Bass, Berry & sims attorneys Taylor Chenery, Lauren Gaffney and Anna Grizzle discussed highlights and key takeaways from the Department of Justice’s (DOJ) 2019 annual report on False Claims Act (FCA) enforcement in an article published by Corporate Compliance Insights.

In 2019, the DOJ obtained more than $3 billion in settlements and judgments from civil cases involving fraud and false claims against the government. Matters involving the healthcare industry continued to dominate the majority of FCA recoveries, constituting $2.6 billion of the more than $3 billion in total recoveries. “Beyond healthcare, other notable enforcement matters in 2019 related to procurement fraud involving entities that contract directly with the federal government and to other fraud schemes where the government allegedly suffered harm due to false certifications or representations, particularly by entities that received federal benefits,” noted the authors.

Another key takeaway from the report involved the reduced payouts to whistleblowers in qui tam suits, which accounted for roughly 70% of all settlements and judgments reported by the government in fiscal year 2019. “During that same period, the government paid out $265 million to the whistleblowers who filed those actions – the lowest total amount rewarded to whistleblowers since 2009,” said Taylor, Lauren and Anna.

While there are no signs of FCA enforcement slowing or any other type of recoveries surpassing the total netted from healthcare fraud matters, the authors expect the focus of enforcement efforts to begin shifting in light of Stark Law and Anti-Kickback Statute revisions proposed by Department of Health and Human Services Office of Inspector General (HHS-OIG) and the Centers for Medicare and Medicaid Services. The proposals, issued in late 2019, would add and modify existing key definitions, safe harbors and exceptions – especially those related to value-based care and value-based arrangements. The final rules are expected this year.

With so many changes expected for the healthcare landscape, healthcare fraud enforcement will continue to be a fast evolving and expanding area of the law. “It will be important to keep up not only with enforcement efforts, but also key regulatory developments that will directly impact the government’s recovery efforts. Other areas, however, should not be overlooked when examining operations; the DOJ’s actions over the past year make clear that the DOJ will be focused on any potential fraud of government contractors across industry sectors,” the attorneys concluded.

The full article, “Takeaways from the DOJ’s 2019 False Claims Act Report,” was published by Corporate Compliance Insights on February 24 and is available online.