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May 11, 2021 by |

Orange County and Los Angeles False Claims Whistleblower Attorney: $4 Million Paid Out In Prescription Drug Fraud Case

ATTORNEY NEWSLETTER

Allegations Of Prescription Drug Overcharges

Illegal Kickbacks Alleged Too

Federally-Funded Military Personnel Program Defrauded

Healthcare fraud is the largest form of fraud against the federal government primarily against Medicare, Medicaid, VA health programs and health programs covering current government employees and military personnel. Various kinds of health care providers may commit this kind of fraud including pharmaceutical companies, medical device manufacturers and distributors, pharmacies, hospitals, nursing homes, physician groups, testing and diagnostic labs, therapy providers, home health car agencies and others. When individuals have information of this kind of fraud, they can bring an action against the offending corporation under the False Claims Act, 31 U.S.C. §§ 3729 et seq. (FCA).  These cases (called qui tams) can result in a reward for the individual bringing the action (referred to as relators).  31 U.S.C. § 3730(c).  Relators in whistleblower cases put a lot of time and work in these cases but the reward can be a substantial percentage of whatever the government ultimately recovers.  31 U.S.C. § 3730(d).  Evans Law Firm, Inc. represents whistleblowers in qui tam cases in Los Angeles or Orange County and throughout California.  If you have credible information of fraud against the government that may be the basis for a whistleblower or qui tam case, call us today at (415) 441-8669.

Prescription Drug Case

In a recently reported settlement of a healthcare fraud qui tam case,[1] two individuals who owned a telemarketing firm that sold anti-inflammatory medications have agreed to pay $4 million to settle claims over defrauding the government over prescription drug costs. The individuals and the telemarketing firm the individuals owned allegedly targeted patients into accepting compounded drugs they didn’t need. According to the complaint, the telemarketing firm then received kickbacks from pharmacies that were reimbursed by the insurers for the cost of the drugs. Many of the claims were paid by TRICARE, the insurance offered to active-duty military personnel, retired military and their dependents.  The patients allegedly did not need the compounded drugs, which are personalized to accommodate a patient’s particular ailments and can sometimes run into the thousands of dollars. Defendants allegedly partnered with various pharmacies to ensure the scripts would be filled, and both parties profited from the scheme. Some pharmacies are also being investigated in connection to the fraud.  These actions allegedly constitute breaches not only of the FCA but also Anti-Kickback Statute, 42 U.S.C. § 1320a-7b, which prohibits payments for referrals of medical services or medications.  The trial date for the case has not yet been set.

Starting A Qui Tam Case

Individuals with original and credible information of false claims 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 Department of Justice (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 your 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.)  Employers are prohibited from retaliating against you for bringing a FCA qui tam case, and your complaint can include claims that the defendant unlawfully retaliated against you.  31 U.S.C. § 3730(h).  Whether your claims are included in the underlying qui tam or the subject of an independent action for damages, reinstatement, double back pay with interest and all other available relief, we can represent you in pursuing that relief.

Contact Us

If you have information regarding a whistleblower or qui tam case for any kind of healthcare fraud against the government here in Los Angeles or Orange County, contact Ingrid M. Evans at (415) 441-8669, or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>. In addition to False Claims Act cases, Ingrid also handles bank fraud whistleblower cases under the Financial Institutions Reform, Recovery, and Enforcement Act (FIRREA), commodities and futures trading cases under the Commodities Futures Trading Commission Whistleblower Program, securities fraud cases under the Securities and Exchange Commission Whistleblower Program and FINRA Whistleblower Office and offshore tax evasion and other tax fraud cases under the Internal Revenue Service Whistleblower Office. 

[1] Evans Law Firm, Inc. was not involved in the case in any way.

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