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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

39 mins ago - Technology

Scoop: More boycotts coming for Facebook

Illustration: Sarah Grillo/Axios

Leaders of the Stop Hate For Profit social media boycott group are discussing whether to organize another campaign against Facebook in light of an explosive investigative series from The Wall Street Journal, Common Sense CEO Jim Steyer tells Axios.

The intrigue: Sources tell Axios that another group, separate from the Stop Hate For Profit organization, is expected to launch its own ad boycott campaign this week.

Democrats' dwindling 2022 map

Illustration: Sarah Grillo/Axios

Democrats are trying to unseat only about half as many Republican House members next year as they did in 2020, trimming their target list from 39 to 21.

Why it matters: The narrowing map — which reflects where Democrats see their best chance of flipping seats — is the latest datapoint showing the challenging political landscape the party faces in the crucial 2022 midterms.

Felix Salmon, author of Capital
1 hour ago - Economy & Business

Evergrande's reassuring default

Illustration: Annelise Capossela/Axios

It's not a Lehman moment but it's still a very big deal. Chinese construction giant Evergrande looks set to default on its $300 billion of liabilities, in a move that has already had global market repercussions.

Why it matters: Evergrande is the first big test of the global financial system — and especially the Chinese financial system — since the pandemic-induced chaos of March 2020, when central banks around the world were forced to take unprecedented measures to prevent total collapse. So far, world markets seem to be coping just fine.