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Posts Tagged ‘FCA’

GSK Pleads Guilty and Pays $3 Billion to Resolve Allegations Brought under False Claims Act by Whistleblowers Represented by K&M

Monday, July 2nd, 2012

Philadelphia, July 2, 2012 – GlaxoSmithKline has agreed to pay $3 Billion in criminal and civil fines, penalties and damages to settle allegations that the company defrauded Medicare, Medicaid and other government funded health care programs in connection with its market practices for Advair, Wellbutrin, Paxil, Lamictal, Zofran, Imitrex, Lotronex, Flovent and Valtrex and Avandia. The settlement is the largest qui tam settlement in U.S. history. The settlement is the largest qui tam settlement in U.S. history.

Gregory Thorpe and Blair Hamrick, the first whistleblowers to file a qui tam action against GSK arising from this marketing misconduct nearly a decade ago, are represented by Kenney & McCafferty. As part of the record setting settlement, GSK agreed to pay $1.17 billion to settle claims brought by Thorpe and Hamrick.  To read more about the settlement, click here.

To read the complaint filed on behalf of Thorpe and Hamrick, click here.  Exhibits accompanying the complaint may be found here.  Additionally, Thorpe’s internal report to compliance executives at GSK may be found within the Exhibits at 0000015-0000027.

To read the Complaint-in-Intervention filed by the United States, click here.

To read the Settlement Agreement, click here.

 

If you have knowledge of healthcare fraud and would like to discuss the possibility of a whistleblower award under the False Claims Act, please contact our whistleblower attorneys today.  Kenney & McCafferty will consult with you about your case, without obligation. All communications with Kenney & McCafferty attorneys regarding your case are confidential and protected by attorney-client privilege.

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Federal Government Recovers $4.1 Billion in Healthcare Fraud Judgments Last Year

Monday, February 27th, 2012

Federal authorities say they recovered $4.1 billion in healthcare fraud judgments last year.  The amount represents the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled.  “These efforts reflect a strong, ongoing commitment to fiscal accountability and to helping the American people at a time when budgets are tight,” U.S. Attorney General Eric Holder said in a statement.

Of the $4.1 billion recovered, approximately $2.4 billion was recovered through civil health care fraud cases brought under the False Claims Act (FCA).  The False Claims Act remains one of the government’s most powerful weapons in its fight against healthcare fraud.  Since January 2009, the DOJ has used the False Claims Act to recover more than $6.6 billion in federal healthcare dollars.  Cases brought under the FCA that contributed to the $2.4 billion recover included unlawful pricing schemes by pharmaceutical manufacturers, illegal marketing of medical devices and pharmaceutical products for uses not approved by the FDA, Medicare fraud by hospitals and other institutional providers, and violations of laws against self-referrals and kickbacks.

These results signify the continued efforts by the government to identify and punish fraud perpetrators who are abusing this country’s healthcare system, and costing American taxpayers billions of dollars.  “Fighting fraud is one of our top priorities and we have recovered an unprecedented number of taxpayer dollars,” Department of Health and Human Services Secretary Kathleen Sebelius said in a statement.  “Our efforts strengthen the integrity of our health care programs, and meet the president’s call for a return to American values that ensure everyone gets a fair shot, everyone does their fair share, and everyone plays by the same rules.”

The $4.1 billion stolen or otherwise improperly obtained from federal health care programs was recovered and returned to the Medicare Trust Funds, the Treasury and others in FY 2011.

For more information, view the Department of Justice’s full press release at http://www.fbi.gov/news/pressrel/press-releases/health-care-fraud-prevention-and-enforcement-efforts-result-in-record-breaking-recoveries-totaling-nearly-4.1-billion.

If you have knowledge of Medicare or Medicaid fraud and would like to discuss the possibility of a whistleblower award under the False Claims Act, please contact our whistleblower attorneys today. Kenney & McCafferty will consult with you about your case, without obligation. All communications with Kenney & McCafferty attorneys regarding your case are confidential and protected by attorney-client privilege.

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US Supreme Court Rules FOIA Responses Trigger Bar Against FCA Claims

Thursday, May 19th, 2011

Justice Clarence Thomas Wrote the Schindler Decision

Justice Clarence Thomas wrote the majority opinion holding that Freedom of Information Act request responses constitute “reports,” relators who rely on FOIA request responses can fall prey to the public disclosure bar of the False Claims Act.  The Court issued the opinion in Schindler Elevator Corp v. United States ex rel. Kirk on May 16, 2011. Justice Ginsburg filed the dissenting opinion, in which Justices Breyer and Sotomayor joined.

Relator Daniel Kirk, a military veteran, worked for Schindler Elevator from 1978 to 2003.  He resigned in September 2003 saying that the company had forced him out.  Kirk filed his False Claims action in 2005.  In an amended complaint in 2007, Kirk alleged that Schindler has improperly submitted for payment hundreds of false claims to the government because Schindler had certified it was in compliance with VEVRAA reporting requirements.  Kirk alleged the certification of compliance was false.

Relator Kirk sought verification that his allegations were correct by asking his wife to ask for Schindler’s reporting information through a FOIA request.  Mrs. Kirk made three requests, and DOL responded with information that showed the reports were not filed for several years in question.

Schindler asked the Court to dismiss the case on the ground that the verification information Mrs. Kirk obtained through the FOIA requests was a “public disclosure.” Under the pre-existing public disclosure rules, whistleblower claims could be dismissed if the relator was found to have “based” the allegations on specified types of publically available information.  In Schindler, J. Thomas said that a FOIA response = a report = a public disclosure.  He left open the question of whether or not Mr. Kirk based his allegations on those FOIA responses.

False Claims actions can be complicated, and the statute requires a whistleblower to be represented by an attorney.  For a free consultation on a potential government fraud claim, please call Kenney & McCafferty, P.C. today.

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Posted in corporate fraud, False Claims Act, government fraud, Uncategorized, Whistleblower Protection | Comments Off

Corporate Attorneys and Investigators Represent the Company – Not Whistleblowers

Wednesday, May 4th, 2011

Corporate investigators and attorneys will protect the company. It's their job.

A long time corporate investigator recently shared his concern that whistleblowers look to corporate investigators and attorneys for help and protection when they blow the whistle.  Nothing could be further from the truth.  “There’s nothing I can do,” said the investigator.  “I’ve seen it over and over again.  They are going to get their heads cut off.”

The investigator said he knew that whistleblowers, no matter the merit of their report, would be skillfully and systematically terminated with a substantial paper trail to support management’s actions.

“They look to me for help,” he said.  “I work for the company.  I tell them that, but they don’t seem to understand.”

Neither did CEO Ian Norris of Morgan Crucible Company.  Morgan Crucible came under government investigation for an international price fixing conspiracy.  CEO Norris began a campaign to obstruct a grand jury investigation, and he shared details of his campaign with Morgan Crucible’s attorney.  When the government learned of Norris’s obstruction, it charged Norris with corruptly persuading, and attempting and conspiring to corruptly persuade, others with intent to influence their testimony in grand jury proceedings.  Morgan Crucible waived its attorney client privilege and granted permission for corporate counsel to testify.  Norris fought the testimony, saying the corporate attorney also represented Norris in his individual capacity and was prohibited from testifying. 

The Third Circuit disagreed, but found that communications about scope of representation were ambiguous.  Ultimately, the court ruled that Morgan Crucible, alone, held the right to waive attorney client privilege, and the attorney testified.

The attorney testified that Norris, in front of counsel, disseminated a false cover story and scripts about the price fixing and encouraged everyone, including counsel, to relay the false information to investigators.  The attorney said he did not know the information was false.

Attorneys and investigators should provide employees with explicit explanations about their role in investigating allegations of fraud within a corporation.  They often do not, for a variety of reasons.  Bottom line – employees need to take steps to protect themselves when they report corporate misconduct internally. 

For a free consult about whether you have a potential government fraud claim, call K&M today.

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Posted in Corporate Tax Fraud, Employment Tax Fraud, False Claims Act, Money Laundering Tax Fraud, Offshore Accouts Fraud, retaliation, SEC Whistleblower Program, Tax Fraud, Uncategorized, Whistleblower Protection | Comments Off

ACLU Loses Attack on Seal Provisions of FCA

Monday, March 28th, 2011

ACLU Loses Attack on FCA Seal

The ACLU lost its most recent attempt to strike down the seal provisions of the False Claims Act. The ACLU had lost its case in the Eastern District of Virginia and then appealed to the Fourth Circuit. The Appellate Court affirmed the district court’s decision to dismiss the ACLU’s case.

The American Civil Liberties Union filed the lawsuit in 2009, making a facial constitutional challenge to the long standing seal provisions of the FCA. The False Claims Act allows the qui tam plaintiff/relator to file the civil complaint under seal, which means the complaint is not served on the defendant until the seal is lifted by judicial order. The seal allows the government time to investigate the complaint without alerting defendants to the specific allegations. Depending on where the case is filed, the government frequently asks the judge for extensions of a sealed complaint to allow it more time to conduct its investigation. At some point, the complaint becomes unsealed.

The seal makes filing False Claims actions more attractive to whistleblowers because the whistleblowers enjoy anonymity while the government is conducting its investigation of the defendants. If the complaint is under seal, the defendant does not know that a whistleblower is involved and many times, does not know that it is being investigated. Whistleblowers who are current employees of a defendant that is committing government fraud are able to assist the government in its recovery of fraudulently obtained government funds without worrying unduly about retaliation for reporting the illegal conduct.

Oddly, the ACLU sought to strike down the seal provisions on the grounds that they acted against the whistleblower’s right to free speech, that the seal violated the public’s right of access to judicial proceedings, and that the seal impermissibly violated the doctrine of separation of powers. The ACLU was not able to point to a single whistleblower that agreed with the ACLU’s position, however, and admitted that it did not have much familiarity with the workings of a qui tam action.

The Fourth Circuit pointed out that seals are often ultimately lifted in qui tam cases and that the United States has a compelling interest in protecting the integrity of ongoing fraud investigations. Kenney & McCafferty applauds the Courts’ rulings in this matter and looks forward to continuing working with qui tam relators in sealed government fraud investigations.

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Posted in Corporate Tax Fraud, False Claims Act, Recent News, retaliation, Uncategorized, Whistleblower Protection | Comments Off

Galileo – History's Greatest Whistleblower?

Tuesday, February 15th, 2011

Galileo faces the Inquisition

February 15, Galileo’s birthday, is a fitting time to reflect upon Galileo’s experience with blowing the whistle on the Ptolemaic theory, the long held belief that the Earth was the center of the universe and that the sun and the planets orbited the Earth. Galileo today is called “the father of modern observational astronomy” and “the father of modern physics.” Stephen Hawking stated, “Galileo, perhaps more than any other single person, was responsible for the birth of modern science.” Most people don’t realize that Galileo was tried by the Inquisition for his advocacy of Copernicanism, found guilty of heresy, and spent the rest of his life under house arrest.

As brilliant he was, Galileo did not understand the environment in which he was operating, and he failed to adhere to rules and constraints placed on those attempting to advance scientific theories in the 1600s. His support of heliocentrism offended the Catholic church. The church admonished Galileo, who thought he would be clever and work around the constraints that had been placed on him. After being chastised, Galileo waited years to publish Dialogue Concerning Two Chief World Systems, but he didn’t follow the rules. To publish, he needed papal permission and formal authorization from the Inquisition. He didn’t get them. Had he followed the rules, Galileo probably could have avoided trial and arrest. Instead, Galileo was:

*   Found “vehemently suspect” of heresy.
*   Sentenced to formal imprisonment, which was later commuted to house arrest.
*   Had his publication, Dialogue, banned.
*   Forbidden to ever publish again.

After his death, the world eventually lauded his contributions, but Galileo died without acclaim and in isolation.

Whistleblowers should learn from Galileo’s mistakes. No matter how brilliant a whistleblower may be, it is impossible for everyone to know everything. There is no substitute for experienced legal advice when one decides to blow the whistle. Galileo originally had many supporters who could have guided him the intricacies of the papacy’s rules for publication. He didn’t ask, and he thought he had the situation well in hand. He was wrong.

If Galileo could not figure out how to maneuver through the intricacies of successfully blowing the whistle, who can? Fortunately, whistleblowers today have Kenney & McCafferty to call for expert advice. Whistleblowers should educate themselves on the pros and cons before blowing the whistle. If you want to report fraud against the government, save yourself some headaches. Get a free consultation by calling Kenney & McCafferty today.

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Posted in Abusive Tax Shelters, Corporate Tax Fraud, Employment Tax Fraud, False Claims Act, IRS Whistleblower Office, Money Laundering Tax Fraud, Offshore Accouts Fraud, retaliation, SEC Whistleblower Program, Tax Fraud, Uncategorized | Comments Off

FERA’s Expansion of the Government’s CID Authority

Friday, February 11th, 2011

In May 2009, President Obama signed the Fraud Enforcement and Recovery Act (“FERA”), which strengthened and expanded the scope of conduct subject to the False Claims Act as well as fortified the government’s ability to investigate a prosecute whistleblower claims.

Among FERA’s many refinements to the False Claims Act is the expansion of the government’s Civil Investigative Demand (“CID”) authority.  The CID authority was added to the False Claims Act in 1986.  In principal, the inclusion of a CID authority in 1986 created a significant weapon in the government’s arsenal to fight fraud and investigate whistleblower cases, as it empowered the government to request documents, submit interrogatories and depose witnesses.  However, as a practical matter, prior to FERA the government seldom availed itself of the CID authority because the statute required the CID to be issued and signed by the Attorney general.

The False Claims Act as amended by FERA permits CIDs to be issued by the Attorney General or his or her designee.  Another significant change to the CID authority for whistleblowers and their counsel is that FERA has facilitated the sharing of information gathered by the government pursuant to a CID.  Now, information gathered pursuant to a CID can be shared with a relator and relator’s counsel if “it is necessary as part of any false claims act investigation.”

Since FERA, Kenney & McCafferty has seen a notable uptick in the government’s use of the CID authority.  The new and expanded CID authority has undoubtedly enhanced both the ability of the government to prosecute fraud successfully as well as accentuated the opportunity for relators and their counsel to play an instrumental role in the investigatory process.

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