The Department of Justice obtained more than $3.5 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year that ended Sept. 30, with $1.9 billion recovered from companies and individuals in the healthcare industry.
Here are seven takeaways from the DOJ's recent report on healthcare fraud recoveries in fiscal year 2015.
1. Hospitals were involved in nearly $330 million in settlements and judgments this past year.
2. One of the significant settlements highlighted by the DOJ was a $250 million deal it reached with 457 hospitals across the nation to settle allegations related to cardiac devices that were implanted in Medicare patients in violation of Medicare coverage requirements.
3. Two of the largest healthcare recoveries in FY 2015 involved Denver-based DaVita Healthcare Partners.
4. DaVita paid $450 million to resolve allegations it knowingly generated unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients, and then billed the government for costs that could have been avoided. DaVita paid an additional $350 million to resolve claims it violated the False Claims Act by paying kickbacks to physicians to induce patient referrals.
5. Several healthcare industry settlements involved violations of Stark Law. The DOJ offered details on a few of the significant Stark Law settlements, including Altamonte Springs, Fla.-based Adventist Health System's agreement to pay $118.7 million to the federal government and four states.
6. Claims involving the pharmaceutical industry accounted for $96 million in settlements and judgments in the fiscal year that ended Sept. 30.
7. Including this past year's $1.9 billion, the DOJ has recovered nearly $16.5 billion in healthcare fraud settlements and judgments since January 2009.
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