Q&A: Whistle-blower lawyer on Amgen settlement, False Claims Act

This interview with Reuben Guttman was conducted by journalist Terry Baynes with Thomson Reuters.

California-based drugmaker Amgen Inc agreed on Tuesday to pay $24.9 million to settle allegations that it provided kickbacks to long-term care pharmacy providers to entice them to switch patients to its anemia drug Aranesp. Whistle-blower Frank Kurnik, a longtime Amgen employee, and the Justice Department accused the company of giving pharmacy providers rebates based on their volume of Aranesp prescriptions.

Reuben Guttman, a lawyer at Guttman, Buschner & Brooks PLLC, who brought the lawsuit on behalf of Kurnik, said the case reflects how prosecutions under the False Claims Act are focusing on conduct higher up the corporate ladder.

Amgen declined to provide a lawyer to discuss the settlement. The company in a statement about the settlement denied all of the allegations.

Reuters asked Guttman about the case and developments in False Claims Act litigation. The questions and answers have been edited for brevity and clarity.

Reuters: What does the case reveal about the type of conduct coming under scrutiny in False Claims Act cases?

Guttman: Typically, you’re talking about kickbacks paid to doctors in a lot of these cases. Instead of going from doctor to doctor and hospital to hospital, Amgen allegedly orchestrated a scheme that paid kickbacks to long-term care pharmacy providers who influenced prescriptions at nursing homes. The case showed how decisions about patient care are being made hundreds of miles away, at a corporate level. Healthcare fraud schemes orchestrated at a corporatewide level are schemes that are going to draw more prosecutorial focus.

Reuters: What were some of the biggest challenges in bringing the case?

Guttman: Typically, in cases like this, you’re talking about numbers of witnesses who can testify to specific kickbacks paid to doctors. This was more complicated, which is why it’s significant. We had to show that the contractual relationships with these long-term care pharmacy providers were actually orchestrated to engage in unlawful conduct. It involved the aggregation of documents and testimony. The challenge is to dig down and show how the schemes are implemented.

Reuters: Was there anything unusual about the case?

Guttman: In comparison to other pharmaceutical cases, this one had a short lifespan. False Claims Act cases can last for more than five years. This one was filed in 2010 and resolved in 2013. That’s light speed for the investigation and resolution of a pharmaceutical case of any magnitude.

Reuters: What explains the faster timeline in this case?

Guttman: The Justice Department is getting more aggressive about investigating these cases. In addition, recent amendments to the False Claims Act give the government more expansive use of “civil investigative demands” before intervening in a case to obtain documents, which they can share with the whistle-blower’s lawyers. That has created new paradigms of government and whistle-blower lawyers working together in reviewing documents. Efficiencies from changes in the law allow cases to move quicker.

Reuters: Is the Justice Department intervening in these cases more often?

Guttman: It really depends on the evidence that’s brought to the Justice Department and the way in which the case is presented. Last year, the Justice Department got about 700 false claims cases. It gets harder and harder for the Justice Department to investigate cases when there are so many cases being filed. If the case is well documented, if the whistle-blower has sufficient facts and is credible, and the whistle-blower’s counsel is present and can present a case, there’s a greater chance of intervention.

Reuters: How is the role of the whistle-blower lawyer changing?

Guttman:
Lawyers for whistle-blowers have to anticipate that when they file a case, they’ll have to see that case through to trial. The frauds are more complex. Even where the case is a great one, you can’t count on the government intervening due to the number of fraud cases being filed. There’s a role for the whistle-blower lawyer who’s willing to be active, work with experts and cooperate with the government in pursuing cases. The government is going to be looking for mechanisms to leverage their resources.

Reuters: Does the case change if or when the government intervenes?

Guttman: Defendants act differently if the government is involved or not. There’s a fear factor that the government is bearing down on you.

$24.9 Million Settlement with Biotechnology Company Amgen, Inc. Resolves South Carolina False Claims Act Lawsuit

PRESS NOTICE
BILL NETTLES
UNITED STATES ATTORNEY
DISTRICT OF SOUTH CAROLINA
1441 Main Street, Suite 500 * Columbia, SC 29201 * (803) 929-3000

April 16, 2013
FOR IMMEDIATE RELEASE
CONTACT PERSON: Fran Trapp
(803) 929-3000
Fran.Trapp@usdoj.gov

COLUMBIA, South Carolina —-United States Attorney Bill Nettles announced a $24.9 million settlement with Amgen, Inc., a California based biotechnology company. Amgen, Inc. agreed to the settlement to address allegations it paid kickbacks to long-term care pharmacy providers Omnicare Inc., PharMerica Corporation, and Kindred Healthcare Inc. in return for implementing “therapeutic interchange” programs that were designed to switch Medicare and Medicaid beneficiaries from a competitor drug to Aranesp. The Government alleged that the kickbacks took the form of performance-based rebates on Aranesp. As part of that program, the Government alleged that Amgen distributed materials designed to recommend Aranesp’s use in patients who did not have “anemia associated with chronic renal failure,” as specified in the approved labeling for Aranesp.

The Government alleged that the kickbacks took the form of performance-based rebates on Aranesp.

The District of South Carolina began investigating these False Claims Act allegations in the summer of 2010. In particular, the investigation focused on whether Aranesp was marketed to patients, many of whom were in skilled nursing facilities, who did not have “anemia associated with chronic renal failure.”

The False Claims Act allows the government to bring civil actions against entities that knowingly use or cause the use of false documents to obtain money from the government or to conceal an obligation to pay money to the government. The lawsuit in this case was initially filed by an Amgen employee under the qui tam or whistleblower provision of the False Claims Act. This provision entitles a private person to bring a lawsuit on behalf of the United States, where the private person has information that the named defendant has knowingly violated the False Claims Act. Under the False Claims Act, the private person, also known as a “whistleblower,” is entitled to a share of the government’s recovery. In this matter, the whistleblower shall receive over $3 million from the proceeds of the settlement.

“By this agreement we are making important strides in holding drug manufacturers accountable for fraudulent and abusive practices not only in South Carolina, but nationwide. I am proud of the tireless work of this office to investigate this case across the country,” said U.S. Attorney Nettles.

This settlement was the result of a coordinated effort by Assistant United States Attorneys Fran Trapp and James Leventis of the U.S. Attorney’s Office for the District of South Carolina, along with the Commercial Litigation Branch of the Justice Department’s Civil Division, FDA’s Office of Inspector General, HHS’s Office of Inspector General, and Defense Criminal Investigating Service, who diligently worked to investigate the allegations and litigate the case.

The whistleblower was represented by South Carolina attorney Richard Harpootlian along with Reuben Guttman and Traci Buschner, of Guttman, Buschner & Brooks PLLC.

FCA Whistleblowers Forced To Go It Alone As DOJ Drags Feet

By Dietrich Knauth

This article was published in Law360 on April 12, 2013.

With the rise in whistleblower cases under the False Claims Act, the U.S. Department of Justice is under pressure to unseal cases in which it hasn’t made a definitive decision whether or not to intervene, forcing whistleblowers to litigate more fraud cases on their own.

Congress and the courts have relaxed the standards for whistleblower eligibility under the FCA, and the lowered standards, along with the increased publicity of high-dollar settlements, has caused the ranks of potential relators to swell. The DOJ reported in December that a record 647 qui tam suits had been filed in 2012, after hovering in the 300s and low 400s for much of the previous decade.

But more whistleblower suits means more work for the DOJ. While whistleblower complaints remain under seal for at least 60 days before the government decides whether or not to intervene, the DOJ has told Congress that cases typically remain under seal for far longer — about 18 months on average, and sometimes cases remain secret for years. That has created pushback from Congress and the courts, who have pressured DOJ to decide more quickly and let the cases be litigated even if it hasn’t quite made up its mind, attorneys say.

“There’s going to be a sea change in terms of how these cases are litigated,” said Reuben Guttman, of Guttman, Buschner & Brooks PLLC. “The message is that more cases are going to be unsealed without a decision on intervention. We have to all assume that we’re going to litigate the case.”

Congress has noticed the backlog, and Sens. Patrick Leahy, D-Vt., and Chuck Grassley, R-Iowa, have introduced legislation, the Fighting Fraud to Protect Taxpayers Act, that would speed up the DOJ’s investigation of sealed FCA complaints by reinvesting some fraud recovery funds into increased investigations.

But the more immediate impact will come from federal courts, which are growing less receptive to the DOJ’s requests for more time to decide whether it will intervene. In response, the DOJ has begun allowing cases to be unsealed with a notice that it will not intervene “at this time,” attorneys say.

“Judges are becoming more demanding as to having the government explain why it needs more time to investigate and make a decision for intervention,” said Ginny Gibson, a Hogan Lovells partner and former federal prosecutor.

In the past, whistleblowers pinned more of their hopes on attracting the DOJ’s intervention, and if the DOJ stayed out, they often dropped cases rather than going ahead at their own expense. But that calculus may have changed, and more experienced whistleblower attorneys are likely to pursue a good case even if the DOJ doesn’t intervene, Gibson said.

“The whistleblowers are stepping up and taking more cases further down the litigation path,” she said. “This is in part because the whistleblower bar has become more sophisticated and better funded.”

In addition to more tenacious whistleblowers, companies will have to fend off suits from unexpected areas, according to Andy Liu, co-chair of the False Claims Act practice at Crowell & Moring LLP. He pointed out that external sources had filed whistleblower complaints against companies that held General Services Administration schedule contracts, premising the suits on alleged violations of the most-favored-pricing clauses in the GSA contracts and the Trade Agreements Act.

“Increasingly, you’re seeing whistleblowers who are not your traditional corporate insiders,” Liu said. “You’re seeing more competitors filing whistleblower suits.”

Adding to the pressure on companies, some courts have also allowed federal government employees to serve as whistleblowers, according to David Nadler, a partner in Dickstein Shapiro LLP’s government contracts group. In Little v. Shell Exploration & Production Co., the Fifth Circuit held that auditors for the U.S. Department of the Interior could sue Shell for undercalculating its royalty payments by $19 million through unauthorized deductions, a ruling that could encourage more government investigators to bring private suits.

For defense attorneys, it’s all part of a trend of widening liability and more aggressive litigation by the DOJ and private relators who are more willing than ever to pick up the slack when DOJ can’t take the lead.

“You don’t want to detract from the DOJ’s own prosecutorial agenda, and they want to save resources for those home-grown cases,” Guttman said.

Whistleblower attorneys are well aware that the DOJ has limited resources and is more than happy to let private relators do the heavy lifting in litigation while it focuses its attention on its own civil and criminal cases, Guttman said. After all, the U.S. government gets paid either way if a FCA suit settles or ends in a monetary judgment.

–Editing by Elizabeth Bowen and Chris Yates.

Whistleblower Bounties Will Prevent Future Fraud and Scandals

By Lianna Brinded

This article was published on April 15, 2013 in the UK’s International Busines Times.

Guttman says the UK has a lot to learn from the US on whistleblower incentives. The only way to prevent large scale scandals, such as Libor fixing and major financial fraud demonstrated by the collapse of Enron, is by installing bounty programmes that reward those who risk their careers to flag up wrongdoing, says one of the world’s most prominent whistleblower attorneys.

Speaking with the IBTimes UK, Reuben Guttman of Guttman, Buschner & Brooks PLLC says that the only way for any country to prevent financial fraud or wrongdoing from spiralling to large scale scandals is by replicating the US programmes and rewards systems for whistleblowers.

“When it comes to complex fraud, such as with UBS client tax evasion or Libor fixing, the only way prosecutors are able to have a solid lead and case, is when insiders come forward with the information,” says Guttman.

“The reality is, the regulators do not have or will not have the resources to investigate and find these forms of information by themselves and many complex fraud cases can be prevented from becoming huge scandals at the detriment to the consumer, shareholder or government, if the right incentives are in place for people who risk their career and employer retaliation,” he adds.

In the US, there are a number programmes, such as ones with the US Internal Revenue Service (IRS) and the Securities Exchange Commission (SEC) coupled with the protection through the Dodd-Frank Act, since 2010.

The programmes allow whistleblowers to not only be rewarded for information, depending on the significance of information and how much it results in recovery for the government or shareholders, but also protects them employer retaliation, such as dismissal or being investigated themselves.

UK To Learn From the US?

According to the SEC’s 2012 Annual Report on the Dodd-Frank Whistleblower Program, the agency received more than 3,000 tips from all 50 states and from 49 countries in a year.

The UK’s Financial Conduct Authority (FCA), previously the Financial Services Authority, has a “whistleblower programme”, but has no reward system for information and various clauses in the law allow companies to skate around the “unfair dismissal” of an employee, as a result of whistleblowing.

“You can bulk enforcement staff at the regulators but you can never beef it up enough to efficiently investigate and enforce compliance,” says Guttman. “For example, the SEC has maybe around one examiner for every $12bn in assets, and it could triple or even quadruple the amount of staff to look into this amount of assets but you would still be massively understaffed. The idea is that you want to basically get to the fraudulent activity before it has a devastating impact on the economy, such as with Tyco, WorldCom and Enron. When Enron collapsed there was a mass loss of jobs and impact on many companies that had dealings with them, but this situation could have been averted if people came forward with information,” he adds.

Guttman has had his fair share of complex litigation and class action cases that have involved the help of whistleblowers.

Serving as lead counsel on several cases, Guttman helped recover $1.6bn for the US government last year in Meredith McCoyd v. Abbott Labs and also represented one of the four main whistleblowers in a case against GlaxoSmithKline that returned over $3bn to the government.

In addition, he represented whistleblower Lynn Szymoniak whose qui tam case, a writ whereby a private individual who assists a prosecution can receive all or part of any penalty imposed, involving fraudulent mortgage assignments, was resolved as part of the government’s $25bn settlement with some of the world’s largest banks.

“Rewarding whistleblowers work and the UK could learn from the US system. This is the biggest difference between us. The reality is that we will be in dire straits if we didn’t have these people coming forward and one of the main issues why people do not blow the whistle elsewhere is because of the huge financial and reputational risk to themselves without the necessary protection or reward,” says Guttman.

“We depend on private institutions for everything, from energy, finance and healthcare but we expect the public institutions to protect us on very little resource. We have a host of corporations that have leaders that are more like temporary caretakers that operate on boosting margins and gains in the short term. But companies cut corners and it is at the detriment to the consumer, the shareholders and the government,” he adds.

Preventing Widescale Disaster

Guttman said the BP’s oil spill in the Gulf of Mexico could have been averted if people working at BP had told the relevant authorities about the levels of safety or “corner cutting” the energy firm was conducting, which eventually led to one of the biggest environmental disasters in history.

Similarly, he says the scope and scale of banks attempting to manipulate the world’s most important interbank lending rates could have also been quashed, if the right environment for whistleblowing was installed.

“Whistleblowing is critically important to avert disaster but to also allow transparency, enforcement and learning curves for the regulators to prevail,” says Guttman.

After Barclays, UBS and RBS became the first three banks to settle with a number of US and UK authorities over Libor fixing, the UK has held a raft of hearings to determine the culture and controls that led to the environment where traders were able to manipulate the lending rate for years.

At the beginning of this year, one of the most senior US financial services regulators Thomas Curry encouraged UK politicians to introduce rewards whistleblowers.

The Office of the Comptroller of the Currency said US regulators greatly benefited this incentive in place as it led to the regulator uncovering wrongdoing and misbehaviour at the banks and other financial institutions.

Looking for Market Integrity in China

Economic forces globally are driving conformity in a wide range of practices, says Reuben Guttman of Guttman, Buschner & Brooks PLLC.

In Hong Kong’s financial district, high end stores like Cartier, Rolex and Burberry outnumber fast food chains like McDonalds and KFC, while up north on Nanjing Xi Lu road in Shanghai, that city’s bustling version of Fifth Avenue, has become a haven for the world’s most high end retailers. With political and cultural difference tempered by economic goals, Hong Kong and mainland China are searching for mechanisms to create greater integrity in financial markets and generally maintain China as a place for investment.

New research

The CFA Institute, a global association of 115 thousand financial analysts, released the results of its Global Market Sentiment Survey of its members at a conference recently held in the city. Although seventeen percent of respondents said that China would provide the best investment opportunity in 2013 – second only to the United States with 32 percent, a majority do not expect the global economy to expand this year and believe that the currently level of integrity for global markets is poor. Over half of the members cited concerns about the ethical culture within financial firms as the source of this lack of integrity, but respondents in Europe and China differed greatly about the most serious ethical issue in the coming year. Respondents in Europe cited the mis-selling of products by financial advisors, but respondents in China cited market fraud and the integrity of financial reporting as substantially greater concerns.

Responding to concerns

Hong Kong appears to be aggressively seeking out ways to respond to these concerns and strengthen investor confidence by providing rights of redress. With the encouragement of the Hong Kong government, the Financial Dispute Resolution Centre has been launched. The FDRC provides rights of redress for small investors with losses up to 500 thousand Hong Kong dollars, or roughly the equivalent of 75 thousand US dollars and 50 thousand British pounds sterling. Hong Kong is also looking at implementing a class action law that will allow investors to aggregate their claims to pursue securities fraud cases.

Bringing conformity

Interest in these changes, at least in Hong Kong, is running high. An investor conference sponsored by the CFA and the International Investor Education Foundation drew nearly 200 participants at the city’s Four Seasons Hotel at the International Financial Center on Hong Kong Island. Speakers included Anthony Neoh, former Chief Advisor to the China Securities Regulatory Commission (CSRC), Paul Smith, Managing Director Asia Pacific, CFA Institute, and Sou Chiam, CEO, Financial Dispute Resolution Centre Ltd. Whatever the outcome of the discussions at this conference, one thing is clear: economic forces in this global economy are driving conformity of financial practices, ethics, and perhaps regulation.

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