Part II in a Continuing Series on Health Care Enforcement
The federal False Claims Act (FCA) is the government's primary and most powerful civil health care fraud enforcement tool. Much of the FCA's power comes from its qui tam provisions, which permit private relators (often called "whistleblowers") to bring claims under the FCA on behalf of the government and which reward them financially for doing so successfully. The Department of Justice (DOJ) reported recovering $2.8 billion in settlements and judgments under the FCA's qui tam provisions last year. By far the largest portion of the 2011 settlement amounts — $2.4 billion — related to federal health care programs. In addition, the DOJ reported that the number of qui tam lawsuits in 2011 increased significantly — rising from between 300 and 400 cases per year to 638.
In this advisory, we look at the trends in 2011 and anticipate enforcement activity in 2012.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.