Notable Healthcare Fraud Recoveries of 2022
- posted: Mar. 21, 2023
- Whistleblower Litigation, Fraud
Government enforcement agencies spent 2022 investigating claims of healthcare fraud, thanks to whistleblowers. The government recovered billions of dollars from healthcare providers, pharmaceutical companies and more.
Most of the cases below involve violations of the federal Anti-Kickback Statute, while whistleblowers are protected under the qui tam provisions of the False Claims Act.
Here are some of the most notable healthcare fraud recoveries of 2022:
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- Biogen: Massachusetts-based Biogen paid $900 million to settle kickback claims. In 2012, a whistleblower alerted authorities that Biogen was paying kickbacks to prescribing physicians to discourage them from prescribing competitors’ products. The Department of Justice declined to intervene, so the whistleblower and their counsel pursued the case on their own.
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- Mallinckrodt: Mallinckrodt agreed to pay $260 million to settle claims that they failed to pay owed amounts in the Medicaid Drug Rebate Program. The whistleblower claimed that the company improperly calculated their rebate amount by choosing the wrong year to peg the average manufacturing price.
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- Medi-Cal: Medi-Cal, California’s Medicaid program, recovered $93.2 million thanks to whistleblowers. These cases involved multiple defendants and primarily arose from payor and provider gamesmanship of the Medical Loss Ratio, a rule which requires a certain percentage of healthcare dollars that must be spent on medical expenses.
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- Florida Birth-Related Neurological Injury Compensation: A Florida fund for people suffering from birth-related neurological complications paid $51 million to resolve allegations of Florida Medicaid fraud. The fund did not cover medical and other required expenses—instead, it directed patients to Florida Medicaid, a payor of last resort. The government did not intervene in this whistleblower action.
These cases likely would not have been litigated without the help of whistleblowers. If you’ve noticed healthcare fraud at your job, an experienced whistleblower attorney at Kardell Law Group can help. Call today for a consultation.
