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Significantly Lower Recoveries in Healthcare Industry According to DOJ’s False Claims Act 2022 Year in Review

The Civil Division of the US Department of Justice (DOJ) released its annual fraud statistics for fiscal year 2022 on February 7. Of the $2.2 billion recovered under False Claims Act (FCA) settlements and judgments, more than $1.7 billion related to matters that involved the healthcare industry, including medical device and pharmaceutical manufacturers.

Of this $1.7 billion, almost half—$843.8 million—came from a single settlement with a whistleblower involving a declined qui tam case against a biopharmaceutical manufacturer. A $260 million settlement involved allegations that a pharmaceutical company knowingly underpaid rebates to Medicaid by claiming that a drug approved in 1952 was new to the market in 2013.

DOJ also pursued multiple cases involving unnecessary drug tests and drug pricing fraud allegations against a Houston-based company that sells active pharmaceutical ingredients to compounding pharmacies, claiming the company reported inflated Average Wholesale Prices and submitted inflated compound prescription claims to TRICARE.

Partner Scott Memmott and associate Tesch West discuss the key takeaways on DOJ’s False Claims Act Year in Review 2022 on our Health Law Scan blog.

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