ATTORNEY NEWSLETTER
Illegal Kickbacks Alleged
Pharmaceutical Company Agrees To Pay $60,000,000 To Settle Claims
How Whistleblower Cases Work
Healthcare providers and drug and medical device manufacturers in the U.S., including pharmaceutical companies, sellers of medical products and devices, physicians, medical labs, and hospitals and clinics, are subject to a number of statutes to prevent any fraudulent billing under government programs like Medicare and Medicaid. One important such law is the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, which prohibits kickbacks to physicians, hospitals, nursing homes and other health care providers for drug and product sales and patient referrals for services covered by Medicare and Medicaid (known as Medi-Cal in California). When the providers violate the Anti-Kickback Statute or certain other federal healthcare laws, they also violate the False Claims Act (“FCA”), 31 U.S.C. §§ 3729-3733, for submitting false claims for payment to the government. One of the underlying protections against fraud in the healthcare field is Individuals with information about this kind of scheme can be rewarded for bringing this kind of illegal practice to light. 31 U.S.C. § 3730(b). The California whistleblower attorneys at Evans Law Firm, Inc. represent individuals who bring FCA cases based for any kind of fraud against Medicare or Medicaid or other government-sponsored healthcare programs. If you have credible, original information of healthcare fraud, call us today at (415)441-8669 or toll-free at (888)-50EVANS (503-8267) and we can help.
Recent Settlement*
The U.S. Department of Justice (DOJ) recently announced that a large pharmaceutical company has agreed to pay $59,746,277 to resolve allegations that a subsidiary of the company knowingly caused the submission of false claims to Medicare and other federal health care programs by paying kickbacks to health care providers to induce prescriptions of one of the subsidiary’s medications. The settlement announced resolves allegations that from 2020 to 2022, the company paid improper remuneration, including in the form of speaker honoraria and meals at high end restaurants, to health care professionals to induce them to prescribe a medication the company produced in violation of the anti-kickback statute. A former sales representative for the company initiated a qui tam suit based on these violations. She will receive approximately $8.4 million as her share of the federal recovery in this case.
“Patients deserve to know that their doctor is prescribing medications based on their doctor’s medical judgment, and not as a result of financial incentives from pharmaceutical companies,” said U.S. Attorney Trini E. Ross for the Western District of New York. “This settlement reflects our commitment to hold those who violate the laws accountable, regardless of their status or prestige.”
“Violations of the anti-kickback statute, such as those alleged in this settlement, can unduly influence prescribers and negatively impact taxpayer-funded health care,” said Deputy Inspector General Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG will continue to collaborate with law enforcement partners to ensure that providers and corporations are held accountable if they attempt to bypass laws meant to protect the integrity of federal health care programs.”
Starting A Qui Tam Action
Any False Claims Act whistleblower case begins by a relator filing a complaint under seal in the federal court usually for the United States District Court for the district where defendant is located or does business. At the same time, the relator submits a disclosure to the DOJ outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims. 31 U.S.C. § 3730(b)(2). (If necessary, the government can, and often does, extend the 60-day period during which the allegations are kept under seal.) If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1). If the government declines to intervene, the relator may proceed with the litigation on his or her own. 31 U.S.C. § 3730(c)(3).
Contact Us
If you have credible information of government fraud in San Francisco or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. also handle bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program.
- Evans Law Firm, Inc. was not involved in the case in any way.
