Healthcare industry-related settlements and judgments from civil cases involving fraud and false claims uncovered by the Department of Justice in the fiscal year ending Sept. 30, 2021, topped $5 billion, the department reported Tuesday.
The amount includes long-term care providers as well as drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians, among others.
In total, the Justice Department reported $5.6 billion in settlements and judgments from civil cases involving fraud and false claims in the fiscal year. The amount represents the second largest annual total in False Claims Act history and the largest since 2014, according to the department, which noted that settlements and judgments since 1986 total more than $70 billion.
“The False Claims Act is one of the most important tools available to the department both to deter and to hold accountable those who seek to misuse public funds,” Acting Assistant Attorney General Boynton said.
One of the recent cases that the department noted involved SavaSeniorCare, which in May agreed to pay $11.2 million to resolve a False Claims Act allegation that its skilled nursing facilities billed the Medicare program for rehabilitation therapy services that “were not reasonable, necessary or skilled,” and to resolve allegations that Sava billed the Medicare and Medicaid programs for “grossly substandard skilled nursing services.”
“In addition, the department continues to focus on inadequate care and other fraud in nursing facilities, which provide care to a particularly vulnerable population (as reflected by the resolutions this year with SavaSeniorCare LLC, discussed above, and Select Medical Rehabilitation Services Inc.),” the department said.
For the time being, skilled nursing and other healthcare providers will remain in the crosshairs of the Justice Department as the agency looks at pandemic-related funding, such as the Paycheck Protection Program and Provider Relief Fund distributions.
