May 10, 2013 — The False Claims Act prohibits drug makers, pharmacies and health care providers from billing federal healthcare programs for drugs prescribed or sold as a result of an illegal kickback scheme. When pharmaceutical companies pay kickbacks to pharmacies, doctors, hospitals or long-term care providers as a way to increase drug sales, and then pass through the cost of the kickbacks to Medicare and Medicaid, the taxpayers foot the bill. To encourage pharmaceutical industry insiders to notify the government, the qui tam provisions of the False Claims Act permit tipsters to file suit for the government’s benefit and then retain a portion of any monies collected.
Kickback Suit Against Amgen Results in $24.9 Settlement
A whistleblower lawsuit filed against Amgen Inc. under the federal False Claims Act will be settled for $24.9 million, according to the U.S. Department of Justice. Amgen is a biotechnology company based in California that makes and sells pharmaceuticals, including Aranesp, used for patients with anemia caused by renal failure.
The whistleblower alleged that Amgen paid illegal kickbacks to long-term care pharmacies to induce them to switch patients receiving Medicare and Medicaid to Aranesp from a competitor’s medication. The scheme was this: the long-term care pharmacies — PharMerica Corporation, Omnicare Inc. and Kindred Healthcare Inc. — instituted “therapeutic interchange” programs by which they switched patients’ medication. In exchange, Amgen allegedly paid the pharmacies performance-based “rebates” based on certain market-share thresholds. At the same time, Amgen allegedly provided nursing home staff and consulting pharmacies with marketing literature that promoted the use of Aranesp even for patients whose anemia was not caused by chronic renal failure.
Informants Use False Claims Act to Foil Kickback Scams
Kickback scams ultimately demand that pharmaceutical company employees and health care workers participate in the fraud or look the other way. Honest people just working to support their families should not be presented with such a dilemma. Still, it takes a lot of courage to step forward and notify the government. Collaborators need to understand their rights. The whistleblower lawyers at Waters & Kraus provide whistleblowers with the skilled legal representation they deserve. Contact us by email or call our qui tam lawyers at 855.784.0268 to learn how we protect and advance the interests of insider employees.