The pharmaceutical industry is worth $300 billion every year. Corporate giants profit through contracts with the Medicare and Medicaid Services (CMS), other government contracts and various private clinics, hospitals and doctors’ offices throughout the country. Various schemes tap into the high-profit sector to fraudulently make more money for pharmaceutical companies, clinics, doctors and patients. Whistleblowers are an important resource for putting an end to pharmaceutical fraud that increases the costs of health care and may put patients’ health in jeopardy.
Schneider Wallace Cottrell Konecky LLP is a renowned national litigation law firm that represents whistleblowers who report fraud and assist with law enforcement investigations. Our attorneys advocate for the rights of whistleblowers who are subjected to retaliation after reporting their employers’ misconduct. We also file qui tam lawsuits under the False Claims Act to stake a claim to money recovered by the CMS or other government agencies based upon the whistleblower’s information and cooperation.
Typical Drug Scams
The doctor or the patient may engage in a variety of drug scams, sometimes both working in concert to make money off of insurance companies or the CMS program. Common scams include:
- Off-label marketing. Although a drug may be prescribed for an off-label purpose, the medication may not be marketed for a purpose that was not approved by the FDA.
- Good manufacturing practice (GMP) violations. GMP violations may rise to the level of fraud when the manufacturer engages in deceptive practices to cut expenses, increase production and profits or avoid FDA regulations.
- Manufactured compound drugs. The FDA only permits compounding of drugs not available through regular manufacturers to meet specific medical needs. Compound pharmacists may be liable for presenting commercially available medication as having been specially formulated, rather than equaling the ingredients found in mass-produced medications.
- Kickbacks. Violations of bribery and anti-kickback statutes occur when a pharmaceutical company gives doctors cash or lavish gifts in return for prescribing certain medications.
- Illegal pricing of Medicare drugs. The CMS sets the lowest price available to all wholesalers, retailers, health care providers, HMOs, nonprofits and government agencies. Fraudulent pricing occurs when the doctor or clinic charges a higher premium than that set by Medicare.
- Pill mills. Pill mills describe clinics that distribute narcotics, usually for pain or anxiety, to patients who do not need the medication or whose identities have been stolen. The narcotics usually end up on the black market or are ingested by drug-addicted patients at the profit of the prescribing clinic and doctors.
Learn More About Pharmaceutical Fraud and Whistleblower Recovery
Consult with experienced attorneys about protecting whistleblower rights and recovering damages for retaliation for reporting pharmaceutical fraud and aiding in investigations of the perpetrator. Schneider Wallace maintains litigation law offices in regions throughout the country in California, Texas and Puerto Rico. We bring cases in nationwide jurisdictions and appear in state and federal administrative agencies and courts.