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Catch of the Week: 345 Charged in $6 Billion National Health Care Fraud and Opioid Takedown

Posted  10/2/20
Paper Ripped Uncovering Medical Necessity Wording
In the largest health care fraud and opioid enforcement action in the Justice Department’s history, 345 defendants—including more than 100 doctors, nurses, and other medical professionals—face charges for submitting over $6 billion in false or fraudulent claims to federal and private insurers.  Defendants stand accused of submitting $4.5 billion in fraudulent claims linked to telemedicine, $845 million...

How Whistleblowers Can Report Fraud Related to Clinical Trials

Posted  09/4/20
Microscope
The COVID-19 pandemic has highlighted the importance of government-funded scientific and medical research, including clinical trials of vaccines, treatments, and more.  We are all potentially at risk if there is fraud and abuse in clinical trials and other research. Individuals with knowledge of fraud and misconduct in federal grants and clinical trials may be able to bring a whistleblower action for that research...

New Settlement Shows the Power of Whistleblowers to Root out Fraud against Private Insurers

Posted  08/6/20
whistle hanging against a chalkboard
The nation’s biggest insurers, Medicare, Medicaid, and TRICARE already incentivize whistleblowers to report fraud. Because those programs are federally-funded, a whistleblower can bring suit under the False Claims Act and share in 15-30% of the recovery. The FCA is a law that allows private individuals alleging fraud against the government to bring a lawsuit in the name of the United States. The law leads to about...

Catch of the Week: Indivior Agrees to Pay $600 Million to Settle Opioid Fraud Case

Posted  07/31/20
pill container spilled over with pills in the form of a dollar sign
The latest in our Catch of the Week series features Indivior Solutions’ (“Indivior”) agreement to pay $600 million to resolve criminal and civil liability associated with the marketing of the opioid-addiction-treatment drug Suboxone. This is in addition to the $1.4 billion resolution with Indivior’s former parent, Reckitt Benckiser Group PLC (“RB Group”) that was previously announced in 2019. Suboxone is a...

Newly Unsealed Whistleblower Lawsuit Alleges Drug Giant McKesson Gave Doctors Illegal Kickbacks in the Form of Free Software

Posted  07/24/20
Close-up of McKesson logo on computer screen
Constantine Cannon LLP is pleased to announce the unsealing of a whistleblower lawsuit its client brought alleging that drug wholesaler McKesson Corp. and its affiliated companies provided illegal kickbacks in the form of free business services to encourage oncologists and other doctors to buy drugs from McKesson. The lawsuit alleges that McKesson gave doctors valuable business-management tools geared towards...

Catch of the Week: Novartis Pays $729 Million to Settle Two Kickback Cases on Heels of $345 Million Foreign Bribery Settlement

Posted  07/2/20
Novartis corporate building
This week and last, pharmaceutical manufacturer Novartis reached three settlements involving very different forms of unlawful kickbacks and bribes.  First, this week the company agreed to pay a total of $678 million to resolve a New York case alleging that it paid inflated “speaking fees” and provided other incentives to doctors to induce them to prescribe Novartis drugs.  Second, Novartis will pay $51.25...

Regeneron: The Government’s Latest Stand against Patient Kickbacks

Posted  06/25/20
pills, syringes, and money scattered around
This week, Boston-based prosecutors have filed a new False Claims Act case against Regeneron, a pharmaceutical company, alleging that it paid patients kickbacks aiming to steer them into using Regeneron’s macular degeneration drug, Eylea. Regeneron allegedly disguised the kickbacks as charitable contributions to a foundation. Prosecutors say that Regeneron only donated exactly enough money to the foundation, called...

The Missing Ventilator Stockpile Was Not Inevitable

Posted  04/3/20
Hospital Building Sign
The coronavirus crisis has been a crash course for the general public in how lifesaving ventilators work.  But the federal government has long known how crucial they are and how important it is to be able to stockpile sufficient numbers.  Five years ago, the government tried to plan ahead by commissioning the design and production of a low-cost ventilator to build up public and private stores in case an...

The COVID-19 Crisis, Whistleblowers, and the Constantine Cannon Whistleblower Team

Posted  03/19/20
Soapy hands under running water faucet
As Constantine Cannon announced earlier this week, in response to the coronavirus (COVID-19) crisis, we have implemented contingency plans to work remotely.  While our work locations have changed, we remain dedicated to our whistleblower clients, and our team continues to provide whistleblowers with support and legal guidance. With offices in New York, D.C., San Francisco, and London, the Constantine Cannon...

Medicaid Drug Rebate Fraud: Should it be an Enforcement Priority?

Posted  03/10/20
pill container spilled over with pills in the form of a dollar sign
Medicaid has one very intuitive approach to keeping drug prices in check. Drug companies, under a law called the Medicaid Drug Rebate Program, must rebate Medicaid programs any money that resulted from the increased drug prices outpacing inflation. Inflation is benchmarked to either 1990, or the first year a drug came to market, which ever is later. As an example of how this works, imagine a pharmaceutical company...
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