The US Department of Justice only intervenes in approximately 25 percent of healthcare-related False Claims Act cases. But when the department does intervene, the case likely will have significant impact—and potentially large financial settlements.

Womble Carlyle Healthcare Litigation attorney Sandy Miller discussed False Claims Act lawsuits and the Justice Department’s role in these cases with Bloomberg BNA. Miller said that when the Justice Department decides to get involved in a whistle-blower case, it may do so to “control the process” in an unsettled area of False Claims Act law.

On the other hand, Miller told Bloomberg BNA that the DOJ may be more willing to not get involved in a False Claims Act case if the case “is not likely to make law.” She said these cases can result in “big recoveries for relators and their counsel.”

Miller also said she believes the biggest False Claims Act settlements in the future will come from pharmaceutical and medical device manufacturers, due to the sometimes aggressive marketing from companies in those fields. “Controlling sales people across the entire United States is very difficult,” she said.

In general, Miller said that defendants should consider settling False Claims Act cases, because the risk of trial is too great. She also said the DOJ’s settlement terms often “have gotten good enough” in comparison to make settlement the prudent choice.

Miller speaks from experience—in 2013, she and the DOJ won the largest fraud verdict against a community hospital in US history in Drakeford v. Tuomey Healthcare. A jury awarded $237 million in the False Claims Act case, and a federal appeals court upheld that verdict in 2015.  The case was ultimately resolved for $72.8 million in late 2015, ending 11 years of litigation.

Sandy Miller has experience representing health care providers in a variety of health law related issues, focusing her practice on federal and state fraud and abuse litigation and qui tam defense.  She has represented clients in federal court litigation and federal administrative proceedings in Florida, North Carolina, South Carolina, Maryland, and Ohio.