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Oct 28, 2022 by |

Los Angeles Whistleblower Attorney: Pharmaceutical Company Agrees To Pay $900 Million To Settle Allegations Of Improper Physician Payments


Former Employee Brought Qui Tam Action

Will Receive $250 Million Reward

Allegations Of Illegal Kickbacks

Frauds committed against the federal or State governments often involve multiple violations of the law.  Private citizens are authorized to bring actions against the entities defrauding the government under the False Claims Act (“FCA”), 31 U.S.C. § 3729 et seq., and may be awarded a percentage of what the government recovers.  In the action, which is known as a “qui tam,” the plaintiff, known as a “relator,” may allege any other violations of law that apply.  Multiple violations occur often when healthcare fraud is the issue.  For example, the alleged misconduct may involve the Anti-Kickback Statute, 42 U.S.C. § 1320a-7b (prohibits kickbacks for medical services referrals), and the Stark Law, 42 U.S.C. § 1395nn (prohibits physicians from referring patients to providers that the physician has a financial interest in) are federal laws designed to ensure doctors make medical decisions with only their patients’ best interests in mind.  The statutes prohibit kickbacks or lucrative referral programs which create monetary incentives that may be opposed to a patient’s best interest. When the kickback relates to a medical service or product paid for by the government (under Medicare or Medicaid, for example) the federal payment is fraudulent because the kickback/referral statutes have been violated.  If you have credible information of fraud against the government in violation of the FCA, Anti-Kickback Statute or Stark Law in Los Angeles or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).

Recent FCA Settlement[1]

In a recent press release by the U.S. Department of Justice (DOJ), a pharmaceutical company has agreed to pay $900 million to resolve allegations that it caused the submission of false claims to Medicare and Medicaid by paying kickbacks to physicians to induce them to prescribe drugs manufactured by the company. In a qui tam lawsuit filed in federal court, a former employee of defendant alleged that the company paid kickbacks to physicians to induce them to prescribe the company’s multiple sclerosis drugs. According to the relator’s complaint, the company offered and paid remuneration, including in the form of speaker honoraria, speaker training fees, consulting fees and meals, to health care professionals who spoke at or attended the company’s speaker programs, speaker training meetings or consultant programs to induce them to prescribe certain MS drugs, in violation of the Anti-Kickback Statute. Under the terms of the settlement, the company will pay $843,805,187 to the United States and $56,194,813 to 15 states. The relator will receive approximately 29.6% of the federal proceeds from the settlement, or close to $250 million.

How A Qui Tam Action Begins

Individuals with original and credible information of false claims, like the former employee in this case, begin FCA qui tam cases by filing a complaint under seal in the federal court. At the same time, the relator submits a disclosure to the DOJ outlining the material evidence the relator has of the alleged false claims. 31 U.S.C. § 3730(b). The seal period of the complaint lasts 60 days during which the DOJ investigates the claims.  31 U.S.C. § 3730(b)(2). (If necessary, the government can, and often does, extend the 60-day period during which the allegations are kept under seal.)  If the government decides to intervene in the case, the government essentially takes over the litigation. 31 U.S.C. § 3730(c)(1).   If the government declines to intervene, the relator may proceed with the litigation on his or her own.  31 U.S.C. § 3730(c)(3).

Contact Us

If you have credible information of government fraud in Los Angeles or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=””></a>.  In addition to FCA and CFCA whistleblower cases, Ingrid and Evans Law Firm, Inc. also handle bank fraud whistleblower cases 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. 

[1] Evans Law Firm, Inc. was not involved in the case in any way.  The case is captioned United States ex rel. Bawduniak v. Biogen Idec, Inc., No. 12-cv-10601-IT (D. Mass.).



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