I posted this last October in 2008 and little did I know how true it would really play out to be as time moved on, those 2 items right there are what seems to make the dollars and profits in healthcare today.  The DOJ certainly has been helped with the efforts of whistle blowers and there’s money here for a reward too.  The largest recoveries have come from both Pharma and Medical Device manufacturers.  Again with competition, the imagemarketing sides of the companies want the products moving and making money, so sometimes things get skewed beyond where they should be in the chase for the dollar.  With transparency we are now just seeing the tip of the iceberg I think as things that used to be swept under the rug as dust no longer exist as they become boulders as soon as they are exposed.  BD 

 The 2 new hot words in healthcare: algorithms and whistleblowers

The Dept. of Justice is making hay from crackdowns on healthcare fraud, according to new numbers indicating that about two-thirds of the $2.4 billion recovered from false claims prosecutions this year were healthcare-related.

The department said it collected $1.6 billion from busts of Medicare and Medicaid fraud rings, off-label marketing and illegal promotion of drugs and devices during fiscal 2009. That's about 66 percent of the total the feds recovered from fraud cases during the year. This year's haul is the second-highest-grossing year ever, according to a DOJ press release.

Officials said more than $2 billion of the funds recovered were the result of lawsuits filed under the False Claims Act's "qui tam" provisions. These cases, also known as "whistle-blower" cases, typically result in a 15 percent to 25 percent payout of awarded penalties to the tipsters. The DOJ said it paid out $255 million in rewards to whistle-blowers in 2009.

DOJ: healthcare fraud recoveries totaled $1.6 billion in FY09 | MassDevice - Medical Device Industry News

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