HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, July 16, 2005

Health Care Fraud - Lucrative for the Government

Mary Anne Mitchell points to an interesting article discussing the money involved in the lucrative False Claims Act cases.  The article concludes by asking where is the money going?  I don't have an asnwer to that . . .   

Boston Bounty Hunters By Charles G. Hardin  --  7/14/2005 12:05:45 AM

The Federal Government has built an incredible money machine in Boston! Aggressive U.S. Attorney Michael Sullivan and his equally aggressive assistants have created a uniquely lucrative legal practice in False Claims Act (FCA) cases. Their renowned Health Care Fraud Unit of the Massachusetts U.S. Attorney's office has (between May 1996 and May 2001), according to the Boston Globe, "recovered $1.54 billion for federal taxpayers, more than 30% of all health care fraud settlements by the nation's 94 U.S. attorney's offices."

That statement was printed before the Unit recovered another $1.561 billion from three more recent cases: TAP Pharmaceuticals in 2001 for $875 million; Bayer in 2003 for a combined $256.5 million, and Warner-Lambert (now Pfizer) in 2004 for $430 million. These three cases of alleged Medicare and Medicaid false claims alone make up nearly half of the $3.225 billion of Department of Justice (DOJ) health care recoveries in those three fiscal years.

This would be a good thing if these big settlements were making Medicare and Medicaid funds whole for their supposed losses and ultimately securing benefits for beneficiaries.

But are they? Let's follow the money.


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