Health Care Fraud

Government spending on escalating healthcare costs has been on the rise over the last several years, costing taxpayers tens of billions of dollars each year. As this weight on taxpayers and the Government continues to grow, so too has the incentive to commit fraud, resulting in the improper expenditure of billions of dollars each year. The False Claims Act provides whistleblowers with knowledge of this fraud to bring an action on behalf of the government to recover government payments wrongfully withheld in violation of the False Claims Act.

In bringing actions for healthcare fraud under the False Claims Act, Stone & Magnanini has been involved in some of the largest healthcare fraud and pharmaceutical fraud cases in history, including numerous cases involving physician Medicare and Medicaid billing fraud and pharmaceutical fraud involving off-label marketing, kickbacks, Stark Act violations, best price violations and other types of fraud. Stone & Magnanini’s nationwide representation of whistleblowers has resulted in the recovery of hundreds of millions of dollars for the government as well as recoveries for the whistleblowers who exposed the fraud and assisted with the government in bringing a successful action under the False Claims Act.

Stone & Magnanini’s recent representation of whistleblowers includes:

  • McKesson Corporation ($190 million settlement): Stone & Magnanini’s representation of a whistleblower led to the settlement of claims by the federal government with McKesson Corporation based on Medicaid overpayments caused by the inflated valuations to First Data Bank, a drug prices publisher whose prices are used by state Medicaid programs to set payment rates for pharmaceutical companies, of a wide variety of brand name drugs. This improper conduct caused First Data Bank to publish inflated Average Wholesale Prices for those drugs. McKesson Corporation agreed to pay the Government $187 million to settle the civil False Claims Act claims against it.
  • Forest Pharmaceuticals ($313 million settlement): The qui tam whistleblower complaint filed on behalf the federal government against Forest Pharmaceuticals, a subsidiary of Forest Laboratories, Inc. arose from false claims submitted to federal health care programs for the antidepressant drugs Celexa and Lexapro, and Levothroid, a drug used to treat hypothyroidism. Among the claims, Forest promoted Celexa and Lexapro for unapproved pediatric use, causing substantial risks for the treatment of children and adolescents with depression. In total, Forest agreed to pay more than $313 million to resolve criminal and civil liability arising from these allegations.

To learn more about reporting Healthcare Fraud or to request a free, confidential case evaluation contact Stone & Magnanini’s Healthcare Fraud Team.