The U.S. Justice Department tallied $1.6 billion in False Claims Act settlements and judgments involving healthcare in fiscal 2009, accounting for two-thirds of the government's total haul of $2.4 billion last year under the fraud-fighting statute. Both the healthcare and governmentwide figures are the second largest since 1987, the year after Congress significantly strengthened the Civil War-era law.
Healthcare makes up bulk of false claims tally
Among the biggest recoveries of the year were a $443 million settlement with Eli Lilly and Co. resolving allegations of off-label marketing, and a $262 million settlement with Quest Diagnostics involving the sale of allegedly unreliable diagnostic kits. In the largest hospital case, Condell Medical Center, Libertyville, Ill., agreed to pay $33.1 million (just before it was acquired by Advocate Health Care, Oak Brook, Ill.) to settle allegations that financial arrangements with a physicians group violated the anti-kickback and self-referral laws.
Tony West, assistant attorney general for the Justice Department's Civil Division, noted in a conference call that the 2009 figures do not reflect the record $2.3 billion criminal and civil resolution with Pfizer announced in September, which was not finalized by the end of the fiscal year.
For fiscal 2008, the department reported healthcare recoveries of $1.1 billion. The biggest year was 2006 when healthcare recoveries reached $2.3 billion, which included a $900 million settlement with Tenet Healthcare.
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