Author Archives: Staff

The DOJ accounted that federally funded Advanced Pain Management Holdings Inc. and its subsidiaries, collectively called APM Entities, have agreed to pay the government $885k to settle a qui tam False Claims Act suit. The complaint alleges that the companies illegally gifted stock shares to non-employee physicians, in violation of the Anti-kickback Act, as compensation based on the number of patient referrals and pain management procedures provides. In addition to offering illegal kickbacks, APM was accused of providing medically unnecessary urine tests, resulting in more testing than was supported by medical records. The whistleblower will receive $142k as her share of the recovery.

Learn more here: https://www.justice.gov/opa/pr/wisconsin-pain-management-companies-settle-false-claims-act-allegations

The Justice Department has announced that California based pharmaceutical company Gilead Sciences, Inc. has agreed to pay $97 million to settle allegations of fraud. Whistleblowers accused the company of using a foundation to illegally pay the prescription copays for a hypertension drug, Letairis, for millions of Medicare patients. Drug companies are prohibited, under the Anti-kickback Statute, from directly or indirectly incentivizing patients to purchase their drug; by covering the copay for Letairis patients, Gilead was able to increase the drug’s price to what would have otherwise resulted in prohibitively expensive copays. The Justice Department stated that price manipulation and unscrupulous subsidization of a company’s own drugs are exactly the types of behavior the Medicare copay structure was designed to prohibit, and that this settlement demonstrates the government’s emphasis on combatting healthcare fraud.

Learn more here: https://www.justice.gov/opa/pr/gilead-agrees-pay-97-million-resolve-alleged-false-claims-act-liability-paying-kickbacks

The DOJ announced that the U.S. has filed a False Claims Act lawsuit against Teva Pharmaceuticals USA Inc. and Teva Neuroscience Inc., accusing the companies of illegally paying the Medicare co-pays for patients taking Copaxone, a drug for multiple sclerosis. The complaint alleges that Teva violated the Anti-Kickback Statute, which prohibits drug companies from “offering or paying, directly or indirectly, any remuneration… to induce Medicare patients to purchase the companies’ drugs.” Teva skirted this regulation by paying seemingly independent charitable organizations with the understanding that the funds would cover Medicare co-pays for patients taking Copaxone. At the same time, the company increased the annual price of the drug from $17,000 to over $70,000. The DOJ states that the government’s pursuit of this lawsuit illustrates the U.S. commitment to preventing pharmaceutical companies from defrauding government programs at the expense of American taxpayers and customers.

Read more here: https://www.justice.gov/opa/pr/united-states-files-false-claims-act-complaint-against-drug-maker-teva-pharmaceuticals

DUSA Pharmaceuticals, Inc. has agreed to pay the U.S. $20.75 million to settle a lawsuit filed under the whistleblower provision of the False Claims Act. DUSA, a subsidiary of Sun Pharmaceutical Industries, Inc., was accused of knowingly promoting a topical drug administration schedule program that resulted in fraudulent billings to Medicare and the Federal Employee Health Benefit Program. DUSA encouraged the drug administration program, which was neither approved within the FDA product instructions nor verified by sufficient clinical data, by offering prescribers paid speaker positions and programs, providing false or misleading information, and promotion by the company sales team. The U.S. alleged that senior officials of DUSA and Sun Pharma were aware that the new administration schedule resulted in significantly lower clearance rates for the indicated health condition, and that pushing the schedule “undermine[d] the health of patients and the financial integrity of federal health care programs.” The whistleblower and relator, a former sales representative of DUSA, will receive $3.5 million as part of the case’s resolution.

Learn more here: https://www.justice.gov/opa/pr/dusa-pharmaceuticals-pay-us-2075-million-settle-false-claims-act-allegations-relating