Fast Facts
about the FCA
 

The Government Counts on Whistleblowers:  More than 80 percent of the False Claims Act cases that are now pursued by the U.S. Department of Justice are initiated by whistleblowers.
 

Cheaters Pay Whistleblower Awards:
Companies cheating the U.S. Government pay whistleblower rewards – not one dime comes from U.S. taxpayers.  The reason for this is that the False Claims Act calls for triple damages so that the Government can be made whole, not only by recouping the cost of whistleblower awards, but also by recovering the cost of investigations, prosecutions, and lost interest.
 

Big Cases Require Big Investments:
Big fraud cases prosecuted under the False Claims Act often require many years of litigation and investigation.  For example, the whistleblower in the first Columbia-HCA fraud case spent 13 years pursuing his False Claims Act lawsuit.  The law firm that spearheaded this case invested more than 85,000 hours in the case.  In the end, the various frauds perpetrated by Columbia-HCA returned over $1.5 billion to the U.S. Treasury.
 

Frivolous Lawsuits are Discouraged:  Because most False Claims Act lawyers work on a contingency basis, they only get paid if they win. This means that they are unlikely to invest time, money and energy building a case that they themselves do not feel will be productive.  In addition, under the False Claims Act, a complainant can be required to pay the defendants attorney’s fees if the court finds that the claim was frivolous or brought primarily for purposes of harassment.
 

The False Claims Act Provides Some Employment Protections: 
If an employee is fired, demoted, harassed, or otherwise discriminated against for filing a False Claims Act suit, the law provides for reinstatement, double back pay, and compensation for special damages, including litigation costs and reasonable attorneys’ fees.
 

Drug Company Frauds are Pervasive and Large: 
Over 180 pharmaceutical fraud cases, covering more than 500 drugs, are now under investigation by the U.S. Department of Justice under the False Claims Act. 

Settlement of just 16 drug manufacturing cases (all those resolved to date) has returned over $4 billion to the U.S. Government and the 50 states.

Routine Mistakes and  Errors are Not  Prosecuted Under the  False Claims Act:
The False Claims Act is not used to correct minor billing mistakes or errors, as these frauds are not systematic and rarely amount to truly large sums of money.   

Major Cases Under Watch:  

Nominal Pricing Fraud:
FCA cases involving violations of the nominal pricing exception have been filed.  Possible cases involve statins, proton pump inhibitors, non-steroidal anti-inflammatory drugs, and others.

Iraq War Fraud:  Numerous large cases dealing with contractor fraud in Iraq are reported to be under investigation, but remain under seal.

Katrina Flood Insurance Fraud: 
A large case alleging fraud against the federal Flood Insurance Program by Nationwide, Allstate and USAA insurance companies, as well as engineering firms that examined property damage after Hurricane Katrina, has come out from under seal and is being investigated by the U.S. Government.

Anti-Psychotic Drugs:  Investigations about the off-label marketing of Zyprexa, Risperdal and Seroquel are under way.   These three drugs represented combined sales of $12 billion in 2006. 
 

Average Wholesale Price Fraud:  The U.S. Government has joined three cases likely to go to trial this summer:  Abbott, Dey and Roxane Pharmaceuticals.  More than 50 other companies face similar charges in Boston.

University of Phoenix:  The Supreme Court has denied cert., and the defendants concede they face a billion dollars in liability. Trial starts this summer.

Outlier Fraud:  Several large outlier fraud investigations against hospitals are under investigation.

 

Newsletters

May 11, 2008
n McKesson to Pay $13.25 Million
n CoxHealth Floats a Number
n Magical Millions
n Wackenhut Under the Glass
 

May 2, 2008M
n UMDNJ Docs Sued for Kickbacks
n GSA's Lurita Doan Loses Job
n Are Fraud Files a Trade Secret?
n Savannah Hospital Pays $5 Million
n Cancer Doc Imports for Resale
n "Undercover" by John Schilling
n New York's Medicaid Work Plan

April 22, 2008
n HHS Say "Tell Us More"
n It Takes a Village to Detect Fraud
n Positively Not Overnight
n Fraud Loophole Eliminated

April 15, 2007
n Radiologist to Pay $7 Million
n NC Dental Chain Pays $10 Million
n Heartland Dental Pays $3 Million
n OMB has Some Explaining to Do
n Entrepreneur of the Year?
n Ista Off-Label Investigation
n Fast Fact: Inflation-adjusing FCA Penalties

April 3, 2008
False Claims Act Amendments
Voted Out Senate Judiciary Committee

March 31, 2008
n Abilify Maker to Pay $4 Million
n HealthEssentials Not Likely to Pay Back Stolen Millions
n AWP Class Action Certified
n Derived Off-label Liability?  
n Psychiatrist to Pay $1.1 Million

March 19, 2008
n CVS Pays $37 Million For Drug Switching
n InterMune CEO Charged
n Pfizer Sales Manager Indicted
n Mounting Zyprexa Liability
n Michigan Money on the Table

March 13, 2008
n Former Pfizer Manager Indicted for Obstruction
n Yale-New Haven Hospital Settles
n WellCare Hires a Fixer
n Precursor to an AWP Settlement?
n Besler to Pay $2.8 Million

March 6, 2008
n Allison Engine at Supreme Court
n Senate Judiciary Hearing on FCA
n Cathedral to Pay $5.3 Million

February 25, 2008
n Allison Engine to Supreme Court
n $215 Million Alabama Jury Award  (non-FCA)
n Quest Reserves $241 Million
n Betting the House
n Wisconsin Passes State FCA

February 15, 2008
n Alabama Takes on Pharma Fraud
n Amgen Subpoenaed for Enbrel
n A Free-Fraud Zone?
n Counting False Claims Act Cases
n Fight Fraud:  Remove The Cap

February 8, 2008
n Merck Settles for $650 Million
n Alabama AWP Trial to Start
n "Undercover" by John Schilling
n Finally A Treatment
n Lilly Sued Over Zyprexa as Settlement Rumors Swirl

January 30, 2008
n Big Dig False Claims Act Case
n Rhode Island False Claims Act Signed Into Law
n Feds Join NJ Outlier Cases
n Passion for Payola is Called . . .
n Washington Defines Success

January 23, 2008
n Supreme Court Gets Briefs in Allison Engine Case
n New Jersey False Claims Act Signed Into Law
n Louisiana Hospital to Pay $1.9 Million for Heart Fraud
n Apollo to Pay $282 Million
n Illinois Expands Its FCA
n Pharma Trinkets to Cameroon

January 10, 2008
n Washington D.C. To Require Pharma Rep Sales Licenses  
n Fraud-fighting Without Teeth
n Orthofix in the Crosshairs
n Dey and Takeda Pay $6.75 Million

December 27, 2007
n Fraud Costs Us More Than an Arm and a Leg
n SBA Fraud Unprosecuted
n $26 Million Hospital Settlement
n CMHS to Pay $1.5 Million
n Orange County to Pay $7 Million
n Illinois Attorney General Refiles on MRI Operators
n Sioux Kevlar Case

December 18, 2007
n Relator Wins Over DoJ Protest
n HealthSouth Pays $14.9 Million
n Law and Odor at Wellcare
n Blue Cross and Blue Shield
Does Payola Politics in RI
n More Tricky Knee Subpoenas

December 10, 2007
n $42 Million Sand Theft
n Ambulance Co. to Pay $6 Million
n Iraq:  Money Without Meter
n Asphalt Co. Settles FCA Case for $8.2 Million
n NJ Hospital to Pay $7.5 Million
n Cigarette Importation FCA
n Harris Hosp. Pays $1.9 Million

December 5, 2007
n Merck Settlement Expected to Top $670 Million
n $25 Million TVA Coal Settlement
n $25 Million Wheelchair Fraud
OK Doctors to Pay
n $1.5 Million

November 28, 2007
n Sleep Center Billing Fraud
n Cheating Death and Medicare
n DoJ's Monitoring Contracts
n The High Price of Whistleblowing
n Federal Whistleblower Odds

November 20, 2007
n DoJ Joins Suit Against Lockheed
n The Biggest FCA Case Ever?
n Peter Rost Gets a Second Chance
n Second Stryker Settlement:  $16.5 Million

November 14, 2007
n Off-Label Narcotic Lollipops
n $28 Million Air Cargo Fraud
n DaVita Investigation in Nevada
n CMS and the Right to Steal

November 08, 2007
n CMS Overpaid $4 Billion
n Willful Injury from Price Fraud
n AZ Hospital Pays $5.8 Million
n More Inquiries at Omnicare
n A Mother's Vengeance
n A Thieving Fraud Inspector
n Adolescent Health Fraud

u The Complete Newsletter  Index