The U.S. government recovered more than $4 billion in fiscal 2010 through fraud prevention and enforcement efforts, according to a new report from the U.S. Department of Health and Human Services and the U.S. Department of Justice. It was the highest annual amount ever recovered from healthcare fraud.

 

The biggest piece of the recoveries—$2.5 billion—came through civil litigation brought under the False Claims Act, a large portion of which involved pharmaceutical companies. This included cases against companies such as Allergan ($225 million), Novartis ($237 million), and AstraZeneca ($520 million) involving off label marketing of drugs.

 

“Our aggressive pursuit of health care fraud has resulted in the largest recovery of taxpayer dollars in the history of the Justice Department,” says U.S. Associate Attorney General Thomas J. Perrelli. “Through this initiative, we are working in partnership with government, law enforcement and industry leaders, and the public to protect taxpayer dollars, control healthcare costs, and ensure the strength and integrity of our most essential health care programs.”

 

The departments called the results “an unprecedented achievement” for the Health Care Fraud and Abuse Control Program, a joint effort of the two departments to coordinate federal, state, and local law enforcement activities to fight health care fraud and abuse. 

 

Under the landmark healthcare reform legislation passed in 2010, the program got a boost in resources to fight fraud, including an additional $350 million in funding. The legislation also provided enhanced screenings and enrollment requirements, increased data sharing across government, expanded overpayment recovery efforts, and greater oversight of private insurance abuses. 

 

Expect more recoveries from the pharmaceutical industry going forward. Last year’s efforts included a pilot program for the U.S. Food and Drug Administration that provided the agency with $1.7 million in funding to investigate fraud. The agency investigates criminal violations of the Federal Food, Drug and Cosmetic Act, the Prescription Drug Marketing Act, the Federal Anti-Tampering Act, and related Federal statutes.