The U.S. Department of Justice (DOJ) reported its False Claims Act (FCA) statistics for the fiscal year ending Sept. 30, 2021. The Justice Department obtained more than $5.6 billion in settlements and judgments from civil cases involving fraud and false claims against the government. Of the more than $5.6 billion, over $5 billion related to matters involving the health care industry, including drug and medical device manufacturers, managed care providers, hospitals, pharmacies, laboratories, and physicians.

Whistleblowers

Congress strengthened the FCA by increasing incentives for whistleblowers to file lawsuits alleging false claims on behalf of the government. A qui tam, or whistleblower action, under the FCA allows individuals known as “relators” to sue a company or individual who has defrauded the government. If the government feels the whistleblower’s claim has merit, it may opt to intervene and take over the case. Involving a forensic accountant in FCA matters is critical as they have the skill set to analyze vast amounts of data and identify patterns and irregularities and summarize and present vast amounts of data in a manner that is both understandable and supportable.

Benefits