Company Allegedly Used Charitable Foundation To Cover Copays
Program Constituted A Kickback For Prescriptions
$97 Million Settlement
On September 23, 2020, the U.S. Department of Justice (DOJ) announced a $97 million settlement with pharmaceutical giant Gilead Sciences, Inc. for allegedly paying illegal kickbacks for drug prescriptions. The action was brought under the False Claims Act (“FCA”) (31 U.S.C. §§ 3729-3733) and the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b. According to the complaint, Gilead used a charitable foundation under its control to pay Medicare patient copays on prescriptions of its drugs to illegally increase sales. Evans Law Firm, Inc. represents individuals who bring FCA cases based on any manner of fraud against the government including by paying illegal kickbacks for drugs or other product sales being covered by government programs like Medicare or Medicaid. If you have credible, original information of healthcare fraud, call us today at (415)441-8669 and we can help.
“Health care fraud costs our country tens of billions of dollars each year because of unscrupulous schemes like the one Gilead orchestrated that dangled kickbacks disguised as copay assistance in front of Medicare patients,” said Joseph R. Bonavolonta, Special Agent in Charge of the Federal Bureau of Investigations, Boston Division, which headed the investigation. According to Mr. Bonavolonta, “Today’s $97 million settlement ensures Gilead pays for defrauding a government insurance program and reaffirms the FBI’s resolve to pursue investigations and exhaust all efforts to uncover these schemes.”
Allegations of the Fraudulent Scheme Explained
The complaint alleged that Gilead used a charitable foundation as a conduit to pay the copay obligations of thousands of Medicare patients taking Letairis (a drug to treat high blood pressure) and to induce those patients to purchase Letairis over its competitors, because Gilead knew the price of Letairis could otherwise pose a barrier to sales. From 2007 through 2010, according to the government, Gilead made payments to its foundation, which, in turn, used those funds to pay copays of patients prescribed Letairis only, not any competing, similar medication. The government alleged that Gilead routinely obtained data from the foundation detailing how much the foundation had spent for patients on Letairis; it then used this information to decide how much to pay to the foundation and to confirm that its payments were sufficient to cover the copays of only patients taking Letairis. The government also alleged that, to generate revenue from Medicare and induce purchases of Letairis, Gilead referred Medicare patients to the foundation, which resulted in claims to Medicare to cover the cost of Letairis.
If you have information regarding healthcare fraud against the federal government or the State of California, contact Ingrid M. Evans and the other California whistleblower attorneys at Evans Law Firm at (415) 441-8669, or by email at <a href=”mailto:email@example.com”>firstname.lastname@example.org</a>. The firm also handles cases involving bank fraud under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program
 Evans Law Firm, Inc. was not involved in the case in any way.