In a recent press release, the U.S. Department of Justice (DOJ) reported that the United States has received $2 billion in judgments and settlements in the fiscal year ending September 30, 2007.
This sum results from the government’s pursuing allegations of Medicaid and Medicare fraud and other acts of deception committed against government healthcare programs. Total dollar recoveries since 1986, when the civil False Claims Act was strengthened, amount to more than $20 billion.

“This year's outstanding recoveries in civil fraud cases demonstrate this administration's unwavering commitment to root out fraud against the government and to ensure that citizens' tax dollars are well spent,” said Peter D. Keisler, Acting Attorney General and Assistant Attorney General for the Civil Division.“

DOJ credits Medicare/Medicaid whistleblowers for program's success

The government attributed much of its success in uncovering wrongdoing and recovering funds to whistleblowers who file suits in the name of the government. They say $1.45 billion of the $2 billion came about because of whistleblower initiatives.

Whistleblowers can file suit on behalf of the government against persons or companies they suspect of fraudulently or falsely claiming federal funds. These whistleblowers have filed cases in areas ranging from agricultural subsidies to defense procurement to Medicare and Medicaid fraud.

In addition to exercising good citizenship, the whistleblowers can share in recovered funds. In fiscal year 2007, they received more than $177 million for their actions.

As has been the case in recent years, most of the fraud settlements and judgments, $1.54 billion, related to the health care field. The largest recoveries flowed to the Department of Health and Human Services, mostly because of its federal and state Medicaid program and its federal Medicare program.

Pharmaceutical companies and other allied companies paid out some of the largest settlements.

Bristol-Myers Squibb Co., Aventis Pharmaceuticals, Inc., Medco Health Solutions, Inc., Purdue Pharma L.P. and Purdue Frederick Co., and InterMune, Inc. paid more than $800 million of the $1.5 billion.

In related action, pharmaceutical fraud cases gave back $264 million to state Medicaid programs.

Have information on Medicaid Fraud?

If you have information about Medicaid fraud, contact the Medicaid Fraud Reporting Center for a confidential claim evaluation today. You may report Medicaid fraud by completing the form on this page, or by calling our Medicaid Fraud Hotline at 1-800-934-2921.