U.S. Department of Justice

A California jury recently rejected antitrust claims brought by a class of California consumers seeking more than $400 million in damages from Sutter Health, a large Northern California hospital system. The case, Sidibe v. Sutter Health, Cas. No. 12-04854, N.D. Cal., originally filed in 2012, alleged that Sutter Health had abused its market position by imposing anticompetitive terms in its agreements with commercial insurers, thereby increasing the prices paid by insured consumers for healthcare in Northern California.
Continue Reading Long-Running Antitrust Case Challenging Sutter Health’s Restrictive Insurance Contracts Ends With a Defense Victory—But Does This Signal “All Clear” for Health Systems?

The U.S. Department of Justice (DOJ) announced recoveries of more than $5.6 billion in False Claims Act settlements and judgments in fiscal year 2021. This amount is a staggering increase from the $2.2 billion recovered during fiscal year 2020 and the second-highest total ever recorded since the FCA was enacted in 1986.

Although a rebound from pandemic-related constraints may explain part of the substantial jump in recoveries, the near record-setting number also reflects the success of various recently implemented DOJ strategies, including using large-scale data mining and AI to identify high-value cases, a targeted approach in deciding when to intervene, and a focus on combating the opioid epidemic.

The healthcare industry continues to be the biggest target, with more than $5 billion, or close to 90 percent, of the awards relating to matters that involved drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

Continue Reading DOJ False Claims Act Recoveries Hit $5.6 Billion for Fiscal Year 2021; Healthcare Industry Remains Biggest Target

The U.S. Department of Justice (“DOJ”) has resolved false claims against a sector not typically prone to FCA attacks—research institutions. In December 2019, the DOJ reached a $5.5 million settlement agreement with a Michigan non-profit research institute, the Van Andel Research Institute (“VARI”). The DOJ alleged that VARI failed to disclose foreign funding upon the application for, and over the term of, a federal grant.
Continue Reading The False Claims Act Goes Abroad: Michigan Research Institute Falls Under DOJ False Claims Act Scrutiny