2012 Record Year for False Claims Act Recoveries
$9 billion in civil fines and criminal penalties associated in FCA cases
FY 2013 starts with $3.5 billion in expected settlements already on deck
In fiscal year 2012, federal and state False Claims Act cases returned over $9 billion back to the government. This sum consists of criminal fines as well as several large state False Claims Act settlements, including over $300 million recovered by the State of California in a single Medicaid HMO case.
Notes Kristin Amerling, President of Taxpayers Against Fraud: “The False Claims Act is working exactly as it should, forging a public-private partnership that incentivizes integrity and discourages wrongdoing, even as it works to keep government and law enforcement more efficient.”
FY 2012 saw increased recoveries under state False Claims Act laws patterned after the federal statute, as well as increased criminal fines associated with larger federal False Claims Act cases.
“While health care fraud still represents the bulk of False Claims Act recoveries at both the state and federal level,” said Amerling, “we are starting to see new areas of inquiry open up, especially in the banking, mortgage, and pension arenas, where state action may bring real dividends.”
The largest recovery in FY 2012 came from the company with the largest False Claims Act settlement in FY 2011, GlaxoSmithKline. FY 2012 also saw a major award paid under the IRS whistleblower program and the first case settled under the SEC whistleblower program. Both programs are modeled on the federal False Claims Act.
“At a time when federal and state governments are facing fiscal challenges, whistleblower programs offer the American people a win-win: billions of dollars recovered, and future frauds deterred.”
Just one week into the new fiscal year, it is too early to predict 2013 False Claims Act recoveries, but $3.5 billion in already-reported False Claims Act settlements lie just ahead.
A chart of top 30 FCA recoveries in FY 2012 follows. Of these 30 recoveries, 28 are whistleblower-initiated.
Top 30 False Claims Act Settlements of FY 2012
GlaxoSmithKline - Illegal marketing of nine different prescription drugs, including Wellbutrin, Paxil, Avandia, Advair, Zofran, Imitrex, Lamictal, Lotronex, Floven, and Valtrex. Settlement includes $2 billion civil, and $1 billion criminal.
Total Settlement: $3,000,000,000
Case Initiated By: Whistleblowers
Abbott Laboratories - Off-label marketing of Depakote. Settlement includes $800 million civil, and $700 million criminal.
Total Settlement: $ 1,500,000,000
Case Initiated By: Whistleblowers
Bank of America - Mortgage and bank fraud.
Total Settlement: $1,000,000,000
Case Initiated By: Whistleblowers and Federal Government
Merck - Illegal marketing of Vioxx. Settlement includes $628.4 million civil, and $321.6 million criminal.
Total Settlement: $950,000,000
Case Initiated By: Whistleblowers
Senior Care Action Network - California Medicaid fraud case. HMO cost reporting fraud.
Total Settlement: $323,670,000
Case Initiated By: Whistleblowers
Actavis - National settlement after trial loss by company in a Texas state FCA case dealing with Average Wholesale Price (AWP).
Total Settlement: $202,600,000
Case Initiated By: Whistleblowers
Deutsche Bank - False certification for HUD/FHA loans.
Total Settlement: $202,300,000
Case Initiated By: Federal Government
Oracle - Failure to provide discount pricing as required.
Total Settlement: $199,500,000
Case Initiated By: Whistleblowers
McKesson - Inflating prescription drug price information. This is the federal part of the McKesson case detailed below.
Total Settlement: $190,000,000
Case Initiated By: Whistleblowers
Citigroup - FHA home loan approval fraud.
Total Settlement: $158,000,000
Case Initiated By: Whistleblower
Johnson& Johnson - Off-label marketing of Risperdal. Texas case, settled in the middle of a trial.
Total Settlement: $158,000,000
Case Initiated By: Whistleblower
McKesson - Inflating inflated prescription drug price information. This is a 29-state settlement that is part of the McKesson case noted above.
Total Settlement: $ 151,000,000
Case Initiated By: Whistleblowers
Sandoz - AWP case never joined by DOJ. Most of the settlement money went to CA and FL.
Total Settlement: $150,000,000
Case Initiated By: Whistleblowers
WellCare Health Plans - Price-gouging, knowingly retaining Medicare and Medicaid overpayments, cherry-picking.
Total Settlement: $137,500,000
Case Initiated By: Whistleblowers
Bank of America, JPMorgan, Wells Fargo, and Citigroup - Mortgage and bank fraud.
Total Settlement: $95,000,000
Case Initiated By: Whistleblowers
Bank of America - Mortgage and bank fraud.
Total Settlement: $75,000,000
Case Initiated By: Whistleblowers
New York City and State - Home healthcare upcoding.
Total Settlement: $70,000,000
Case Initiated By: Whistleblowers
LHC Groups - Home healthcare provider billing fraud.
Total Settlement: $65,000,000
Mylan - California False Claims Act case dealing with AWP.
Total Settlement: $57,000,000
Case Initiated By: Whistleblowers
DaVita - Texas settlement dealing with Epogen over-fill kickback.
Total Settlement: $55,000,000
Case Initiated By: Whistleblowers
Harbert Corporation - Settlement of price-gouging in 1990s-era USAID construction contract.
Total Settlement: $47,000,000
Case Initiated By: Whistleblowers
JPMorgan Chase - Mortgage and bank fraud.
Total Settlement: $45,000,000
Case Initiated By: Whistleblowers
Orthofix International - Illegal marketing of a bone growth stimulation device and illegal kickbacks.
Total Settlement: $43,000,000
Case Initiated By: Whistleblowers
MetLife - Unclaimed benefit / escheatment in MN insurance case.
Total Settlement: $40,000,000
Case Initiated By: Whistleblowers
ATK Launch Systems - Dangerous and defective illumination flares sold to the Army and the Air Force.
Total Settlement: $37,000,000
Case Initiated By: Whistleblowers
Blackstone Medical - Illegal marketing of a bone growth stimulation device and illegal kickbacks.
Total Settlement: $32,000,000
Case Initiated By: Whistleblowers
Maersk Line - Submitting inflated cargo invoices for goods shipped to U.S. troops in Afghanistan and Iraq.
Total Settlement: $31,900,000
Case Initiated By: Whistleblowers
GE Healthcare - Diluting cardiac diagnostic drug.
Total Settlement: $30,000,000
Case Initiated By: Whistleblowers
Odyssey Healthcare - Billing for hospice care not legally covered by Medicare.
Total Settlement: $25,000,000
Case Initiated By: Whistleblowers
Merck - Price-gouging on Medicaid drugs to Massachusetts.
Total Settlement: $24,000,000
Case Initiated By: State Government
Medtronic - Cardiac defibrillator and pacemaker fraud.
Total Settlement: $23,500,00
Case Initiated By: Whistleblowers
TOTAL - $9,094,474,000
Note: Approximately 100 other False Claims Acts, totaling approximately $150 million, were settled in FY 2012.
Source: Taxpayers Against Fraud
Notes Kristin Amerling, President of Taxpayers Against Fraud: “The False Claims Act is working exactly as it should, forging a public-private partnership that incentivizes integrity and discourages wrongdoing, even as it works to keep government and law enforcement more efficient.”
FY 2012 saw increased recoveries under state False Claims Act laws patterned after the federal statute, as well as increased criminal fines associated with larger federal False Claims Act cases.
“While health care fraud still represents the bulk of False Claims Act recoveries at both the state and federal level,” said Amerling, “we are starting to see new areas of inquiry open up, especially in the banking, mortgage, and pension arenas, where state action may bring real dividends.”
The largest recovery in FY 2012 came from the company with the largest False Claims Act settlement in FY 2011, GlaxoSmithKline. FY 2012 also saw a major award paid under the IRS whistleblower program and the first case settled under the SEC whistleblower program. Both programs are modeled on the federal False Claims Act.
“At a time when federal and state governments are facing fiscal challenges, whistleblower programs offer the American people a win-win: billions of dollars recovered, and future frauds deterred.”
Just one week into the new fiscal year, it is too early to predict 2013 False Claims Act recoveries, but $3.5 billion in already-reported False Claims Act settlements lie just ahead.
A chart of top 30 FCA recoveries in FY 2012 follows. Of these 30 recoveries, 28 are whistleblower-initiated.
Top 30 False Claims Act Settlements of FY 2012
GlaxoSmithKline - Illegal marketing of nine different prescription drugs, including Wellbutrin, Paxil, Avandia, Advair, Zofran, Imitrex, Lamictal, Lotronex, Floven, and Valtrex. Settlement includes $2 billion civil, and $1 billion criminal.
Total Settlement: $3,000,000,000
Case Initiated By: Whistleblowers
Abbott Laboratories - Off-label marketing of Depakote. Settlement includes $800 million civil, and $700 million criminal.
Total Settlement: $ 1,500,000,000
Case Initiated By: Whistleblowers
Bank of America - Mortgage and bank fraud.
Total Settlement: $1,000,000,000
Case Initiated By: Whistleblowers and Federal Government
Merck - Illegal marketing of Vioxx. Settlement includes $628.4 million civil, and $321.6 million criminal.
Total Settlement: $950,000,000
Case Initiated By: Whistleblowers
Senior Care Action Network - California Medicaid fraud case. HMO cost reporting fraud.
Total Settlement: $323,670,000
Case Initiated By: Whistleblowers
Actavis - National settlement after trial loss by company in a Texas state FCA case dealing with Average Wholesale Price (AWP).
Total Settlement: $202,600,000
Case Initiated By: Whistleblowers
Deutsche Bank - False certification for HUD/FHA loans.
Total Settlement: $202,300,000
Case Initiated By: Federal Government
Oracle - Failure to provide discount pricing as required.
Total Settlement: $199,500,000
Case Initiated By: Whistleblowers
McKesson - Inflating prescription drug price information. This is the federal part of the McKesson case detailed below.
Total Settlement: $190,000,000
Case Initiated By: Whistleblowers
Citigroup - FHA home loan approval fraud.
Total Settlement: $158,000,000
Case Initiated By: Whistleblower
Johnson& Johnson - Off-label marketing of Risperdal. Texas case, settled in the middle of a trial.
Total Settlement: $158,000,000
Case Initiated By: Whistleblower
McKesson - Inflating inflated prescription drug price information. This is a 29-state settlement that is part of the McKesson case noted above.
Total Settlement: $ 151,000,000
Case Initiated By: Whistleblowers
Sandoz - AWP case never joined by DOJ. Most of the settlement money went to CA and FL.
Total Settlement: $150,000,000
Case Initiated By: Whistleblowers
WellCare Health Plans - Price-gouging, knowingly retaining Medicare and Medicaid overpayments, cherry-picking.
Total Settlement: $137,500,000
Case Initiated By: Whistleblowers
Bank of America, JPMorgan, Wells Fargo, and Citigroup - Mortgage and bank fraud.
Total Settlement: $95,000,000
Case Initiated By: Whistleblowers
Bank of America - Mortgage and bank fraud.
Total Settlement: $75,000,000
Case Initiated By: Whistleblowers
New York City and State - Home healthcare upcoding.
Total Settlement: $70,000,000
Case Initiated By: Whistleblowers
LHC Groups - Home healthcare provider billing fraud.
Total Settlement: $65,000,000
Mylan - California False Claims Act case dealing with AWP.
Total Settlement: $57,000,000
Case Initiated By: Whistleblowers
DaVita - Texas settlement dealing with Epogen over-fill kickback.
Total Settlement: $55,000,000
Case Initiated By: Whistleblowers
Harbert Corporation - Settlement of price-gouging in 1990s-era USAID construction contract.
Total Settlement: $47,000,000
Case Initiated By: Whistleblowers
JPMorgan Chase - Mortgage and bank fraud.
Total Settlement: $45,000,000
Case Initiated By: Whistleblowers
Orthofix International - Illegal marketing of a bone growth stimulation device and illegal kickbacks.
Total Settlement: $43,000,000
Case Initiated By: Whistleblowers
MetLife - Unclaimed benefit / escheatment in MN insurance case.
Total Settlement: $40,000,000
Case Initiated By: Whistleblowers
ATK Launch Systems - Dangerous and defective illumination flares sold to the Army and the Air Force.
Total Settlement: $37,000,000
Case Initiated By: Whistleblowers
Blackstone Medical - Illegal marketing of a bone growth stimulation device and illegal kickbacks.
Total Settlement: $32,000,000
Case Initiated By: Whistleblowers
Maersk Line - Submitting inflated cargo invoices for goods shipped to U.S. troops in Afghanistan and Iraq.
Total Settlement: $31,900,000
Case Initiated By: Whistleblowers
GE Healthcare - Diluting cardiac diagnostic drug.
Total Settlement: $30,000,000
Case Initiated By: Whistleblowers
Odyssey Healthcare - Billing for hospice care not legally covered by Medicare.
Total Settlement: $25,000,000
Case Initiated By: Whistleblowers
Merck - Price-gouging on Medicaid drugs to Massachusetts.
Total Settlement: $24,000,000
Case Initiated By: State Government
Medtronic - Cardiac defibrillator and pacemaker fraud.
Total Settlement: $23,500,00
Case Initiated By: Whistleblowers
TOTAL - $9,094,474,000
Note: Approximately 100 other False Claims Acts, totaling approximately $150 million, were settled in FY 2012.
Source: Taxpayers Against Fraud