The U.S. Justice Department closed its fiscal 2007 books with a tally of healthcare-related False Claims Act recoveries that was down by a third from the previous year. But experts say the government is hardly losing interest.
The department informally rang in a new year of healthcare collections last week, announcing that Arizona Heart Hospital in Phoenix would pay $5.8 million to settle allegations of wrongfully billing Medicare for procedures involving graft devices in a clinical trial.
A Justice Department spokesman couldnt confirm that the Arizona case would yield first recovery in the fiscal year started Oct. 1, but the news came just a few days after the department trumpeted the take during the year that just ended: $1.54 billion from healthcare-related settlements and judgments, accounting for 77% of the total amount collected.
The 2006 healthcare sum was a banner one$2.2 billionsupercharged by Tenet Healthcare Corp.s agreement to pay $920 million in a global settlement disposing of a broad array of allegations against the for-profit hospital chain. In contrast, the 2007 figure saw the biggest settlements from pharmaceutical companies and devicemakers, led by a $328 million payment from Bristol-Myers Squibb Co. and subsidiary Apothecon to settle allegations that included promotion of off-label uses and kickbacks to doctors, wholesalers and retailers.
I think the cases against hospitals and health systems are inevitably going to slow down, said health lawyer B. Scott McBride, a partner in law firm Baker Hostetler in Houston. McBride said an increasing focus on compliance programs, internal reviews and self-reporting have allowed hospitals and systems to address payment issues as they arise, and at the same time avoid allegations they have the required intent under the False Claims Act.