News & Views

What Does the latest DOJ Fraud Statistics Overview mean for Medicare Fraud and Medicaid Fraud Qui Tam Whistleblowers?

New healthcare qui tam filings have steadily increased over the years from 3 in FY 1987 to a high of 500 in FY 2013.  The continuation of this  steady progression is  reflected in the latest  Fraud Statistics Overview  – Health and Human Services  (October 1, 1987 – September 30, 2013) issued on December 23, 2013 from the Civil Division, Department of Justice.   In FY 2013 (as has been the trend since 1987) an overwhelming amount of relator share awards came from cases in which the United States intervened (or otherwise pursued).  This is a clear indication that it is an uphill climb for whistleblowers to pursue cases in which the Government has not intervened (for whatever reason).  The statistics bear that out year after year. With that said, it is the non-intervened case recoveries, sometimes in the hundreds of millions,  in which whistleblowers choose to pursue nonetheless, keeping Defendants and the Department of Justice in check. The total number for FY 2013 settlement and judgment recoveries in healthcare fraud cases is $2.615 billion and those numbers are clearly on the rise.

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