FIRST PERSON: Don’t Muzzle the Whistleblowers

RIPPING OFF THE U.S. government has reached epidemic proportions. The Department of Justice estimates that fraud costs the Medicare system alone between $30-$60 billion annually. But instead of fines and jail time, fraudsters are frequently rewarded with more government business. And if the U.S. Chamber of Commerce and its allies have their way, these fraudsters will gain enhanced legal protection. The U.S. Supreme Court recently heard oral arguments in a critical case testing the right of citizens to bring suit in the name of the United States in order to recover damages from corporations or individuals that have cheated the government. By taking up the case known as Schindler Elevator, the high court is looking into whether a private citizen can secure information from a Freedom of Information Act request and use that information to form the basis of a qui tam or False Claims Act whistleblower lawsuit…

Read the complete article here: https://www.law.com/corpcounsel/almID/1202489937878/

Advanced Care Scripts Inc., $1.4 million

United States of America ex rel. Paul Nee v. Biogen, Inc., et. al. District of Massachusetts.

GBB attorneys settled this qui tam suit against Advanced Care Scripts and Biogen, one of the worlds’ largest pharmaceutical companies. The complaint, filed by a whistleblower under the False Claims Act, alleged that Defendants used charitable organizations in a kickback scheme to pay the Medicare copays for multiple sclerosis drugs Avonex and Tysabri. Medicare subsequently paid the claims for these drugs, which can cost as much $80,000 per patient per year. 

Read more: https://www.prnewswire.com/news-releases/pharma-giant-and-speciality-pharmacy-settle-case-alleging-false-claims-violations-301195541.html?tc=eml_cleartime

Biogen Inc., $22 million

United States of America ex rel. Paul Nee v. Biogen, Inc., et. al. District of Massachusetts.

GBB attorneys settled this qui tam suit against Advanced Care Scripts and Biogen, one of the worlds’ largest pharmaceutical companies. The complaint, filed by a whistleblower under the False Claims Act, alleged that Defendants used charitable organizations in a kickback scheme to pay the Medicare copays for multiple sclerosis drugs Avonex and Tysabri. Medicare subsequently paid the claims for these drugs, which can cost as much $80,000 per patient per year. 

Read more: https://www.prnewswire.com/news-releases/pharma-giant-and-speciality-pharmacy-settle-case-alleging-false-claims-violations-301195541.html?tc=eml_cleartime

Biogen Inc. and Advanced Care Scripts Inc. to Pay $23.4 Million in False Claims Settlement

One of the world’s largest pharmaceutical companies, Biogen, Inc., and a large specialty pharmacy, Advanced Care Scripts, Inc. (ACS), will pay a combined $23.4 million to settle allegations under the Federal False Claims Act that kickbacks were used to induce the sale of drugs used to treat multiple sclerosis. Biogen will pay $22 million and ACS will pay $1.4 million.

The settlement was reached in United States of America ex rel. Paul Nee v. Biogen, Inc., et. al., 17-CV-10192-MLW, pending in the United States District Court for the District of Massachusetts. The complaint – filed by a whistleblower under the False Claims Act – alleged that Defendants profited from “engaging in a kickback scheme that uses it free drug program and so called financial assistance to charities as conduits to induce and steer” patients to the drugs Avonex and Tysabri, which are drugs reimbursed under the federal Medicare program….

Read the full press release here:

https://www.prnewswire.com/news-releases/pharma-giant-and-speciality-pharmacy-settle-case-alleging-false-claims-violations-301195541.html?tc=eml_cleartime

Home Healthcare Agency Settles Whistleblower Suit for $5.8m

Doctor’s Choice Home Care, Inc. and former executives have agreed to pay $5.8 million to settle allegations that the home health agency engaged in a variety of conduct in violation of the False Claims Act, including providing illegal remunerations or bonuses for referring physicians. Doctor’s Choice, which provides medical services to Medicare patients in their homes, was also accused of pressuring clinicians to increase the number of visits to Medicare patients to avoid triggering protocols that reduce Medicare payments for low-visit patients. This settlement specifically contends that Doctor’s Choice acted in violation of both the Stark Law and the Anti-kickback Statute of the False Claims Act.

The suit was brought by four whistleblowers, all former employees of Doctor’s Choice.

Read the full press release here: https://www.justice.gov/opa/pr/home-health-agency-and-former-owner-pay-58-million-settle-false-claims-act-allegations

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