The U.S. Dept. of Justice secured $3 billion in civil settlements and judgments for fraud cases in the fiscal year ending Sept. 30 — the largest-ever annual recovery of funds defrauded from federal government.
Healthcare fraud cases accounted for $2.5 billion in False Claims Act recoveries last year, 83 percent of the year’s total. The Dept. of Health & Human Services reaped the biggest recoveries, largely attributable to its Medicare and Medicaid programs, according to a statement from the DOJ.
“Under Attorney General Eric Holder’s leadership, our aggressive pursuit of fraud under the False Claims Act has resulted in the largest two-year recovery of taxpayer dollars in the history of the Justice Dept. Nowhere is this more apparent than in our success in fighting health care fraud," assistant attorney general Tony West said in prepared remarks.
The DOJ pulled in about $1.6 billion in false claims recoveries during fiscal year 2009.
The total recovery for 2010 is not far off from the Taxpayers Against Fraud Education Fund’s $3.16 billion estimate, released last month. The advocacy group’s report revealed that drug makers Allergan Inc. (NYSE:AGN) and AstraZeneca LP (NYSE:AZN) together accounted for one-third of the settlements.
But the DOJ has fallen behind in FCA cases, according to the advocacy group, which believes that the DOJ needs more resources.
“Right now, simply put, the U.S. government is being outgunned and outmanned by the people who are stealing from it,” TAF spokesperson Patrick Burns told NPR.
In other news from Washington, the Obama administration rolled back certain healthcare reform legislation measures in a win for big business.
The administration loosened new rules for so-called “mini-med” insurance policies, which companies like McDonalds said threatened their profits.
The fast-food chain provides about 30,000 of its low-wage workers a $13.09 a week for a plan that tops out at $2,000 a year in benefit payments. The company said it would need to drop the program because it couldn’t meet new regulations set out in the Patient Protection and Affordable Care Act that required 80 to 85 percent of an insurance plan’s revenues to go towards medical payments. McDonalds claimed that the high administrative costs of the plan prevented it from meeting the new payment ratio.
Some Democrats wanted to due away with such plans because of their limited coverage.
HHS said rolling back the regulations would allow employees of companies like McDonalds to keep the coverage they have and expects the bare-bones “mini-med” plans to effectively disappear by 2014, as lower-wage earners qualify for insurance tax credits.