It's been known for some time that the False Claims Act is driving healthcare fraud enforcement, but new Justice Department statistics indicate the trend is escalating.
Overall, about 4,500 False Claims Act lawsuits have been filed since the Civil War-era law was strengthened in 1986, and about 52% of those have been in healthcare. But in past three years, more than 70% of such suits have been in healthcare, said Joyce Branda, deputy director of the fraud section for commercial litigation in the Justice Department's civil division.
"The government enforcement agenda in healthcare is being shaped, to a very large extent, both on the criminal and civil side, by whistleblower lawsuits," Branda said in a speech at the American Bar Association's Healthcare Fraud Institute in New Orleans. "As one case comes forward and gains attention, others follow."
The pharmaceutical industry is the No. 1 target right now, and the role of state attorneys general in healthcare fraud enforcement is growing, she said.
"The more communication and coordination between federal government agencies and state Medicaid fraud control units, the better we do," Branda said. "We're using sophisticated technology to share evidence and develop expertise. This is virtually unprecedented for us and it's working."