False Healthcare Claims Settlements Hit $1.7 Billion in 2022

The DOJ reports that 2022’s False Claims Acts settlements included claims for DME, drugs, home health, managed care, hospitals and physicians.

• By David Kopf
• Feb 09, 2023

Settlements and judgments under the False Claims Act exceeded $2.2 billion in the fiscal year ending Sept. 30, 2022, and healthcare-related claims represented $1.7 billion of those judgments, the Department of Justice reported.

The government and whistleblowers were parties to 351 settlements and judgments in FY 2022, marketing the second-highest number of settlements and judgments in a single year. Recoveries since 1986, when Congress strengthened the False Claims Act, now exceed $72 billion.

“Protecting taxpayer dollars by preventing fraud and abuse is a critical priority for the Department of Justice,” said Principal Deputy Assistant Attorney General Boynton. “The large number of settlements and judgments this past year demonstrates that the False Claims Act remains one of the most important tools for ensuring that public funds are spent properly and advance the public interest.”

The $1.7 billion in healthcare-related judgments and settles covered claims such as DME, drug and medical device manufacturers, home health and managed care providers, hospitals, pharmacies, hospice organizations, and physicians. The recoveries restored funds to federal programs, including Medicare, Medicaid, and TRICARE. In addition to the $1.7 billion in recoveries arising from federal losses, the DOJ also helped recover additional amounts for various state Medicaid programs not included in the federal tally.

When it comes to DME-related settlements, the DOJ highlighted Philips RS North America, LLC, formerly Respironics Inc., for paying $24.75 million to resolve allegations that it provided unlawful kickbacks to DME providers to induce them to select Respironics’ equipment. The inducements allegedly came in the form of physician prescribing data that Respironics provided free of charge yet knew was valuable in assisting DME suppliers’ marketing efforts to physicians.