The federal False Claims Act is one the most powerful tools used by the federal government to recover fraudulently paid monies. In fiscal year 2021 (FY2021), the Department of Justice recovered over $5.6 billion with the False Claims Act in civil cases. These monies came from both cases that ended in settlements and judgments. FY2021 is now the second year with highest recoveries, after those made in 2014. Of these recovered amounts, over $5 billion were related to fraud in the healthcare field.
Of relevance is the large amount recovered from opioid litigation and, specifically, from Purdue Pharma. Purdue Pharma promoted its opioids in an unsafe manner and went so far as to pay kickbacks in exchange for prescriptions of its opioid products.
Concerning whistleblowers, over $1.6 billion of recoveries came from cases initiated under the qui tam provisions of the False Claims Act, or around 30% of all recoveries. Qui tam cases are initiated by whistleblowers via legal counsel, effectively alerting the government of fraud. Almost 600 new qui tam cases were filed in FY2021. Lastly, whistleblowers were awarded over $320 million in FY 2021.
In addition to the Purdue matter, some other large cases involved Arriva Medical, LLC, Sutter Health, and Apria Healthcare LLC. Arriva paid $160 million due to an alleged kickback scheme involving diabetic testing equipment. Sutter Health paid $90 million due to allegations of submitting inaccurate health information for patients enrolled in Medicare Advantage. Lastly, Apria paid over $37 million to the federal government due to allegations of improper co-pay waivers and billings for medically unnecessary non-invasive ventilators.