On January 15, the Department of Justice (DOJ) released its annual report on civil fraud recoveries for FY2024 along with a press release highlighting DOJ’s civil enforcement efforts. 

Our key observations from DOJ’s release are:

1. Total Recoveries Remain Comparatively Low. The reported $2.9 billion total civil fraud recovery is the fourth-lowest total recovery since 2010 and showed only a modest increase over FY2023’s (adjusted) recovery of $2.78 billion.
2. Healthcare Industry-Related Recoveries Continue Downward Trend. The annual total recoveries involving the healthcare industry were the lowest in more than a decade at $1.67 billion. This continues a significant trend in which four of the past five fiscal years (2020, 2022, 2023 and 2024) have seen recoveries under $1.9 billion. By comparison, from FY2010 to FY2019, total annual recoveries never fell below $2.1 billion.
3. Percentage of Total Recoveries Involving Healthcare Industry Continues to Decline. False Claims Act recoveries involving the healthcare industry amounted to approximately 57.3% of the total recoveries. The percentage of recoveries involving the healthcare industry typically has hovered over 80% in the past. While the dip in the percentage of recovery associated with the healthcare industry last year was attributable to a large False Claims Act settlement involving the U.S. Department of Defense (DOD), that was not the case this year, as DOD False Claims Act settlements accounted for only $93 million of the civil fraud settlement total. The declining percentage of recoveries involving the healthcare industry instead resulted from $1.15 billion in recoveries characterized by DOJ as “non-HHS [Department of Health and Human Services] and non-DOD.”  
4. Number of Newly Filed Qui Tam Lawsuits Smashes Prior Record. For more than a decade, newly filed qui tam lawsuits brought by False Claims Act relators hovered in the 600s – with a high of 757 new lawsuits filed in FY2013 and a low of 598 new lawsuits filed in FY2021. Newly filed qui tam lawsuits in FY2024 significantly eclipsed FY2013’s prior record high, with 979 new lawsuits filed by relators last year. A staggering 609 of those lawsuits concerned matters outside of the healthcare industry.  
5. Recoveries Stemming from Qui Tam Lawsuits Remain High. Given the substantial number of qui tam lawsuits filed each fiscal year, it comes as no surprise that recoveries stemming from such lawsuits continue to drive overall civil fraud recoveries. Over 82% of the civil fraud recoveries, or nearly $2.2 billion of the $2.9 billion in total recoveries resulted from settlements and judgments associated with qui tam lawsuits. With 2,351 new qui tam lawsuits filed during the last three fiscal years, such lawsuits undoubtedly will remain the driving force for years to come.  
6. Percentage of Qui Tam Lawsuits Involving Healthcare Industry Continue Downward Trend. Last year, we noted the declining number of qui tam lawsuits involving the healthcare industry. While that number ticked slightly upward in FY2024 to 370 lawsuits (compared with 349 lawsuits in FY2023), the percentage of qui tam lawsuits involving the healthcare industry declined sharply, dropping to only 38% and down from 49% in FY2023. Whether that percentage dip continues to result in a declining percentage of total civil fraud recoveries involving the HHS-Office of Inspector General remains to be seen.  
7. Drop in Relator Recoveries Involving Healthcare Matters Where DOJ Declined to Intervene. The total share of awards relators obtained from qui tam actions involving federal healthcare programs where DOJ declined to intervene ($189.5 million) was the lowest total since FY2020.
8. What to Make of the Number of Non-Qui Tam Matters. Last year, DOJ touted the filing of more than 500 new non-qui tam matters. That number reflected the highest False Claims Act matters initiated by DOJ since the 1986 False Claims Act amendments, and over 200 matters more than FY2022. Nearly all involved consent judgments and small dollar recoveries stemming from false claims associated with the pandemic-related Paycheck Protection Program (PPP), with over 300 of those matters filed in the U.S. District Court for the Northern District of Mississippi. In FY2024, DOJ announced 423 non-qui tam matters. Not surprisingly, a large majority of these cases again involved PPP-related matters filed in the same judicial district.
9. MA/AKS & Stark. Among the key healthcare-related settlements, significant areas of focus included Medicare Advantage (MA), the Anti-Kickback Statute (AKS) and Stark Law violations. We will cover each of these areas of focus, along with nearly every other False Claims Act settlement from 2024, in our Healthcare Fraud & Abuse Year in Review settlement chart. 
10. Controlled Substances Act/Cybersecurity/Pandemic Fraud. The government reiterated the intersection of the False Claims Act and enforcement priorities concerning opioids and drug diversion, cybersecurity, and pandemic relief-related fraud schemes. We will discuss each of these areas of focus in our Healthcare Fraud & Abuse Year in Review “Issues to Watch” section
11. FY2025 is off to a Strong Start. With nothing earth-shattering about the announced FY2024 recoveries, DOJ made particular note of significant recoveries that came in the door after the close of FY2024. Of course, the total sum of recoveries in any particular fiscal year is simply a result of where recoveries fall on the calendar each year. That said, it is fair to say that FY2025’s total recoveries are off to a strong start with more than $850 million dollars recovered in just two matters involving Teva Pharmaceuticals ($425 million) and Raytheon ($428 million). 

Be on the lookout for our 13th annual Healthcare Fraud & Abuse Review, which will be released later this year and will provide a comprehensive analysis of enforcement developments affecting the healthcare industry, significant court decisions involving the False Claims Act, and an overview of settlements involving fraud and abuse issues.