Posts Tagged ‘Qui Tam’
Tuesday, March 5th, 2013
Kenney & McCafferty is proud to announce that it represents a key Par Pharmaceutical insider whose knowledge, information, and evidence were central to Par’s decision today to pay $45 million to settle civil and criminal allegations. The settlement resolves allegations that Par willfully defrauded Medicare, Medicaid, and other government funded health care programs in connection with the launch of a long-term care sales force to promote Megace ES for off-label uses, including weight loss in elderly patients.
Kenney & McCafferty represented whistleblower Christine Thompson, who filed a qui tam action against Par arising from this misconduct. As a result of her efforts in coming forward with this information as well as her assistance throughout the government’s investigation, Ms. Thompson is entitled to receive a percentage of the government’s civil recovery.
To read more about the Par case, including the complaint, click here.
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.
Wednesday, March 21st, 2012
Pfizer Inc. has agreed to pay Oregon more than $3.3 million to settle claims that the company used misleading statements and studies to market Zyvox. The settlement comes after a two-year state investigation into the marketing of the company’s drug, which is used to treat pneumonia and bacterial skin infections.
Oregon Attorney General John Kroger announced the settlement on Tuesday. The settlement follows a 2009 multistate settlement concerning Zyvox, as well as other drugs, which included $2.3 billion in fines against the company.
“Our investigation was aggressive, detailed, went placed that the federal settlement didn’t and provided additional settlement to the state of Oregon,” said David Hart, a senior AG who headed the investigation.
The complaint, filed in Marion County Circuit Court, alleged that Pfizer used “unreliable and unsubstantiated claims” in marketing Zyvox as a better alternative than its generic competitors.
Pfizer denied the allegations, yet released a statement saying it was “pleased to resolve this investigation and avoid the further time and cost of litigation.”
For more information on the settlement, see the full article in the Washington Post at http://www.washingtonpost.com/business/industries/pfizer-agrees-to-pay-oregon-33m-in-antibiotic-marketing-case/2012/03/21/gIQAfGx1QS_story.html.
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.
Tuesday, March 13th, 2012
Another whistleblower lawsuit with ties to the $1 Billion False Claims Act Bank of America settlement announced on February 9, 2012 by the United States Attorney’s Office for the Eastern District of New York has been unsealed. The suit charges the bank with fraud violations under the Home Affordable Modification Program (“HAMP”).
Gregory Mackler, a former contractor with the servicing outsourcerUrban Lending Solutions, filed the lawsuit in July. The lawsuit charges BofA with developing procedures that kept trainees like Mackler from researching or resolving any HAMP inquiries or complaints in order to avoid millions of dollars in losses while benefitting from the financial incentives of the program. The Treasury Department paid $1.8 billion in HAMP servicer incentives through December, according to the special inspector general of the Troubled Asset Relief Program.
In February, a whistleblower complaint was unsealed from Kyle Lagow, a former employee in a Countrywide appraisal unit which detailed allegations of Countrywide’s “corrupt underwriting and appraisal process. Final settlement documents have yet to be filed in the BoA settlement, which the U.S. Attorney’s Office said was the largest ever False Claims Act payout related to mortgage fraud.
If you have knowledge of Corporate Fraud, including Mortgage 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.
The Department of Justice has until March 16 to decide whether to intervene in the Mackler and Lagow cases.
Tags: bank whistleblower, False Claims Act, FERA, mortgage whistleblower, Qui Tam
Posted in Bank Fraud, bank whistleblower, corporate fraud, False Claims Act, FHA fraud, HUD fraud, mortgage fraud, Recent News | Comments Off
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.
Thursday, May 19th, 2011
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.
Tags: abuse, clarence thomas, corporate fraud, corruption, False claims, False Claims Act, FCA, FERA, fraud, fraud reward, government fraud, public disclosure, Qui Tam, reward, supreme court whistleblower, tax whistleblower, whistle blower, whistle blowing, whistleblower appeals, whistleblower reward, whistleblowing, wrongful termination
Posted in corporate fraud, False Claims Act, government fraud, Uncategorized, Whistleblower Protection | Comments Off
Wednesday, May 4th, 2011
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.
Tags: abuse, attorney general, corporate fraud, corruption, False claims, False Claims Act, FCA, FERA, fraud, fraud reward, government fraud, health care fraud, IRS whistleblower, IRS whistleblower program, medicare fraud, pharmaceutical fraud, Qui Tam, retaliate, retaliation, SEC whistleblower, Tax cheat, tax evasion, Tax Fraud, tax whistleblower, whistle blowing, whistleblower award, whistleblowing, wrongful termination
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
Monday, March 28th, 2011
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.
Tags: abuse, corruption, False claims, False Claims Act, FCA, fca seal, FERA, fraud reward, government fraud, government fraud recovery, Qui Tam, relator reward, whistle blowing, whistleblower, whistleblower reward
Posted in Corporate Tax Fraud, False Claims Act, Recent News, retaliation, Uncategorized, Whistleblower Protection | Comments Off
Wednesday, March 16th, 2011
In the fight against Medicare fraud, whistleblowers remain a strong weapon in the government’s arsenal. Last year, the federal government recovered $4 billion stolen from U.S. taxpayers through Medicare fraud. Much of that money was recovered through qui tam cases initiated by whistleblowers under federal and state false claims acts.
In 2010, Medicare covered 47 million beneficiaries, and had estimated outlays of $509 billion, of which the federal government lost nearly $48 billion on improper payments for Medicare. The Center for Medicare and Medicaid (CMS)- the agency within the Department of Health and Human Services that administers Medicare- estimates that nearly 10% of all Medicare payments are fraudulent
To combat Medicare fraud, the federal government is now stressing prevention. According to Peter Budetti of CMS, the focus is now on stopping bad actors from enrolling in Medicare.
Yet, as fraudulent schemes become more sophisticated and more difficult to detect, the federal government likely has no choice but to continue its current “pay and chase” method of fighting healthcare fraud. Under the “pay and chase” method, the government reimburses Medicare claims and, then, chases down those claims which are fraudulent. As long as those defrauding the government remain one step ahead of those chasing them, whistleblowers remain a key tool in the fight against Medicare fraud.
In the coming years, the federal government is going to rely on the sharp eyes and inquisitive minds of Medicare beneficiaries. Currently, the government is asking Medicare recipients to look closely at their Medicare bills, explanation of benefits and credit reports to determine if service tests, medications, or medical equipment listed on the documents was never administered or delivered. The government is also requesting those recipients pay attention to names of unknown physicians, therapists, or other healthcare providers charging Medicare services for services allegedly performed.
Kenney & McCafferty would like to help you assess whether you have a viable whistleblower claim. If you have knowledge of Medicare fraud, call K&M for a free consultation.
Wednesday, March 9th, 2011
In response to a formal inquiry by Senators Charles Grassley (R-IA) and Patrick Leahy (D-VT), on January 24, 2011, the Department of Justice (“DOJ”) and Health and Human Services (“HHS”) issued a joint response detailing the nature and scope of False Claims Act cases both under seal and resolved by the Department of Justice as of January 4, 2011.
According to the response letter, as of January 4, 2011, there were 1,341 qui tam cases under investigation, 885 of which allege some form of health care fraud. Of those 885 cases, 867 actually involve Medicare or Medicaid. Although, there have been no intervention decisions as to any of the aforementioned cases, the sheer volume of cases pending appears to suggest that Americans are becoming less tolerant of fraud and more willing to step forward.
Impressively, over the course of the last five years, the Civil Division of the Department of Justice, in connection with United States Attorneys’ offices, has obtained 541 settlements and judgments in qui tam actions totaling approximately $9.6 billion. Further, since the beginning of the 2011 fiscal year alone, the Civil Division has obtained 19 settlements and judgments totaling more than $1.2 billion.
In addition to the civil fines and penalties, the joint response also addresses DOJ’s tendency to favor parallel civil and criminal proceedings when it is in the best interest of the United States. By way of example, the response points to the area of pharmaceutical fraud which, since January 2009, has resulted in the recovery of more than $3 billion in criminal fines, forfeitures, restitution, and disgorgement, as well as 26 convictions.
While there is always room for improvement, ultimately, FY 2010 rendered impressive statistics in the ongoing effort to combat health care fraud, including a 16% increase over FY 2009 in the number of defendants charged.