam cases in the past five years.
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Posted on November 29, 2010 by Debra A. McCurdy

DOJ Announces Health Fraud Recovery Amounts for FY 2010

The U.S. Department of Justice (DOJ) recovered $3 billion in False Claims Act civil settlements and judgments in fiscal year (FY) 2010 – a record $2.5 billion of which involved health care fraud recoveries -- the DOJ announced November 22, 2010. Most of the FY 2010 settlements and judgments (over $2.3 billion) were recovered in qui tam (whistleblower) lawsuits, resulting in $385 million in awards to relators. The largest FY 2010 False Claims Act recoveries involved the pharmaceutical and medical device industries, which accounted for $1.6 billion in settlements. 

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Posted on March 4, 2009 by Debra A. McCurdy

American Recovery and Reinvestment Act -- Health Information Privacy/Incentives, Medicaid Funding & Other Health Provisions

This post was written by Karl A. Thallner, Jr., Carol C. Loepere, Debra A. McCurdy, Brad M. Rostolsky, Jacqueline B. Penrod, and Amie E. Schaadt.

On February 17, 2009, President Obama signed into law H.R. 1, the American Recovery and Reinvestment Act (the “ARRA”). The sweeping $790 billion economic stimulus package includes a number of health care policy provisions. Reed Smith's Health Care Memorandum summarizes the major health policy provisions of the Act.

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