The Justice Department secured $1.12 billion in fiscal 2008 from settlements and judgments from healthcare organizations alleged to have defrauded the government.
The figure is down from $1.53 billion reported for the previous year. Healthcare cases accounted for 84% of the total of $1.34 billion the department secured through fraud and False Claims Act actions, most of which were initiated by whistle-blowers.
In the biggest cases of 2008: Merck & Co. agreed to pay the federal government $361.5 million to resolve allegations involving Medicaid rebates and Pepcid discounts for hospitals; Cephalon agreed to pay $258 million to resolve alleged marketing off-label uses for three of its drugs; and Amerigroup agreed to pay $225 million to end a case in which its Medicaid HMO in Illinois was alleged to have turned away or discouraged enrollment by pregnant women and other high-cost patients. Nearly 60% of the 2008 healthcare total comes from pharmaceutical manufacturers and retailers.
Organizations entering settlements typically assert in the agreements that the decision does not reflect an admission of liability or wrongdoing.
The totals from year to year arent directly comparable. The 2008 Amerigroup settlement, for example, replaces a judgment against the company that the Justice Department hailed in 2007; an agreement was reached in order to end the companys appeal. The departments biggest healthcare haul ever was $2.3 billion in 2006, a year that included a $920 million global settlement by Tenet Healthcare Corp. -- by Gregg Blesch