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Capitol Health Call
February 8, 2012

Health Care Fraud

JAMA. 2012;307(6):553. doi:10.1001/jama.2012.90

The Department of Justice announced December 19 that it had secured more than $3 billion in settlements and judgments in civil cases involving fraud against the government in the fiscal year ending September 30, 2011. This total included $2.4 billion in recoveries for fraud committed against federal health care programs.

Enforcement actions involving the pharmaceutical industry were the source of the largest recoveries in 2011, totaling almost $2.2 billion. One of the largest recoveries reported by the Justice Department was $900 million from 8 drug makers to resolve allegations that they had engaged in unlawful pricing to increase profits. Another was $750 million paid by GlaxoSmithKline to resolve criminal and civil allegations that the company knowingly submitted, or caused to be submitted, false claims to government health programs for adulterated drugs and for drugs that failed to conform with the strength, purity, or quality specified by the Food and Drug Administration.

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