Articles Tagged with pharmaceutical fraud lawyer

jonathan-perez-409943-copy-300x200A doctor was arrested on December 13, 2018 for improperly distributing opioids to his patients and billing Medicare for the drugs. The doctor now faces 45 federal charges relating to healthcare fraud for not only prescribing illicit drugs to patients but requiring those with insurance to accept injections so that he could bill additional costs to public health programs like Medicare. While this is an extreme example of pharmaceutical fraud, there are numerous smaller incidents of pharmaceutical fraud that take place every day. If you believe your employer or healthcare provider is engaging in pharmaceutical fraud or any type of healthcare fraud, contact the qui tam attorneys at Willoughby Brod immediately to report the fraud.

What is Pharmaceutical Fraud?

Pharmaceutical fraud involves illegal actions that pharmaceutical companies engage in that violate the False Claims Act (FCA) or California False Claims Act (CFCA) and result in false claims to insurers and Medicare/Medicaid.

We can tell you that the False Claims Act is a powerful tool for fighting the growing epidemic of health care fraud in the United States.  We prefer, however, to show you by citing some of the biggest verdicts and settlements in the field.  This week, we highlight a settlement involving allegations of Medicaid fraud in the pharmaceutical industry.  As a Medicare and Medicaid fraud whistleblowers’ law firm, we help honest witnesses bring lawsuits in cases like this one to fight back against pharmaceutical company fraud and other cases of fraud against government health care programs.

Drug Company to Pay $784.6 Million to Settle Claims It Failed to Report Accurate Pricing Data and Underpaid Medicaid Drug Rebates

On April 27, the Department of Justice (“DOJ”) issued a press release announcing that Wyeth and Pfizer (Pfizer acquired Wyeth after the alleged conduct ended; defendants referred to collectively as “Wyeth”) have agreed to pay $784.6 million to settle a False Claims Act suit alleging Wyeth committed Medicaid fraud by reporting false prices on pill$two of its medications.  The complaint alleged that Wyeth gave thousands of hospitals deep discounts on two protein pump inhibitor drugs but failed to report these lower prices to the government.  Allegedly, Wyeth used a bundled sales agreement to induce hospitals to purchase two of its drugs and place them on hospital formularies.  The government believes Wyeth sought to control the hospital market in part because patients often stay on the drugs for a long time after discharge and payers, including Medicaid, would then end up paying nearly full price for the medications.

pill$As consumers of health services, we rely on medical professionals to help us protect our own health and the health of others.  The vast majority of medical professionals are dedicated to providing the best care possible.  Sadly, however, there are some people who abuse the public’s trust, often risking the health and welfare of others for personal gain.  Today’s post will focus on pharmacies and pharmacy fraud, a category that includes pill restocking schemes.  These schemes may include Medicare fraud, Medicaid fraud, and/or fraud on private insurance providers.  People who become aware of such schemes, including patients, pharmacy employees, and other medical professionals, can help fight back.  As a pharmacy fraud law firm, we work with concerned citizens to stop these crimes and protect the health of innocent Americans.

Restitution Order in Alleged Pill Restocking Case

Last week, according to WZZM13, a federal judge handed down an order for restitution in a case that has already let to more than a dozen arrests.  WZZM reports that, according to this ruling, the drug restocking scheme cost Medicare over $64 million and cost Medicaid $18.2 million with an additional $4.7 million lost by Blue Cross Blue Shield of Michigan.  The ruling decrees that the CEO and six others must collectively pay $8.8 million, 10% of the total amount lost by public and private insurers due to the fraud.