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Apr 14, 2021 by |

California and San Francisco Whistleblower Attorney: Individuals Recover $1.6 Billion in 2020 In False Claims Cases Involving The Healthcare Industry


Department of Justice Announces Fiscal Year 2020 Recoveries

Close to 90% of Recoveries Come From Individual Whistleblower Cases

Whistleblowers Filed 672 Qui Tam Suits In 2020

The Department of Justice (DOJ) obtained more than $2.2 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. 30, 2020.  Of the more than $2.2 billion in settlements and judgments recovered, over $1.8 billion relates to matters that involved the health care industry, including drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians. $1.6 billion of that $1.8 billion came from settlements and recoveries in qui tam cases brought by individuals under the False Claims Act.  See False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq.  As the DOJ acknowledges in its 2020 Report, “one thing is abundantly clear: This year—and many years to come—undoubtedly will see a remarkably high number of whistleblower lawsuits and government-initiated actions filed under the FCA in an effort to clamp down on fraud and abuse.”  Qui tam cases start with initiated by filing a complaint on behalf of the government, under seal, and providing a copy of the complaint and a statement regarding their evidence to the government for evaluation.  31 U.S.C. § 3730(b).  If you have credible information for a false claims whistleblower case on behalf of the federal government here in San Francisco or elsewhere in the Bay Area or throughout California, call us today at (415)441-8669 and we can help.

2020 Statistics on False Claims Cases

The largest FCA recoveries in 2020 came from the drug industry.[1]  For example, on pharmaceutical manufacturer paid over $591 million to resolve claims that it paid kickbacks to doctors to induce them to prescribe its drugs.  According to the DOJ, sales representatives at the pharmaceutical company, on the instruction of their managers, selected high-volume prescribers to serve as paid “speakers” to induce the prescribers to write prescriptions on drugs produced by the drug maker.   During the year, the DOJ continued to investigate efforts by drug makers to protect high prices by funding the co-payments of Medicare patients.  Congress included co-pay requirements in the Medicare program, in part, to serve as a check on health care costs, including the prices that pharmaceutical manufacturers can demand for their drugs.  This year, two pharmaceutical manufacturerspaid a combined total of over $148 million to resolve claims that they illegally paid patient copays for their own drugs through purportedly independent foundations that the companies in fact treated as mere conduits for these payments. 

Rewards in Whistleblower Suits

Of the $2.2 billion in settlements and judgments reported by the government in fiscal year 2020, over $1.6 billion arose from lawsuits filed under the qui tam provisions of the False Claims Act.  During the same period, the government paid out $309 million to the individuals who exposed fraud and false claims by filing these actions. The number of lawsuits filed under the qui tam provisions of the Act has grown significantly since 1986, with 672 qui tam suits filed this past year – an average of nearly 13 new cases every week. “Whistleblowers with insider information are critical to identifying and pursuing new and evolving fraud schemes that might otherwise remain undetected,” said Acting Assistant Attorney General Clark.  “These individuals often make substantial sacrifices to bring these schemes to light, and our efforts to protect taxpayer funds continue to benefit from their actions.”

If an employee, former employee, or other individual with information of this kind fraud, files a qui tam case under the FCA he or she may be eligible for a reward if the government ultimately recovers from the wrongdoer.  31 U.S.C. §3730(d).  If the relator/plaintiff is a current employee, the employee/relator is protected from employer retaliation for bringing a qui tam case. 31 U.S.C. § 3730(h). If you are fired because you brought any fraud to light, you can fight back under the law.  You may be entitled to sue your employer and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2). The litigators at Evans Law Firm can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.  We know how to investigate and litigate retaliation cases with the aim of obtaining our clients all relief available under all governing laws.

Contact Us

If you have credible information of fraud against the government that could be the basis of a False Claims qui tam case, call Ingrid M. Evans and our other San Francisco whistleblower attorneys at (415) 441-8669, or by email at <a href=””></a>.  In addition to whistleblower cases under the FCA and CFCA, Ingrid and our other whistleblower attorneys also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program. 

[1] Evans Law Firm, Inc. is not involved in the cases described in this blog, but does represent a whistleblower in a large case against a drug manufacturer, that has been actively litigated in the Federal and now State Courts.

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