What Are the Success Rates of False Claims Act Cases?

November 27th, 2018 by Mike Bothwell

Find out why success rates of false claims act cases remain high.

Success Rates of False Claims Act CasesThe success rates of False Claims Act cases have been on the rise for the past decade. Unfortunately, as financial rewards grew, so did the number of nuisance cases. The government spends money whenever they investigate an FCA lawsuit, so eventually, the Department of Justice asked prosecutors to assess cases more diligently. Specifically, they chose to place emphasis on the right to file for dismissal of certain lawsuits to avoid unnecessary costs.

The goal of a memo released in January 2018 by Michael Granston, the director of the Commercial Civil Fraud Division of the DOJ, was to reduce government waste and conflicts associated with FCA litigation. Once public, the Granston Memo created the impression the government would not be as supportive of FCA cases as it had been in the recent past. The memo caused worry the lawsuits weren’t as likely to be successful. Thankfully, that isn’t how things have played out in practice.

Hundreds of Cases, a Handful of Dismissals

When a whistleblower files a lawsuit, government agencies assess the case to see if they should intervene. It’s beneficial when a government agency joins a case. It brings a tremendous number of resources to the table. Whistleblowers usually have the choice to continue the case on their own if the government refuses. There is one exception: 31 U.S. Code § 3730(c)(2)(A).

The law allows for the government to file for a dismissal of a case when it meets specific guidelines. Lawsuits have clarified when these requests are appropriate. Namely, they must pertain to:

  • Meritless or opportunistic qui tam cases
  • Lawsuits that would interfere with federal policies and procedures
  • Lawsuits that would interfere with existing cases initiated by the government

Over the year, as whistleblowers filed more than 700 qui tam lawsuits, the government sought to dismiss only a handful. Most recently, the government sought to dismiss 11 cases, all filed by the same plaintiff, which claimed preauthorization of prescriptions and patient education materials supplied by pharmaceutical companies amount to illegal kickbacks.

These are helpful resources which help patients enjoy a safer, higher quality of care, and federal regulations require them in some cases. It was right for the government to intervene. Not only did the decision save money, but it protected the rights and safety of patients and the efficiency of existing healthcare programs. It’s obvious the memo has not created a wave of dismissal requests as some feared.

However, finding a lawyer experienced in the type of FCA case you want to file is more important than ever. You’ll need to be able to follow the letter of the law, and each type of violation has its own specifics.

Success Rates for Qui Tam Cases Remain High

According to data tabulated by Taxpayers Against Fraud, approximately 80 percent of FCA cases are qui tam suits. The overwhelming majority result in monetary settlements, awards, or restrictions for companies.

In one of the first cases of the new year, the pharmacy giant, Walgreens, reached a historic agreement with the government in a prescription billing scheme reported by an employee. The whistleblower in that case will receive 21 percent of a record-breaking $60 million settlement.

Together, the lawsuits recovered over $3.7 billion in federal funds last year – the eighth year in a row where awards have capped $3 billion – and qui tam suits recovered more, on average, than those the government waged on its own. In 2017, cases where the government declined to intervene resulted in awards of $426 million.

Despite the Granston Memo, FCA cases remain one of the most effective means of fraud detection in government spending. That’s true in large part to qui tam provisions which reward individuals financially for filing suit. Since 1986, whistleblowers involved in qui tam suits have collected more than $6.5 billion.

That’s different from saying anyone who files a lawsuit is going to cash in. Before taking up a cause, it’s important to work with a lawyer who can accurately assess your chances of winning and research whether or not the government will have cause to try to dismiss your case.

What Do We Need for the Laws to Change?

President Lincoln passed the FCA with the help of Congress in the 1800s. Fraudsters took advantage of Civil War funding without delivering on their promises. As a result, soldiers starved and froze to death without adequate supplies. The war was long, and the lack of reliable supplies led to significant losses on both sides. Legislators couldn’t ignore it.

In the 1940s, Congress revisited the FCA, making changes to the law which severely limited the benefits and benefits it would provide. Corruption soared again until, in the 1980s, Congress dealt with massive misspending within the Department of Defense.

These days, it’s used mostly to protect people against healthcare fraud. Legislators know these cases aren’t just saving money. They’re saving lives. It’s doubtful they’ll limit the reach of the FCA anytime soon. However, there are higher expectations placed on lawyers who try these cases.

Finding the right person for the job is more important to your success than ever. You’ll find the team you need by contacting the skilled FCA case attorneys at Bothwell Law Group by clicking or calling 770.643.1606 today.

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