As predicted, health care fraud enforcement under the False Claims Act (“FCA”) continues to be a top priority for the Department of Justice (“DOJ”). In fiscal year 2021, the DOJ obtained more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims against the government, more than $5 billion (or nearly 90%) of which related to the health care industry. That is nearly three times as much as the $1.8 billion recovered from the health care industry in 2020 and nearly twice the $2.6 billion recovered in 2019.
Notably, over $1.6 billion of the 2021 fiscal year recoveries arose from lawsuits filed by private citizens (known as whistleblowers or “relators”) under the qui tam provisions of the FCA. Successful relators are entitled to a percentage of the final judgment or settlement, and in fiscal year 2021 the government paid out $237 million to FCA qui tam relators. For example, in a settlement DOJ announced on March 7, 2022, a qui tam relator received approximately $4.9 million as part of the resolution of FCA allegations he filed against pharmaceutical company Mallinckrodt ARD LLC. Not surprisingly, the number of lawsuits filed under the qui tam provisions of the FCA has grown significantly, with 598 qui tam suits filed this past year—an average of over 11 new cases every week.
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