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DOJ Reports $4.7B in FCA Recoveries in FY16

Client Alert | less than 1 min read | 12.16.16

On December 14, 2016, DOJ reported that it recovered more than $4.7 billion in settlements and judgments from civil FCA cases in FY16, making it the third highest annual recovery in FCA history. Of the FY16 recoveries, $2.5 billion related to health care fraud, $1.7 billion related to the financial industry, and the remaining $500M related to higher education, procurement, and other federal programs.

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Client Alert | 8 min read | 03.05.26

Fifth Circuit Decision in Health Care Fraud Case Highlights Importance of Careful Drafting in Civil RICO Complaints

A recent decision by the United States Court of Appeals for the Fifth Circuit, Farmers Texas County Mutual Insurance Co. v. 1st Choice Accident & Injury, LLC, No. 24-20275 (5th Cir. Feb. 24, 2026), offers important lessons for health care payors and other potential plaintiffs considering civil claims under the federal Racketeer Influenced and Corrupt Organizations Act (RICO). Although the Fifth Circuit’s decision focused on a procedural issue, the underlying case turned on a fundamental pleading failure: the plaintiff insurers did not adequately describe the fraudulent network they were suing as a RICO “enterprise.” The result was dismissal of a $14 million fraud case....