Justice Department recovers $1.12 billion from fraud

Every year the Justice Department tries to recover as much as it can from healthcare organizations that have allegedly defrauded them: this year the total it recovered was $1.12 billion dollars.

This is down slightly from last year, when the Justice Department recovered a reported $1.53 billion. However, the year-to-year results are not directly comparable, since some of the settlements made in one year are actually included in the next year's total.

Of the fraud and False Claim Act actions that the department recovered this year, healthcare accounted for 84 percent of the total amount secured.

Some of the biggest cases of the year included Merck & Co's $361.5 million settlement to resolve allegations involving Medicaid rebates and Pepcid discounts for hospitals, Cephalon's $258 million to resolve alleged marketing off-label uses for three of its drugs, and Amerigroup's $225 million to end a case involving allegedly turning away or discouraging enrollment of pregnant women and other high-cost patients in Illinois.

To learn more about the recoveries:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
Amerigroup to pay $225M in Medicaid fraud settlement
Merck agrees to $58M settlement on Vioxx ads
Cephalon settlement requires physician payments to be disclosed