Healthcare companies paid almost 90% of the fraud settlement proceeds the U.S. Justice Department collected in fiscal 2021, the federal government said Tuesday.
The DOJ's civil division secured $5.6 billion in False Claims Act settlements and judgments in the year ended September 30, 2021, the second largest annual total in the law's history. Of that, more than $5 billion related to fraud and false claims in the healthcare industry, including managed care providers, hospitals, drug and medical device manufacturers, hospice providers, labs and doctors.
The DOJ said in a news release that its healthcare fraud enforcement efforts aim to restore funds to federal programs like Medicare, Medicaid and Tricare, the healthcare program for military service members and their families.
"But just as important, the department's vigorous pursuit of healthcare fraud prevents billions more in losses by deterring others who might try to cheat the system for their own gain," the department said. "In many cases, the department's efforts also protect patients from medically unnecessary or potentially harmful actions."
Healthcare comprised 80% of settlement proceeds between 2017 and 2020. The DOJ noted that the $5 billion in healthcare settlements doesn't include additional amounts recovered for state Medicaid programs.Far and away the largest FCA settlement in fiscal 2021 were those reached with prescription drugmakers for their role in fueling the opioid epidemic. Purdue Pharma agreed to a $2.8 billion unsecured bankruptcy claim in October 2020 as part of an agreement to resolve civil allegations that the company promoted its drugs to healthcare providers for uses known to be unsafe and paid kickbacks to increase prescriptions of its drugs. Another manufacturer, Indivior, paid $209 million to resolve civil allegations regarding inappropriate prescriptions for the opioid addiction treatment drug Suboxone.