False Claims and Qui Tam Enforcement

Fiscal Year 2023 marked the fifteenth straight year of recoveries exceeding $2 billion, hitting a record $2.68. Over $1.8 billion of these recoveries come from the healthcare industry alone. With an emphasis on data from enforcers and relators, and incentive programs encouraging whistleblowers, the FCA remains a steadfast tool that promises to only get stronger.

DOJ has continued to utilize data across the enforcement landscape, diving deeper into pandemic-related fraud and Medicare advantage matters, identifying outliers to indicate likely fraud. Additionally, whistleblowers and relators filed 712 qui tam cases in 2023, with settlements and judgements exceeding $2.3 billion. With the introduction of the DOJ’s new Corporate Whistleblower Awards Pilot Program, the intersection of the Anti-Kickback Statute and the FCA, and rigorous investigations into the minutiae of fraud, enforcement efforts have never been more powerful.

Considering judicial questions surrounding knowledge standards for liability, cybersecurity adequacy, and the constitutional validity of the qui tam provision, the future of the False Claims Act landscape remains uncertain.