DOJ Releases False Claims Act Results for 2023

The Department of Justice (DOJ) just released its False Claims Act results for 2023.  By all accounts, it was another big year for the government’s primary fraud-fighting tool.  The top-line numbers are roughly $2.7 billion in total recoveries from 543 settlements and judgments, the highest number of settlements and judgments in a single year.  This brings the total tally of False Claims Act recoveries to more than $75 billion since 1986, when Congress substantially strengthened the statute.

One of the unique features of the False Claims Act is the authority it provides whistleblowers to bring lawsuits on behalf of the government against those committing fraud against the government.  In return, successful whistleblowers can receive up to 30% of any government recovery.  Unsurprisingly, since 1986 when Congress increased these whistleblower incentives, whistleblowers have been leading the charge in False Claims Act enforcement.

This past year was no different on the whistleblower front, with roughly 85% of the recoveries ($2.3 billion) coming from actions originated by whistleblowers.  For their efforts, they received roughly $350 million in whistleblower awards.  And as the DOJ highlighted, whistleblowers continue to press forward, filing 712 False Claims Act cases this past year, an average of more than 13 new cases a week.

Here are the four areas of fraud DOJ highlighted where it found most success last year:

• Healthcare Fraud. As usual, healthcare fraud led the way with roughly 70% of the recoveries ($1.8 billion) coming from various healthcare-related schemes, including those involving Medicare Advantage (Medicare Part C) fraud; unnecessary services; substandard care; conduct contributing to the opioid epidemic; and unlawful kickbacks.
• Procurement Fraud. After healthcare fraud, procurement fraud is typically the next biggest area of False Claims Act enforcement.  While it often involves military contracts, it also includes any government contracts for goods or services.  The big winner this year was Booz Hamilton, which agreed to pay $377 million to settle DOJ and whistleblower charges of improperly billing government contracts for costs incurred in the company’s non-governmental commercial and international contracts.  It is one of the largest procurement settlements ever.
• Pandemic Fraud. Given the vast amount of COVID-relief funding the government doled out over the past few years, there has been an equally historic amount of fraud in securing this funding.  The two primary areas of government focus are improper payments under the Paycheck Protection Program (PPP) and schemes by health care providers to profit from the pandemic by billing for unnecessary tests and services.
• Cyber Fraud. DOJ launched its Civil Cyber-Fraud Initiative in October 2021, which focuses on using the False Claims Act to go after government contractors and grantees that violate applicable cybersecurity requirements.  The government identified two enforcement successes in this area last year for companies that failed to properly secure personal information and trusted internet connections.

In announcing last year’s results, DOJ stressed the importance of the False Claims Act, noting it “remains one of our most important tools for rooting out fraud, ensuring that public funds are spent properly, and safeguarding critical government programs.”  DOJ also went out of its way to give a special shout out to whistleblowers and the key role they play in the agency’s fraud-enforcement efforts:

We are grateful for the hard work and courage of whistleblowers who play a critical role in identifying fraud, often at substantial risk to themselves.  Our efforts to ensure that public funds are spent properly continues to benefit greatly from their actions.

Making it very clear that if you have information relating to fraud against the government, DOJ wants to hear from you.  If you would like to speak to an experienced member of the Constantine Cannon whistleblower team to learn more about what it means to be a whistleblower, please do not hesitate to contact us for a free and confidential consult.

Read More

• FTC: Consumers Lost Over $10 Billion to Fraudsters in 2023
• Top Ten Non-Healthcare False Claims Act Recoveries for 2023
• Top Ten Healthcare False Claims Act Recoveries for 2023
• I Think I Have A Whistleblower Case

Tagged in: FCA Federal, Government Procurement Fraud, Healthcare Fraud, Importance of Whistleblowers,