Home Health & Hospice Week

It’s not your imagination if you’re feeling the heat of federal scrutiny. Last year the feds settled violations related to the healthcare industry at upwards of $5 billion — and a good chunk of that was due to whistleblowers.

The Department of Justice highlighted its many set­tlements in its fiscal year 2021 breakdown, reminding that healthcare fraud led the agency’s settlements and judgments. “The department’s vigorous pursuit of health care fraud prevents billions more in losses by deterring others who might try to cheat the system for their own gain,” the DOJ says in a release.

Healthcare cases ran the gamut, reaching $5.6 billion in settlements and judgments, the DOJ notes. Of that amount, “over $1.6 billion arose from lawsuits filed under the qui tam provisions of the False Claims Act,” the Justice Department highlights. “During the same period, the government paid out $237 million to the individuals who exposed fraud and false claims by filing these actions. The number of lawsuits filed under the qui tam provisions of the Act has grown significantly since 1986, with 598 qui tam suits filed this past year — an average of over 11 new cases every week,” the DOJ emphasizes.

“Industry insiders are uniquely positioned to expose fraud and false claims and often risk their careers to bring these schemes to light,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “Our efforts to protect taxpayer funds benefit from the courageous actions of these whistleblowers, and they are justly rewarded under the False Claims Act.”

In its recap of 2021 cases and statistics, the DOJ highlights the whistleblower lawsuit against home health chain BAYADA. In that case, the company paid $17 million to settle charges — $3 million of which went to an executive whistleblower (see HCW by AAPC, Vol. XXX, No. 33).

The Justice Department also lists “hospice organizations” among the provider types involved in settlements and judgments.