False Claims Act Attorney Group

Mylan to Pay $57M for Causing US and CA to Overpay for Drugs

casey — Fri, 13 Apr 2012 19:11:47 +0000

On February 28, 2012, Bloomberg News reported the settlement of a False Claims Act case in which Mylan Inc. (MYL), the generic-drug company, agreed to pay $57 million to settle claims it caused the U.S. and California to overpay for drugs.

The settlement came in cases filed by Ven-A-Care of the Florida Keys Inc., a specialty pharmacy, which claimed that Mylan defrauded the U.S. and California by falsely reporting inflated prices of drugs. Mylan knew that the governments would use those false reports to set higher reimbursement rates for Medicaid, Ven-A-Care claimed. California will get $26.3 million, the U.S. will get $22.2 million, and Ven-A-Care and its attorneys will get $8.5 million, court records show.

Ven-A-Care has settled more than two dozen lawsuits since 2000 that allowed state and federal governments to collect more than about $3 billion. Ven-A-Care collected more than $400 million in whistle-blower fees during that period.

Ven-A-Care sued under the U.S. False Claims Act and a similar statute in California, which lets whistle-blowers sue on behalf of the government and share in any recovery. While the California attorney general joined the lawsuit, the U.S. Justice Department didn’t.

The U.S. will still share in the recovery in the lawsuit, which is part of the so-called average wholesale price litigation consolidated before U.S. District Judge Patti Saris in Boston. She must approve the settlement.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

14 Hospitals to Pay Over $12M for Kyphoplasty Procedures

casey — Fri, 13 Apr 2012 18:45:00 +0000

Fourteen hospitals located in New York, Mississippi, North Carolina, Washington, Indiana, Missouri and Florida have agreed to pay the United States a total of more than $12 million to settle allegations that the health care facilities submitted false claims to Medicare, the Justice Department announced on February 7, 2012.

The settlements resolve allegations that these hospitals overcharged Medicare between 2000 and 2008 when performing kyphoplasty, a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In many cases, the procedure can be performed safely as a less-costly outpatient procedure, but the government contends that the hospitals performed the procedure on an inpatient basis in order to increase their Medicare billings.

All of the settling facilities were named as defendants in a qui tam, or whistleblower, lawsuit brought under the False Claims Act, which permits private citizens, known as “relators,” to bring lawsuits on behalf of the United States and receive a portion of the proceeds of any settlement or judgment awarded against a defendant.

The lawsuit was filed in 2008 in federal district court in Buffalo, N.Y., by Craig Patrick and Charles Bates. Mr. Patrick is a former reimbursement manager for Kyphon, and Mr. Bates was formerly a regional sales manager for Kyphon in Birmingham, Ala. The relators will receive a total of approximately $2.1 million from the settlements.

The Justice Department has now reached settlements with more than 40 hospitals totaling over $39 million to resolve false claims allegations related to kyphoplasty claims submitted to Medicare. These settlements follow the government’s 2008 settlement with Medtronic Spine LLC, corporate successor to Kyphon Inc., which paid $75 million to settle allegations that the company defrauded Medicare by counseling hospital providers to perform kyphoplasty procedures as an inpatient procedure even though the minimally-invasive procedure should have been done in many cases on an outpatient basis.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Citigroup to Pay $158M Over Bad Loans

casey — Fri, 13 Apr 2012 18:32:58 +0000

On February 16, 2012, Citigroup agreed to pay $158 million to settle a lawsuit over bad loans that the bank passed on to the Federal Housing Administration to insure. The whistle-blower who originally brought the case, Sherry Hunt, an employee of Citi’s mortgage department, said the company actively undermined the process that was supposed to check for fraud in order to push through reckless loans and get higher profits.

Of the $158 million in the settlement, Hunt will receive $30 million. Under the False Claims Act, whistle-blowers are rewarded for bringing in cases resulting in settlement in which it was alleged the government was defrauded.

According to the lawsuit, the bank passed along subpar loans to the Federal Housing Administration until very recently, making “substantial profits through the sale and/or securitization of FHA-backed insured mortgages” while “it wrongfully endorsed mortgages that were not eligible.”

In the settlement, Citi, which was bailed out by taxpayers in 2008 to the tune of $45 billion, “admits, acknowledges, and accepts responsibility” for passing on bad loans.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Johnson & Johnson Pays $158M to Settle False Claims Act Case

casey — Tue, 07 Feb 2012 02:59:44 +0000

On January 19th, 2012, the AP reported that the state of Texas and a subsidiary of health care giant Johnson & Johnson reached a $158 million settlement in a Medicaid fraud lawsuit. The settlement allows the drugmaker to pay a fraction of the potential $1 billion in penalties and fines that state officials had initially sought.

The lawsuit was one of dozens of state and federal cases alleging that the company committed fraud by making false or misleading statements about the safety, cost and effectiveness of the anti-psychotic medication Risperdal, and improperly influencing officials and doctors to push the drug. The lawsuit said the company engaged in illegal marketing practices and kickbacks in an effort to boost Risperdal, and also alleged the drugmaker falsely told doctors Risperdal was safe to use with children when federal regulators had not approved its use.

The lawsuit originally was filed in 2004 by whistleblower Allen Jones, a former employee of the Office of the Inspector General of Pennsylvania, who said he uncovered the drug company’s actions in Texas while investigating claims in his home state. Texas joined the lawsuit in 2006.

Lawyers for Texas and Jones had said Texas was a key market for the drug companies because schizophrenic patients often rely on Medicaid to pay for medications, and Texas has one of the largest populations of Medicaid patients.

As the whistleblower, Jones will receive a portion of the settlement, but he said Thursday he doesn’t know yet how much. Details of the settlement were not released.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Actavis to Pay $118.6M for Medicaid Fraud

casey — Fri, 13 Jan 2012 01:18:44 +0000

On January 4, 2012, Bloomberg News reported that units of Actavis Group Hf agreed to pay $118.6 million to resolve claims that they caused the U.S. and four state governments to overpay for drugs.

The settlement, filed Dec. 29 in federal court in Boston, followed an $84 million accord announced a day earlier in a lawsuit by the state of Texas, bringing the total to $202.6 million. In February, a state court jury in Austin ordered units of the Iceland-based company to pay $170 million for inflating billings to the Texas Medicaid program.

In the larger accord, Actavis settled with the U.S., New York, Florida, South Carolina and Iowa. The U.S., Florida and Texas cases were filed by Ven-A-Care of the Florida Keys Inc., a specialty pharmacy which prosecuted them civilly.

Ven-A-Care sued under the U.S. False Claims Act and similar statutes in Florida and Texas, which lets whistle-blowers sue on behalf of the government and share in any recovery. The states pursued their cases separately.

Ven-A-Care claimed that Actavis defrauded the U.S. and state governments by falsely reporting inflated prices of drugs. Actavis knew that the governments would use those false reports to set higher reimbursement rates for Medicaid, Ven-A-Care claimed. Actavis denied wrongdoing in the settlements.

The Justice Department didn’t join the case, although it recovered $108 million. Between the two cases, Ven-A-Care collected $15.6 million, court records show.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Merck to Pay $950 Million for Illegal Marketing of Vioxx

casey — Mon, 12 Dec 2011 02:14:17 +0000

U.S. Pharmaceutical Company Merck Sharp & Dohme to Pay Nearly One Billion Dollars Over Promotion of Vioxx®

On November 23rd, 2011, the Department of Justice announced that American pharmaceutical company Merck, Sharp & Dohme agreed to pay $950 million to resolve criminal charges and civil claims related to its promotion and marketing of the painkiller Vioxx^® (rofecoxib). Under the terms of the resolution, Merck plead guilty to a a violation of the Food Drug and Cosmetic Act (FDCA) for introducing a misbranded drug, Vioxx^®, into interstate commerce. Under the terms of its plea agreement with the United States, Merck will plead guilty to a misdemeanor for its illegal promotional activity and will pay a $321,636,000 criminal fine.

Merck is also entering into a civil settlement agreement under which it will pay $628,364,000 to resolve additional allegations regarding off-label marketing of Vioxx^® and false statements about the drug’s cardiovascular safety. Of the total civil settlement, $426,389,000 will be recovered by the United States, and the remaining share of $201,975,000 will be distributed to the participating Medicaid states. The settlement and plea conclude a long-running investigation of Merck’s promotion of Vioxx^®, which was withdrawn from the marketplace in September 2004.

Under the provisions of the FDCA, a company is required to specify the intended uses of a product in its new drug application to FDA. Once approved, the drug may not be marketed or promoted for so-called “off-label” uses – any use not specified in an application and approved by FDA – unless the company applies to the FDA for approval of the additional use. Merck’s criminal plea relates to misbranding of Vioxx^® by promoting the drug for treating rheumatoid arthritis, before that use was approved by the Food and Drug Administration (FDA). The FDA approved Vioxx^® for three indications in May 1999, but did not approve its use against rheumatoid arthritis until April 2002. In the interim, for nearly three years, Merck promoted Vioxx^® for rheumatoid arthritis, conduct for which it was admonished in an FDA warning letter issued in September 2001.

The parallel civil settlement covers a broader range of allegedly illegal conduct by Merck. The settlement resolves allegations that Merck representatives made inaccurate, unsupported, or misleading statements about Vioxx’s cardiovascular safety in order to increase sales of the drug, resulting in payments by the federal government. It also resolves allegations that Merck made false statements to state Medicaid agencies about the cardiovascular safety of Vioxx, and that those agencies relied on Merck’s false claims in making payment decisions about the drug. Finally, like the criminal plea, the civil settlement also recovers damages for allegedly false claims caused by Merck’s unlawful promotion of Vioxx for rheumatoid arthritis.

“We will continue to work with our law enforcement partners to aggressively investigate and prosecute pharmaceutical companies – no matter how large – when they improperly market their products,” said Daniel R. Levinson, Inspector General of the United States Department of Health and Human Services. “Merck’s comprehensive corporate integrity agreement requires top company officials to complete annual compliance certifications, and obligates Merck to post information about physician payments on its website.”

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Sandoz Agrees to Pay $150 Million to Resolve Drug-Price Case

casey — Sun, 11 Dec 2011 19:19:08 +0000

On November 23, 2011, Bloomberg News announced the settlement of a False Claims Act case in which Novartis AG’s Sandoz unit agreed to pay $150 million to resolve claims that it caused the U.S. and state governments in California and Florida to overpay for drugs.

The U.S. will recover $86.5 million, California will get $40 million and Florida will receive $15.2 million under the agreement filed Nov. 16 in federal court in Boston.

Ven-A-Care of the Florida Keys Inc., a specialty pharmacy, sued Sandoz under the U.S. False Claims Act, as well as similar laws in California and Florida. Ven- A-Care will get $8.3 million from Florida and California. Its share of the U.S. recovery wasn’t stated in court documents.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Pfizer to Pay $14.5 Million for Off-Label Promotion of Detrol

casey — Wed, 26 Oct 2011 20:11:29 +0000

On October 21, 2011, the US Department of Justice announced that the American pharmaceutical company Pfizer Inc. agreed to pay $14.5 million to resolve False Claims Act allegations related to its marketing of the drug Detrol.

The settlement addresses allegations that Pfizer illegally marketed Detrol, a drug for the treatment of overactive bladder, for use in male patients suffering from benign prostatic hypertrophy and several allied conditions, for which the Food and Drug Administration (FDA) had not approved the drug as safe and effective.

Under the terms of the settlement, the $14.5 million recovery will be divided between the United States and participating state Medicaid programs, with $11,878,846 going to the federal government and $2,621,154 going to state Medicaid programs. Under the qui tam provisions of the False Claims Act, whistleblowers will receive a $3,282,019 share of the federal recovery.

“Whistleblowers play an important role in protecting taxpayer funds from fraud and abuse,” said Tony West, Assistant Attorney General of the Justice Department’s Civil Division. “Settlements like this one help maintain the integrity of FDA’s drug approval process and support important federal and state health care programs.”

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.

Jim VanderLinden featured on Minnesota Public Radio

nick — Tue, 27 Sep 2011 23:03:04 +0000

The problem of Medicaid fraud has been in the news a lot lately in Minnesota. These small victories have only scratched the surface, as many cases of large-scale Medicaid fraud have – as of yet – continued without consequence. Minnesota Public Radio’s Mark Olson recently interviewed our own Jim Vanderlindenfor a report on the fight against Medicaid fraud.

St. Louis Park attorney James Vander Linden represents whistleblowers, company insiders filing claims for money recovered from employers suspected of stealing funds. He has spent years trying to recover Medicaid and Medicare dollars, and he doesn’t think the government has enough muscle to go after the big time health care fraud perpetrators.

“The real problem,” he says, “is corporate America.”

Read the rest or listen to the story below.

Fresenius to Pay $83.6M to Settle Medicare Fraud Case

casey — Sat, 27 Aug 2011 18:47:29 +0000

On May 26, 2011, the US Department of Justice announced the settlement of a whistleblower case that found three medicare companies guilty of fraudulent billing to the Medicare program. Renal Care Group (RCG), Renal Care Group Supply Company (RCGSC) and Fresenius Medical Care Holdings, Inc. (FMC) will pay $82,642,592 plus costs for improper billing for home dialysis supplies and equipment from 1999 to 2005.

The Court’s orders in this case discuss the concerns of multiple RCG employees who complained about the operation and Medicare billing activity of the RCGSC, including one regional manager who wrote, “I do not wish to go to jail,” and felt the company’s actions “were not in the best interests of patients,” after receiving a corporate directive about converting patients into the RCGSC.

The government’s complaint alleged that between January 1999 and December 2005, RCGSC submitted claims to the Medicare program for home dialysis supplies provided to ESRD patients for reimbursement of the supplies and equipment. All of these claims, as well as related claims for support services rendered by RCG dialysis clinics were false because the defendants were prohibited from and not qualified to bill Medicare for these home dialysis patients.

Under federal law, the Medicare program pays companies that provide dialysis supplies to ESRD patients only if the companies that provide the supplies are truly independent from dialysis facilities and the ESRD patient chooses to receive supplies from the independent supply company. Defendants set up a sham billing company, RCGSC, that was not independent from RCG. Further, RCG interfered with ESRD patients’ choice of supply options, requiring patients to “move” to RCGSC. Even after RCG employees raised concerns and industry competitors closed their supply companies, RCG kept RCGSC open because of the illicit revenue it created.

Renal Care Group argued that they did not violate Medicare rules because of industry standards and certain disclosures to Medicare that RCG claimed to have made. However, the Court rejected those arguments because of the clarity of the Medicare requirements and RCG’s reckless disregard for Medicare’s legal mandates. The Court stated that the “Defendants cannot effectively set aside those commands by their cited interactions with Medicare officials.” The Court further noted that RCG failed to heed the advice of the company’s lawyers when operating the supply company, and also discussed an internal audit of the supply company that found that 100% of the company’s files were missing information that Medicare required for billing.

If you are seeing fraud on the government, contact us by calling 800-377-1812 for strictly confidential advice from experienced counsel, with no fee obligation.