DOJ’s 2024 FCA Report Reflects All-Time High in Qui Tam Filings

The U.S. Department of Justice, Civil Division (DOJ) just released its annual report on False Claims Act (FCA) settlements and judgments. In fiscal year 2024, DOJ obtained $2.9 billion in settlements and judgments under the FCA, an amount just above 2023’s results.

The $2.9 billion recovered was down from DOJ’s heady years between 2010 to 2017 when DOJ’s FCA settlements and judgments never went below $3 billion. DOJ’s 2024 press release and accompanying statistics reveal five interesting points that companies should know about.

• Whistleblowers Set a New Record for Filing Qui Tam Suits

Whistleblowers, or “relators” as they are commonly called, filed 979 qui tams in 2024. Last year’s qui tam filings increased 37% from 2023. Before last year, the best year for qui tams filings was in 2013, when relators filed 757 qui tam suits. 

As for FCA suits directly filed by DOJ (including U.S. Attorneys), 2024 was the second-best year ever for DOJ direct-filed cases with 423 cases filed. That number was down 19.8% from the 505 direct file suits DOJ in 2023. 

Surprisingly, the growth in qui tam filings was largely attributable to the “other” category of cases not involving the U.S. Department of Health and Human Services or the U.S. Department of Defense. In 2024, 58.7% (575) of all qui tams as well as 312 direct-filed matters were in the “other” FCA category.

The importance of whistleblower qui tams to FCA enforcement overall is reflected in the proportion of 2024 qui tam recoveries when compared with DOJ’s direct-file cases:  over $2.4 billion of the overall $2.9 billion (82.7%) in 2024 settlements and recoveries arose from qui tam filed suits.

• DOJ Had the Second Most FCA Settlements Ever, But It Had Fewer Blockbuster Recoveries Than in Years Past

Just below 2023’s all-time record of 566 settlements, DOJ had 558 settlements and recoveries in 2024.  Judging from its press release announcing its 2024 FCA results, DOJ had fewer blockbuster settlements than in years past and most FCA settlements were smaller relatively speaking. 

However, a handful of blockbuster settlements and judgments appear to comprise most of the $1.675 billion total in health care fraud settlements:  two “opioid crisis” related bankruptcy settlements, Endo Health Solutions at $475.6 million and Rite Aid at $401.8 million, a $345 million Stark Law related FCA settlement with Community Health Network, Inc., and a $108 million settlement with Walgreens over billing for prescriptions that were ordered but never picked up.

• Health Care Fraud FCA Settlements and Filings Continue to Predominate But Have Fallen Off From Prior Years.

In keeping with the pattern of many years, health care fraud cases comprised the largest portion of FCA judgments and settlements:  $1.675 billion or 57.3% of all FCA recoveries. That amount, however, is the lowest in total recoveries in health care since 2010 when it was $2.521 billion.  In 2023, by contrast, health care fraud settlements and recoveries represented 67% of the overall $2.68 billion in FCA judgments and settlements.  The health care fraud settlements reflected DOJ’s health care enforcement priorities: pursuing health care providers such as pharmaceutical companies and pharmacies that contributed to the opioid crisis; providers who billed federal health care programs for medically unnecessary services and substandard care; false claims arising in Medicare Advantage (Part C) programs; Anti-Kickback and Stark Law violations; and frauds relating to COVID-19 testing and treatment programs.

In 2024, new health care fraud related FCA case filings were down.  For example, only 370 qui tam health care related cases were filed last year, the second lowest since 2010.  As for direct-file health care fraud cases, DOJ filed 85 in 2024, which is down from the highest in 2020 (121), a 42.3% decrease.

• FCA Cases Relating to PPP Loans Appear to Be Partially Responsible for the Explosion in the Number of “Other” FCA Cases.

DOJ’s “other” category reflected $1.15 billion in FCA settlements and judgments, a 211% increase over 2023’s $370 million recovered and the best year since 2017.  Nearly a majority of 2024’s settlements and recoveries –250—related to pandemic-related fraud, which is one of DOJ’s “key enforcement priorities."  These included false claims relating to the COVID era’s Paycheck Protection Program administered by the Small Business Administration.  DOJ obtained “more than $250 million” in settlements and judgments related to pandemic-related fraud.

Another of DOJ’s key FCA enforcement priorities that falls within the “other” category concerns “using the False Claims Act to promote cybersecurity compliance by government contractors and grantees by holding them accountable when they knowingly violate applicable cybersecurity requirements.”  However, DOJ reported just two cyber-related FCA settlements along with one filed case.

• DOJ Continues to Promote Benefits of Self-Disclosures and Cooperation in Resolving FCA Cases.

DOJ announced that it “remained committed to incentivizing and rewarding entities and individuals that self-disclose misconduct, demonstrably cooperate in the course of an investigation, and take effective remedial measures.”  Though its press release did not identify them, DOJ stated that “[m]ultiple settlements over the last year acknowledged such cooperative measures and reflected . . . reduced penalties or damage multiples in connection with the resolution”.  We have previously discussed the benefits of self-disclosure to DOJ in our June 2024 alert which discussed three FCA settlements. 

With the advent of the Trump Administration, we will have to see if DOJ maintains or changes its FCA enforcement priorities and its civil prosecution of FCA matters.  That said, at her confirmation hearing this week, Pam Bondi, President Trump’s nominee for Attorney General, indicated her support for FCA whistleblowers and the importance of the FCA.

Please contact A. Brian Albritton, Raquel Ramirez Jefferson or any member of the Phelps Health Care or White Collar Defense and Investigations teams if you have questions or need advice or guidance.