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Illustration: Aïda Amer/Axios

Every year since 2010, the Department of Justice has recovered at least $2 billion from hospitals, doctors, pharmaceutical firms and other health care companies for allegedly defrauding the federal government.

The big picture: Federal fraud settlements from the health care industry totaled $2.5 billion in the 2018 fiscal year alone, according to newly released figures. A look at those settlements shows the wide variety of tactics health care companies have allegedly used to steer money to themselves.

The details: A slew of allegations in large cases cropped up this year.

  • Exaggerating how sick Medicare Advantage patients are, leading to a $270 million settlement against DaVita.
  • Pressuring doctors to admit patients from emergency rooms, leading to a $260 million deal against a hospital system that is now owned by Community Health Systems.
  • Using a charitable foundation as a way to fund patients' drug copays, leading to a $24 million settlement against Pfizer.
  • Numerous settlements against hospitals and other providers for things like false billing practices or paying kickbacks for physician referrals.

What's next: The 2019 fiscal year is off to a fast start, with a few prominent settlements involving allegations of hospitals purposely overpaying for physician practices, orthopedic providers willfully gaming the billing system, and a broadening investigation into Medicare Advantage coding.

  • The health care industry is asking for more wiggle room on the federal law that outlaws kickbacks.
  • But government watchdogs will more closely scrutinize overbilling.

The bottom line: Large settlement amounts indicate the government is willing to hunt down bad actors, but also that the industry knows the health care system is still ripe for abuse — or, as the industry argues, overly burdened with regulations.

  • That likewise makes it unclear if DOJ penalties deter fraudulent behavior, or if corporate health care just views settlements as the cost of doing business.

Go deeper

Updated 9 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Eniola Odetunde/Axios

  1. Health: Most vulnerable Americans aren't getting enough vaccine information — Fauci says Trump administration's lack of facts on COVID "very likely" cost lives.
  2. Politics: Biden unveils "wartime" COVID strategyBiden's COVID-19 bubble.
  3. Vaccine: Florida requiring proof of residency to get vaccine — CDC extends interval between vaccine doses for exceptional cases.
  4. World: Hong Kong to put tens of thousands on lockdown as cases surge.
  5. Sports: 2021 Tokyo Olympics hang in the balance.
  6. 🎧 Podcast: Carbon Health's CEO on unsticking the vaccine bottleneck.

Trump impeachment trial to start week of Feb. 8, Schumer says

Senate Majority Leader Chuck Schumer. Photo: The Washington Post via Getty

The Senate will begin former President Trump's impeachment trial the week of Feb. 8, Majority Leader Chuck Schumer announced Friday on the Senate floor.

The state of play: Schumer announced the schedule after reaching an agreement with Republicans. The House will transmit the article of impeachment against the former president late Monday.

10 hours ago - Health

CDC extends interval between COVID vaccine doses for exceptional cases

Photo: Joseph Prezioso/AFP via Getty

Patients can space out the two doses of the coronavirus vaccine by up to six weeks if it’s "not feasible" to follow the shorter recommended window, according to updated guidance from the Centers for Disease and Control and Prevention.

Driving the news: With the prospect of vaccine shortages and a low likelihood that supply will expand before April, the latest changes could provide a path to vaccinate more Americans — a top priority for President Biden.