Class Action Blog : Consumer Fraud, Consumer Protection, Securities and Antitrust Lawyer & Attorney : Meiselman, Denlea, Packman, Carton & Eberz

More so than ever, pharmaceutical companies are getting caught offering incentives to their sales representatives to advocate to medical providers to prescribe their medications for off-label use. That is, for use in treating various diseases which have not been approved by the Food & Drug Administration (“FDA”). As a result, a number of pharmaceutical representatives have reaped huge rewards from successful Qui-Tam actions which are lawsuits filed under the False Claims Act.

Many recent examples abound, such as a whistleblower action filed by a former Pfizer sales representative against Pfizer alleging that the company promoted the sale of four drugs -- Bextra, Geodon, Zyvox, and Lyrica -- for unapproved uses, which in turn caused Medicaid and Medicare to pay false claims for reimbursement submitted to them by medical providers across the country. In 2009, after a six-year legal battle, Pfizer settled the case for $2.3 billion dollars. The former sales representative was awarded $51 million dollars as a result.

One of the very first such Qui-Tam lawsuits was filed 14 years ago by another former Pfizer employee, David Franklin. The whistleblower suit alleged that the Pfizer was illegally promoting the prescription drug Neurontin for off-label uses.  Indeed, during one training trip for its sales representatives, the company videotaped its lawyers instructing Pfizer employees that off-label promotion was illegal. The whistleblower suit alleged that Pfizer then proceeded to turn off the videotape, joked about making sure it was off, and trained their representatives on how to break the law and promote off-label uses. As a result, Pfizer sales representatives were promoting Neurontin to medical providers for treatment of seizures, bipolar disorders, migraines and other ailments.

Even though the government decided not to intervene and prosecute the case, Mr. Franklin continued with his Qui-Tam lawsuit on his own. Pfizer finally settled the action this year for $430 million and Mr. Franklin was awarded about $26 million for his whistleblower role.

Another famous Qui-Tam lawsuit was filed by 6 employees of Eli Lilly & Company alleging that Zyprexa was marketed off-label for untested and unapproved uses.  Eli Lilly allegedly created a sales team of 180 "specialty" sales representatives to promote Zyprexa for a number of off-label, unapproved FDA uses to sedate and control elderly nursing home residents exhibiting symptoms of agitation, anxiety, insomnia, depression and dementia. But the medication had been approved by the FDA to treat only bipolar and schizophrenic patients. In 2009, the US Attorney's Office for the Eastern District of Pennsylvania announced that Lilly will pay $1.4 billion for its illegal off-label marketing of the antipsychotic drug. The six whistleblowers who brought the whistleblower suit will share approximately 18 percent of the recovery.

If you are a current or former employee of a pharmaceutical company and believe that your employer is engaged in unlawful practices, including promoting its medications for off-label uses thereby engaging in Medicaid and/or Medicare fraud, you may be entitled to a multi-million dollar award. You can help your fellow hardworking taxpayers -- and earn millions of dollars in the process -- by blowing the whistle on unlawful pharmaceutical practices.

If you know or suspect that a pharmaceutical company is engaged in unlawful sales practices, including Medicaid and/or Medicare fraud and/or promoting its medications for off-label treatments, please contact us to discuss your legal options.

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When a medical provider in New York State -- a hospital, doctor, clinic, pharmacy or medical supply company -- commits fraud against New York State, everyone pays.  You, as a taxpayer, end up picking up the state's losses through an increase in your state and local taxes.  But individuals who know of fraud being committed against New York State and/or New York City can put a stop to it by becoming whistleblowers.

Under New York State’s (and New York City’s) whistleblower law known as the False Claims Act (“FCA”), a whistleblower can bring a "Qui Tam" lawsuit against companies and individuals that are cheating New York State and/or New York City.   A Qui Tam lawsuit is an action filed by an individual on behalf of the state and/or city under the FCA.

In the face of widespread fraud and in an effort to strengthen New York State’s efforts to fight Medicaid fraud, which is driving up spending and taxes at the state and local levels, Senate Republican Leader Dean Skelos announced the creation of the Senate Republican Task Force on Medicaid Fraud.  “There is no excuse for tolerating any fraud in a program that is the fastest-growing and largest single component of state and county budgets,” said Senator Skelos.  “Medicaid fraud drives up state spending and taxes as well as local property taxes.  We must fight fraud aggressively, restore accountability and integrity to the Medicaid program, and ensure that tax dollars are spent wisely to help the people who really need help, not enrich criminals who prey on the system.”

“Medicaid fraud is possibly costing New York State taxpayers billions of dollars.  It’s crucial that we act immediately to prevent this type of fraud at the state and local levels,” said Senator Kemp Hannon.  “During a time when every single cent counts, we cannot afford to let the possibility of this amount of money fall through the cracks of the system through fraud and abuse.”

Indeed, whistleblowers are rewarded a significant portion of the proceeds collected on behalf of New York State or New York City.  In fact, whistleblowers are entitled to collect at a minimum 15% to 30% of the total amount of the fraudulent money recovered, and many whistleblowers have collected millions of dollars.

The widespread problem of Medicaid fraud has been highlighted by several reports issued by the state Comptroller’s office that documented millions of dollars in Medicaid overpayments and billing errors. Chemung County Executive Thomas J. Santulli, President of the New York Association of Counties, said, “Recently, New York City and forty-two New York Counties obtained a victory in federal court against 13 pharmaceutical manufacturers for fraudulent pricing through the Medicaid Program. These types of actions continue to demonstrate the relevance and importance of county governments insuring the integrity of the Medicaid Program in New York.” Moreover, in December, the state Comptroller released the results of an audit that identified as much as $92 million in Medicaid overpayments, billing errors and other problems.

If you are aware of Medicaid and/or Medicare fraud being committed against New York State and/or New York city by a doctor, hospital, clinic, pharmacy and/or medical supply company, you may be entitled to a multi-million dollar award.  You can help hardworking New York taxpayers from being cheated -- and earn millions of dollars in the process -- by blowing the whistle on Medicaid and Medicare fraud.

 If you know or suspect that Medicaid and/or Medicare fraud is being committed in New York, please contact us to discuss your legal options.

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When an individual, company, county or city commits fraud against the United States government, everyone pays. You, as a taxpayer, end up picking up the government's losses through an increase in your taxes. But individuals who know of fraud being committed against the government can put a stop to it by becoming whistleblowers.

Under the federal whistleblower law known as the False Claims Act (“FCA”), a whistleblower can bring a "Qui Tam" lawsuit against companies and individuals that are cheating the government. A Qui Tam lawsuit is an action filed by an individual on behalf of the federal government under the FCA. In the face of widespread fraud, Congress passed the FCA hoping that it would decrease fraud that results in the loss of hundreds of millions if not billions of dollars in public funds. The FCA prohibits presenting any false claim for reimbursement to the United States government, either intentionally or unintentionally, and eliminates the so called hear-no-evil see-no-evil defense. Examples of whistleblower lawsuits include Medicare and Medicaid fraud, defense contractor fraud, customs fraud, bid-rigging on government projects, environmental fraud and research fraud.

As an example of an individual filing a claim under the FCA, a speech therapist in New York, Hedy M. Cirrincione, filed a whistleblower lawsuit against Jefferson County, New York, claiming that the County had improperly collected Medicaid reimbursements. As a result of Ms. Cirrincione’s whistleblower suit, the case settled for a record-breaking $540 million, with Ms. Cirrincione collecting $10 million. The settlement set a record for a recovery for the Medicaid program, and is the seventh largest whistleblower suit in history.

In another example, the pharmaceutical company Amgen has been accused by a whistleblower of engaging in illegal kickbacks to promote sales of its anemia drug Aranesp. Kassie Westmoreland, a former Amgen sales representative, filed a whistleblower suit alleging that Amgen provided free samples of Aranesp to doctors and clinics. The free samples had small extra amounts of the drug, or overfill, in each vial. The medical practices could then make a profit by billing insurers, including state Medicaid programs, for the extra drug. The lawsuit asserts that New York’s Medicaid program was defrauded of at least $1.8 million.

In yet another example, South Texas Health Systems agreed to pay $27.5 million to settle a whistleblower suit claiming that it paid kickbacks to doctors who referred patients to its hospitals. The whistleblower suit was filed by a former employee of South Texas Health Systems, Bruce Moilan, who alleged the kickbacks were disguised through sham contracts. Mr. Moilan received $5.5 million in the settlement, and the rest of the money went to state and federal taxpayers, including $2.3 million to reimburse the Texas Medicaid program.

There are even whistleblower suits that are unconventional. For example, a sharp-eyed attorney in Washington, D.C. did some investigating after spotting patent markings on the lid to his daily cup of coffee and discovered that the patent had actually expired some 20 years before. Now the lawyer is seeking millions of dollars in damages in a Qui Tam suit against the lid maker, Solo Cup. This same attorney has also filed a similar suit against razor company Gillette. The U.S. Justice Department is also supporting a Qui Tam action in a separate case filed over Brooks Brothers' expired patent claim on its "original Adjustolox" bow tie. As such, consumers should take a look at items they use regularly, and see if the item has a patent number stamped upon it. It may be that the patent has expired, in which case a whistleblower action can be filed against the manufacturer.

If you are aware of fraud being committed against the government, you may be entitled to a multi-million dollar award.  You can help hardworking taxpayers from being cheated -- and earn millions of dollars in the process -- by blowing the whistle on fraud.

If you know or suspect that a business, corporation, municipality, city and/or state are defrauding the U.S. government, please contact us to aid you in an investigation and to discuss your legal options.

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