DOJ recovers $2.5B from healthcare false claims cases: 5 things to know

The Department of Justice obtained more than $4.7 billion in fraud and false claims settlements and judgments in fiscal year 2016 — the third highest annual recovery in False Claims Act history — and more than half of the amount recovered came from the healthcare industry. 

Here are five things to know about the DOJ's false claims recoveries.

1. From FY 2009 through FY 2016, the DOJ recovered $31.3 billion in settlements and judgments from civil cases involving fraud and false claims.

2. The DOJ obtained an average of $4 billion per year from settlements and judgments in civil cases involving the False Claims Act from FY 2009 through FY 2016.

3. In FY 2016, which ended Sept. 30, the DOJ recovered $2.5 billion from the healthcare industry in False Claims Act cases. That amount represents only federal losses. In many of the cases, the healthcare companies agreed to or were ordered to pay additional amounts to state Medicaid programs.

4. FY 2016 marked the seventh consecutive year the DOJ's civil healthcare fraud recoveries exceeded $2 billion.

5. Of the amount recovered from healthcare organizations in FY 2016, hospitals and outpatient clinics accounted for $360 million. Within the hospital sector, Tenet Healthcare had the largest payout in FY 2016. The Dallas-based hospital operator paid $244.2 million to the federal government to resolve allegations that four of its hospitals paid illegal kickbacks for referrals. Including the $123.7 million paid to state Medicaid programs and the $145 million forfeited, Tenet paid approximately $514 million to resolve the case.

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