Health-care fraud investigations paying dividends, Justice Department official says

Acting Assistant Attorney General Stuart F. Delery told lawyers at the American Bar Association’s ninth National Institute on the Civil False Claims Act and Qui Tam Enforcement that health-care prosecutions have worked for taxpayers.

"Since January 2009, the Civil Division, working with our partners in the U.S. Attorney offices, has recovered over $11.1 billion under the False Claims Act," Delery told the group last week, according to text of his speech. "Of this amount, more than $7.4 billion was recovered in health care fraud matters, with the largest recoveries coming from the pharmaceutical and medical device industries. These are historic figures."

Qui tam is the abbreviated Latin phrase that translates, in practical terms, to whistle-blowers speaking up about what they perceive as malfeasance.

While whistle-blowers sometime benefit financially if a case gets all the way to conclusion, many have started out frustrated by attempts to fix the problem within their company.

The audience included attorneys who represent companies.

"Protecting taxpayer dollars is one of the Attorney General’s core priorities," Delery said. "This includes a commitment to increase our efforts to reduce fraud at the outset. Although the recoveries I discussed earlier reflect the impressive work of this department, it would be better if we did not need to bring these cases at all. The department is well aware of the fact that litigation can only plausibly reach a fraction of the fraud committed against U.S. Government programs – which likewise makes the prevention of fraud a more potent tool for protecting the interests of the United States than efforts to undo the damage of completed schemes.

"That is why we continue to pursue non-monetary remedies and other measures to help prospectively reduce fraud. And it is why we want to engage with you and your clients to encourage self-reporting, discuss forward-looking compliance measures, and generally work cooperatively to try to eliminate fraud. Litigation to recover the costs of fraud is a far inferior option to preventing fraud in the first place."

Delery's full speech is here.