False Claims Act Update & Alert
Taxpayers Against Fraud Education Fund | Washington, D.C. | WWW.TAF.ORG
March 7, 2007
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$3.9 Billion in Pharmaceutical Fraud Is Just the Tip of the Iceberg
WASHINGTON, DC, March 8 -- Taxpayers Against Fraud Education Fund has released a new study which notes that in the last two years, pharmaceutical manufacturers have paid a total of $1.6 billion to resolve allegations of Medicare and Medicaid fraud, but that these cases represent just the tip of the iceberg as more than 180 additional cases remain under seal,representing scores of billions of additional stolen dollars.
In total, more than $3.9 billion has been recovered from drug manufacturers over the past six years as the result of just 16 cases brought by whistleblowers under the False Claims Act.
Of the six False Claims Act cases that were settled in Fiscal Years 2005 and 2006, all involved fraud against Medicaid, and all were initiated by whistleblowers.
Under the False Claims Act, private citizens with inside information about fraud can file suit to recover money stolen from the government. Under the False Claims Act, damages can be tripled and statutory fines assessed, with 15-30% of the money recovered going to citizen whistleblowers for their help in prosecuting the case.
The pharmaceutical companies involved are among the largest drug companies in the world: GlaxoSmithKline, Pfizer, AstraZeneca, Schering-Plough, and Bayer.
Notes Jim Moorman, President of Taxpayers Against Fraud Education Fund, "These large pharmaceutical frauds are not billing errors -- they appear to be carefully crafted business plans that involve kickbacks, false pricing, and deceptive accounting. Some are also crafted to circumvent laws prohibiting the marketing of drugs for inappropriate uses. These schemes steal money from America's taxpayers and deprive America's oldest, sickest and poorest of badly needed Medicaid services."
Andy Schneider, the author of the TAFEF report, notes that "FCA whistleblower cases against drug manufacturers have had a demonstrable impact on Medicare and Medicaid prescription drug policy," and that more case are sure to follow. Bristol-Myers Squibb has already announced that it expects to pay $499 million later this year to settle allegations relating to fraudulent pricing and marketing of drugs for the treatment of schizophrenia and bipolar disorder, while the DoJ has intervened in whistleblower cases against Abbott Laboratories and Dey Inc.
To read TAF's newest report ::
"The Role of the False Claims Act in Combatting Medicare & Medicaid Fraud by Drug Manufacturers: An Update"
Top Ten Medicaid
False Claims Act Settlements
(Note that every one involves a drug manufacturer).
Rank
Case (Settlement Date)*
Settlement Amount**
1
Serono (10/17/05)
$567.1 million
2
Schering-Plough II (7/29/04)
$282.4 million
3
Schering-Plough III (8/29/06)
$251.1 million
4
Bayer II (4/16/03)
$242.1 million
5
Pfizer II (Warner-Lambert) (5/13/04)
$152 million
6
King Pharmaceuticals (10/30/05)
$124.1 million
7
GlaxoSmithKline I (4/16/03)
$85.1 million
8
TAP Pharmaceuticals (10/3/01)
$56.7 million
9
Abbott Laboratories (7/23/03)
$50.2 million
10
Pfizer I (10/28/02)
$49.0 million
Total Medicaid Recoveries
$1.86 billion
*Includes cases brought by government (9) and cases brought by whistleblowers (1-8, 10)
** Federal and state recoveries to Medicaid. Amounts do not include Medicare recoveries or criminal fines