Success Of The False Claims Act In Combating Healthcare Fraud

False Claims Act cases have returned over $30 billion to the federal government over the last quarter century. The vast majority of the recoveries were the result of courageous whistleblowers who stood up against their dishonest employers, and filed healthcare fraud qui tam lawsuits.

In recent years, False Claims Act offenders have aggressively pushed to derail the False Claims Act qui tam mechanism. However, Congress has refused to ignore success of this important fraud-fighting weapon.

Recently, Taxpayers Against Fraud reminded Congress and the public about the real-world success of the Act, when it released its report, The Importance of Whistleblowers to Reducing Fraud Against the Federal Government and Recovering Funds for Taxpayers. Authored by economist Jack Meyer of Health Management Associates, the report is a response to a paper published by the U.S. Chamber of Commerce.

The Department of Justice recoveries from False Claims Act cases exceeded $3.5 billion for the fourth consecutive year.  This brings the total False Claims Act recoveries from January 2009 to the end of FY 2015 to $26.4 billion.  Of the $3.5 billion recovered in the  last fiscal year, $1.9 billion came from defendants in the healthcare industry resulting from allegations involving unnecessary or inadequate care, paying kickbacks to health care providers to induce the use of certain goods and services, or overcharging for goods and services paid for by Medicare, Medicaid, and other federal health care programs..  At the time the fiscal year numbers were reported, Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division stated, “The False Claims Act has again proven to be the government’s most effective civil tool to ferret out fraud and return billions to taxpayer-funded programs.”

Whistleblower Actions Recover Nearly $3 Billion in FY2015

The United States Department of Justice announced that it secured more than $3.5 billion in settlements and judgments in civil cases involving fraud against the federal government in the fiscal year ending September 30, 2015. Of particular note, $2.9 billion, or 82% of the recoveries, were from private actions filed under the qui tam, or whistleblower, provisions of the federal False Claims Act. In crediting whistleblowers with bringing the lion’s share of the recoveries, Principal Deputy Attorney General Benjamin Mizer stated, “Many of these recoveries obtained under the False Claims Act result from courageous men and women who come forward to blow the whistle on fraud they are often uniquely positioned to expose.”

Once again, the False Claims Act was particularly effective at recovering stolen health care dollars due to Medicare fraud. In fact, $1.9 billion, or over 50%, of the recoveries, were from actions alleging healthcare fraud against federal health care programs. The most egregious violators were hospitals, dialysis providers, and pharmaceutical manufacturers, accounting for $1.2 billion, or nearly 63%, of all healthcare dollars returned to the federal government. Nolan Auerbach & White’s clients were responsible for recovering over 40% of all dollars collected from pharmaceutical manufacturers in FY2015.

Not only has the federal government and whistleblowers used the Act to return more than $48 billion for the United States Treasury, this remarkable number has continued to climb in recent years, particularly after the federal False Claims Act was modernized in 2009. Indeed, qui tam recoveries in the past five years account for half the settlement dollars recovered under the modern False Claims Act.

Your courage, perseverance, and heroism are necessary in the fight against healthcare fraud. Nolan Auerbach will fight for you, your principles, and your just reward – you can count on that! Contact us.

REAL PEOPLE making real change Meet Some of our Heroes

Kathleen Hawkins

Dignity Health
$37 million

Kathleen Hawkins, RN MSN, had been employed by Defendant, Catholic Healthcare West (CHW) for approximately 6 years when she decided she had had enough of trying to change the hospital system from within.

CHW, a California not-for-profit corporation that operated hospitals in California, Arizona, and Nevada, was at the time the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in California.


Joe Strom

Johnson & Johnson
$184 Million

Joe Strom contacted us in 2005. We were very grateful that he did. We immediately formed an all-star legal team and a process to stop a very harmful pharmaceutical marketing strategy. It was this process we set into motion that ultimately returned hundreds of millions of dollars to the U.S. Treasury, and a portion of that, very well-deserved, into Joe’s bank account.

Joe told us a very troubling story about the off-label promotion of a pharmaceutical drug for patients who already suffered from chronic heart failure.


Bruce A. Moilan Sr.

$27 Million

Bruce Moilan was a seasoned hospital systems expert by the time he contacted our Firm. At the time he decided to file his qui tam lawsuit, he was employed by South Texas Health System as a System Director for Materials Management. In this position, he oversaw $24 million in annual purchases of supplies and equipment and helped determine budget, reduction and cost analysis throughout the contract bidding and negotiations process. His job was to insure proper implementation for purchasing, receiving and management of inventory, for McAllen Hospitals, L.P.



“I collaborated with Nolan, Auerbach and White on a broad variety of cases where whistleblowers stepped forward to disclose tactics employed by large companies to influence physicians' medical decision-making in patient care. They provide ample resources to not only optimize their client cases, but in doing so consistently leverage best medical evidence to further patient safety and resource utilization.”

— Fred Polsky M.D., Former Medical Director, CMS Zone 7 Integrity Contractor

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