Healthcare Fraud

A settlement has been reached in a whistleblower class action lawsuit brought against Plaza Health Network (originally known as Hebrew Homes Health Network) who is accused of making illegal payments to doctors for referrals of Medicare patients, submitting false claims to Medicaid and Medicare for therapy services that were never provided or charged at inflated cost, and inflating the value of Plaza's real estate assets to get low-interest government loans.

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Of the $17 million settlement, the whistleblower will receive a $4.25 million share of the settlement.

According to federal authorities, Plaza was operating a “sophisticated kickback scheme” between 2006 and 2013, hiring doctors to supposedly serve as “medical directors.” In reality, the positions didn't exist but were used so that the doctors would refer patients to the company’s facilities.

A settlement has been reached in a whistleblower class action lawsuit brought against OtisMed Corporation who is accused of marketing and distributing the OtisKnee without receiving approval or clearance from the FDA for the device. 

OtisMed was fined $34.4 million in the criminal action and was ordered to pay $5.16 million in criminal forfeiture.  Additionally, OtisMed agreed to pay $41.2 million to resolve the originally filed whistleblower lawsuit.

A settlement has been reached in a whistleblower class action lawsuit brought against GlaxoSmithKline who is accused of promoting some of its antidepressants for unapproved uses and failing to report safety data about a top diabetes drug and improper marketing of a half-dozen other drugs.

The settlement includes $1 billion in criminal fines and $2 billion in civil fines.  $300 million of the settlement will go to states and other public health authorities.  A portion of the civil fine will go to the contributing whistleblowers.

The case was originally filed in 2012 in the U.S. District Court for the District of Massachusetts.

A settlement has been reached in a whistleblower class action lawsuit brought against Boehringer Ingelheim Pharmaceuticals Inc who is accused of defrauding Medicare and other government healthcare programs and promoting uses of its drugs and endangering patients' health.

The settlement of $95 million settlement will be distributed as follows; the federal government will obtain $78,455,048 (of which the whistleblower will receive over 21%), and state Medicaid programs will obtain $16,544,952.

Filed in 2005, the whistleblower complaint alleged off-label marketing of four drugs: Aggrenox, Atrovent, Combivent and Micardis. The government's allegations specifically were that Boehringer  promoted Aggrenox for certain cardiovascular events such as myocardial infarction and peripheral vascular disease; that Combivent was marketed for use prior to another bronchodilator in treating COPD; and that Micardis was marketed for treatment of early diabetic kidney disease. The uses were not for medically accepted indications and were not covered by federal health care programs.

A settlement has been reached in a whistleblower class action lawsuit brought against Johnson & Johnson who is accused of defrauding the state of Texas by misleading doctors about its antipsychotic drug Risperdal.

Johnson & Johnson's Janssen Pharmaceuticals subsidiary will pay the settlement and the whistleblower will recieve a portion of the settlement.

Filed in 2004, the originally filed whistlebower lawsuit claimed that Johnson & Johnsonhad bribed a Texas official to get Risperdal included in a preferred medication formulary operated by the state.

A settlement has been reached in a whistleblower class action lawsuit brought against Johnson & Johnson who is accused of misbranding its drug Natrecor, used to treat heart failure.

Johnson & Johnson has agreed to pay the government a criminal fine of $85 million.

Filed in July 2011, the complaint alleges Johnson & Johnson was misbranding the medicine because its labeling lacked adequate directions for use.

A settlement has been reached in a whistleblower class action lawsuit brought against GlaxoSmithKline who is accused of  improperly manufacturing drugs and selling adulterated drugs.

The settlement includes a criminal fine and forfeiture totaling $150 million and a $600 million civil settlement. The whistleblower will receive  $96 million of the settlement.

Filed in 2004, the whistleblower lawsuit alleged that GlaxoSmithKline was selling tainted drugs under false pretenses. The medicines, made at a Glaxo plant in Cidra, Puerto Rico, were misidentified as a result of product mix-ups, according to papers filed in federal court in Boston. The affected drugs included the antidepressant Paxil CR and the diabetes treatment Avandamet.

A settlement has been reached in a whistleblower class action lawsuit brought against Johnson & Johnson who is accused of promoting the following prescription drugs; Risperdal, Invega and Natrecor, for uses not approved as safe and effective by the Food and Drug Administration (FDA). Additionally they are accused of payment of kickbacks to physicians and to the nation’s largest long-term care pharmacy provider.

The settlement includes $1.72 billion in civil settlements with federal and state governments as well as $485 million in criminal fines and forfeited profits. Whistleblowers in three states will collect $167.7 million.

The government's criminal complaint over Risperdal charged that from 2002 to 2003, sales representatives of Johnson & Johnson subsidiary Janssen Pharmaceuticals promoted the antipsychotic to physicians and other prescribers who treated elderly dementia patients by urging them to use the drug to treat symptoms such as anxiety, agitation, depression, hostility and confusion despite the drug only being approved to treat schizophrenia at that time. Sales reps were allegedly offered incentives for off-label promotion of the drug.

The civil complaint alleges that between 1999 and 2005, Johnson & Johnson and Janssen promoted Risperdal and a similar drug, Invega, to control numerous behavioral problems in seniors, children and the mentally disabled .

A settlement has been reached in a whistleblower class action lawsuit brought against Extendicare Health Services Inc, and its subsidiary Progressive Step Corporation who are accused of billing government medical assistance programs for materially substandard and inadequate nursing home care provided to residents.  

The settlement details are as follows; the federal government will receive $32.3 million and the eight state Medicaid programs will receive $5.7 million. The settlement also resolves the cases filed by 2 whistleblowers who will recieve $1.8 million and $260,000 of the government’s settlement. 

Filed in April 2010, the originally filed whistleblower lawsuit alleged that Extendicare billed Medicare and Medicaid for medically unreasonable and unnecessary rehabilitation therapy services between 2007 and 2013, as well as providing poor care, which led to multiple reports of nursing home neglect, including falls, dehydration reports, malnutrition, and failure to provide adequate catheter care to residents.

A settlement has been reached in a whistleblower class action lawsuit brought against Novartis Pharmaceuticals Corp, who is accused of promoting Trileptal for uses not approved by the U.S. Food and Drug Administration, and for paying kickbacks to doctors to prescribe that drug and five others.

Novartis will pay $185 million in the criminal case and will pay $237.5 million to resolve allegations that it caused Medicare and other Federal programs to pay for Novartis drugs under fraudulent circumstance. The four whistleblower cases filed by former Novartis employees, resulted in sharing $25,675,035 of the Federal recovery.

The lawsuit was first filed against Novartis Pharmaceuticals Corp by a former sales representative in January 2011. According to the complaint, from January 2002 to November 2011, Novartis often paid doctors to speak about its drugs and programs that were supposed to have educational purposes, but which in reality were often social occasions or not held at all.