News & Cases

The federal government has filed a False Claims Act lawsuit against Teva and one of its subsidiaries. According to the complaint, the company violated the Anti-Kickback Statute in its marketing of its drug Copaxone. Prosecutors claim Teva illegally paid Medicare co-pays through corrupt foundations in order to boost sales of the multiple sclerosis medication.

No sooner had the lawsuit been announced than the value of Teva's shares dropped by about 10 percent, a clear indication that the company may be liable for millions of dollars in damages. This is a big blow for Teva, which has seen Copaxone sales dwindle over the last few years. Once a $4.2 billion-per-year earner, the drug brought in a meager $628 million (combining U.S. and European sales) between January and June of 2020.

Funneling Kickbacks Through Co-Pay Assistance Foundations

The DOJ alleges that between 2007 and 2015, Teva's purported donations to The Assistance Fund and Chronic Disease Fund were, in fact, illegal kickbacks because they were made knowing the foundations would use the money to assist patients with Copaxone co-pays, ultimately benefitting Teva. Meanwhile, the company increased the price of the drug by nearly 330%. By 2015, an annual supply cost a staggering $73,000....

An Oklahoma hospital, its manager and part-owner, the physician group that created the hospital, and two of the group's physicians will collectively pay $72.3 million to settle claims that they conspired to defraud the federal government and the State of Oklahoma.

The alleged kickback scheme was described in detail in a False Claims Act lawsuit filed against several defendants, including the Oklahoma Center for Orthopaedic and Multi-Specialty Surgery (OCOM), a surgical hospital; USP, a hospital management company; Southwest Orthopaedic Specialists (SOS), a group of orthopaedic surgeons; and two SOS physicians named Anthony L. Cruse and R.J. Langerman.

According to the whistleblower complaint, SOS, OCOM, and USP, the corporation that controls OCOM, conspired to defraud Medicare, Medicaid, TriCare, and Blue Cross Blue Shield Federal....

Novartis has agreed to pay $678 million to resolve allegations that it systematically violated the Anti-Kickback Statute in its marketing of Lotrel, Diovan, Tekturna, Exforge, Valturna, Tekamlo, and Starlix. Prosecutors alleged the drugmaker paid for lavish meals, golfing trips, and purported professional events at Hooters to induce doctors to prescribe its cardiovascular and diabetes drugs. According to the underlying lawsuit, high-prescribing physicians received hundreds of thousands of dollars for speaking at sham professional events.

According to the former Novartis sales representative who filed the complaint, the whistleblower’s former employer paid for nearly 80,000 of these sham events between 2002 and 2011. The Department of Justice later joined the False Claims Act lawsuit to try to recover funds paid by Medicare and other government health care programs for prescriptions tainted by the defendant’s alleged misconduct. The original lawsuit was filed in 2011, and the DOJ joined as a plaintiff in 2013.

The Justice Department’s investigation revealed that Novartis’s sham informational roundtables were often held at expensive restaurants like NYC’s Eleven Madison Park and D.C.’s Charlie Palmer Steak. In reality, prosecutors claimed, the roundtables were an excuse to treat physicians to fancy meals. In many cases, doctors got paid for speaking at events that never happened....

Governor Cuomo has signed an order to strengthen whistleblower protections for New York State’s health care workers. Described as, “An act to amend the labor law, in relation to prohibiting health care employers from penalizing employees because of complaints of employer violations,” New York Senate Bill S8397-A/A.10326 was sponsored by NYS Senator

Diane J. Savino and co-sponsored by NYS Senators Alessandra Biaggi, David Carlucci, Leroy Comrie, and Robert Jackson.

The New York State Senate’s website states that the new legislation “prohibits health care employers from penalizing employees because of complaints of employer violations,” providing “health care workers with greater whistleblower protections in the State of New York, so that patient care can improve and such workers can be safe.”

The act amends New York State’s labor law, creating “a new definition of ‘improper quality of workplace safety,’ where an employee is protected from employer retaliation if they report violations of this category.” Under the amended legislation, employees are also protected from retaliation if they report violations to news organizations or social media....

The COVID-19 pandemic has taken a tremendous toll on America’s elderly population. Nursing home residents have been hit the hardest, with 20,000 dead across the country as of mid-May. Many of those people have died due to negligence from staff and administrators. Naturally, families want to sue the culprits. Meanwhile nursing home operators are demanding immunity, often with success.

Prominent Elder Law attorney Brian Mahany explains, “If you live in Florida and watch the news, nursing home administrators are demanding immunity from lawsuits and even criminal prosecution. So far, 16 states have already caved to pressure from well-paid healthcare lobbyists.”

Mahany has it right. States that have passed COVID-19 immunity laws for nursing homes include some of the hardest hit by the pandemic. New York is one of them. As residents get infected and die en masse at facilities all over NYS, legal liability for inadequate care has become a thing of the past. When residents need the highest quality of care to prevent Coronavirus infection, nursing home administrators get a free pass to disregard mandatory care standards....

Despite the slowing down of markets due to the COVID-19 pandemic, April 2020 has been a prolific month for the Securities Exchange Commission. The agency’s Office of the Whistleblower has announced a $27 million award followed by a $5 million award.

Upon the announcement of the $27 million award, the agency hailed it as a milestone for its whistleblower program, which brought the total amount of SEC whistleblower awards “over the $400 million mark.” Up until April 20th, 2020, that number has risen to $430 million, awarded to 80 whistleblowers over eight years. In 2019 alone, the agency received more than 5,200 tips from over 70 countries.

The $27 million award surpassed the SEC panel’s initial recommendation. The agency said in a statement that the award recipient provided information about misconduct “occurring, in part, overseas,” and tried to report internally on multiple occasions before contacting the SEC. The unusually high amount of the award reflected the whistleblower’s “substantial amount of ongoing assistance and cooperation” and the many “critical investigative leads” they provided, the Commission explained....

Guardian Elder Care Holdings Inc. and a list of related entities, including Guardian LTC Management and Guardian Rehabilitation Services (collectively, Guardian), have agreed to pay $15.4 million to settle a False Claims Act lawsuit. According to the complaint, Guardian billed government healthcare programs for medically unnecessary services. The company allegedly defrauded both Medicare and the Federal Employees Health Benefits Program.

Pennsylvania-headquartered Guardian operates over 50 nursing facilities in Pennsylvania, Ohio, and West Virginia. According to the whistleblower lawsuit filed by two rehab managers who worked at a Guardian facility in Carlisle, Guardian caused some of its facilities in all three states to bill the government for medically unnecessary services, at the highest level of Medicare reimbursement, solely to maximize profits.

The whistleblower complaint resolved by the $15.4 million settlement was filed under the False Claims Act (“FCA”). Under the FCA, whistleblowers with original information about a fraud can come forward and become eligible for an award ranging between 10 and 30 percent of any resulting recovery. The two whistleblowers in this case, Philippa Krauss and Julie White, will share a $2.8 million award....

In 2016, a New Yorker reporter noted that contractors outnumbered U.S. troops three to one in Afghanistan. Part of the reason for this was that moving around on the ground was so dangerous in Afghanistan that our government basically paid local people to risk their lives, for example, by driving trucks and transporting materials for the U.S. military.

“The jobs were dangerous—more contractors had been killed so far that year than U.S. soldiers—but the payoff was substantial,” The New Yorker stated. “Between 2007 and 2014, the U.S. spent eighty-nine billion dollars on contracting in Afghanistan.”

But in an impoverished war zone, U.S. military contracts have inevitably led to large-scale corruption, and as several lawsuits now allege, the result has often been that our country has indirectly funded its own enemies.

Trucking contractors in Afghanistan, for example, were described in a House Committee report as fueling “a vast protection racket run by a shadowy network of warlords, strongmen, commanders, corrupt Afghan officials, and perhaps others,” adding that “protection payments for safe passage [were] a significant potential source of funding for the Taliban.” ...