Pharmaceutical whistleblower lawsuits have also been brought under the federal False Claims Act against pharmaceutical manufacturers and other companies who provide illegal kickbacks to doctors to induce the preferential prescribing of the manufacturer’s drugs. This also constitutes pharmaceutical fraud. The federal Anti-Kickback Statute prohibits offering to pay or paying any remuneration to any person to induce such person to purchase any good service, or item for which payment may be made in whole or in part under a Federal healthcare program. The federal Anti-Kickback Statute does not only prohibit direct bribes. Rather, the law also prohibits providing health care professionals with other direct and indirect forms of compensation. For example, providing doctors with fancy hotel stays and travel accommodations may violate the federal Anti-Kickback Statute and give rise to a claim under the False Claims Act.
Obviously, companies in the pharmaceutical industry are aware of the prohibitions of providing bribes to physicians to induce preferential prescribing of the manufacturer’s medication. As a result, whistleblowers have brought cases under the federal False Claims Act alleging pharmaceutical companies violated the federal Anti-Kickback Statute where the compensation provided to physicians was disguised to make it appear to be a proper payment.
In the past, whistleblowers have alleged that pharmaceutical manufacturers committed pharmaceutical fraud and violated the federal Anti-Kickback Statute (and therefore the federal False Claims Act) through the use of “speaker programs.” It is common for pharmaceutical manufacturers to have speaker programs. These programs are designed to inform other health care professionals about the pharmaceutical manufacturer’s drugs. The physician speakers are paid by the pharmaceutical company for speaking at these events. Some companies, however, have used their speaker programs to unlawfully induce the preferential prescribing of its medication. Basically, it has been alleged that pharmaceutical manufacturers paid physician speakers to preferentially prescribe its medications and used the speaker program to disguise these kickbacks. Paying doctors to prescribe their medication under the guise of speaker compensation is pharmaceutical fraud and violates the federal Anti-Kickback Statute and therefore the False Claims Act.
The use of copay coupons by federal health care beneficiaries is pharmaceutical fraud and is a violation of the federal Anti-Kickback Statute. Copay assistance coupons are used to assist patients paying for brand name drugs, which are significantly more expensive than generic drugs. The higher copay cost for brand name drugs may dissuade some patients from taking these drugs and may dissuade physicians from prescribing these expensive medication. For this reason, many pharmaceutical manufacturers of brand name drugs off copay assistance coupons to patients. However, the use of these coupons by federal health care beneficiaries is illegal and violates the federal Anti-Kickback Statute. The use of copay coupons by federal health care beneficiaries is pharmaceutical fraud and violates the federal Anti-Kickback Statute because those coupons are meant to induce patients to buy brand name drugs.
The use of copay coupons also costs federal health care programs millions of dollars. Patients with Medicare coverage only pay a small percentage of the actual costs of their medication. The remaining costs is paid by Medicare. If patients are encouraged by copay coupons to choose more expensive, brand name medications, instead of equally effective, generic medications, it is the federal government who pays more. This is so because the copay assistance coupons only lower the cost of the copay paid by the patient, not the cost of the brand name medication. Therefore, it is a violation of the federal Anti-Kickback Statute and False Claims Act to provide copay assistance coupons to Medicare patients because although the patient may pay less the government pays significantly more when a patient chooses brand name medication over generic drugs.
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Ross M. Wolfe and the Weiser Law Firm litigate whistleblower lawsuits on a contingent fee basis, so whistleblowers do not pay attorneys’ fees or court costs unless there is a recovery.
Please contact Ross M. Wolfe if you would like to speak with a whistleblower attorney for more information about the whistleblower process, pharmaceutical fraud, pharmaceutical kickback violations or to schedule a free consultation to discuss your potential case.