Tuesday, April 27, 2010

AstraZeneca will pay $520 million in off-label marketing settlement

The U.S. Dept. of Justice announced that pharmaceutical company AstraZeneca will pay $520 million to settle allegations of off-label marketing.

Charges that the company illegally marketed the anti-psychotic drug Seroquel were originally raised in a lawsuit brought under the qui tam provisions of the False Claims Act.

The civil settlement resolves allegations that by marketing Seroquel for uses that had not been approved by the FDA, the company caused false claims for payment to be submitted to federal insurance programs. The federal government will receive $301,907,007 from the settlement, and the state Medicaid programs and the District of Columbia will share up to $218,092,993.

Monday, April 26, 2010

HHS OIG adds state Medicaid Fraud Control Unit information

The Inspector General for the Dept. of Health and Human Services has created a page on its website that collects information about state Medicaid Fraud Control Units (MFCUs).

State MFCUs investigate and prosecute fraud by Medicaid providers as well as patient abuse and neglect in "board and care" facilities that do not receive Medicaid funding. In certain circumstances they may also investigate program fraud involving Medicare or other Federal programs.

The OIG page provides links to a directory of MFCU contacts, annual reports, and state enforcement actions, as well as regulatory and policy information.

Former whistleblower special counsel will plead guilty to withholding evidence

The Washington Post reports that Scott J. Bloch, the Bush-era director of a federal office in charge of protecting government whistleblowers from unfair treatment, will plead guilty to withholding information from congressional investigators.

The United States Attorney's Office for the District of Columbia filed papers accusing Bloch of failing to truthfully answer questions about whether he arranged for private computer technicians to "scrub" his office computer and that of other political appointees. The Project on Government Oversight has posted a copy of that filing.

Monday, April 19, 2010

NY AG says Medicaid fraud unit recovered $283 million in 2009

New York Attorney General Andrew Cuomo announced that the state's Medicaid Fraud Control Unit (MFCU) recovered more that $283 million in 2009.

The unit also obtained 148 criminal convictions related to Medicaid fraud.

Cuomo's office submitted an annual report to the Secretary of the U.S. Department of Health and Human Services. It details the activities and successes of NY's MFCU.

The report highlights Operation Home Alone, an investigation of corruption in the home care industry; settlements with several pharmaceutical companies, including Eli Lilly, Pfizer, Mylan Pharmaceuticals, Astra Zeneca, and Aventis for off-label marketing, kickbacks, misreporting prices, and other fraud; nursing home fraud investigations; and other types of program fraud.

Tuesday, April 13, 2010

Maryland Governor signs False Claims Act

Governor Martin O’Malley has signed the Maryland False Health Claims Act, introduced as Senate Bill 279.

The Governor's press release says that the new legislation will allow Maryland to recover damages and penalties from individuals who defraud the state by filing false claims against state health plans and programs, including Medicaid. It is expected to recover millions of dollars by cracking down on waste, fraud and abuse in these public health programs.

The bill has an effective date of October 1, 2010.

Tuesday, April 06, 2010

SEC Inspector General recommends improvements to its whistleblower program

The Securities & Exchange Commission has had a bounty program for whistleblowers in place since 1989, but has made only five payments for a total of $159,537.

A report from the SEC's Inspector General says that "the current SEC bounty program is not fundamentally well-designed to be successful."

The report, Assessment of the SEC’s Bounty Program, recommends that the agency engage in outreach to publicize the program; develop criteria for the awarding of bounties; institute procedures for tracking whistleblower tips; and incorporate best practices from the Dept. of Justice and Internal Revenue Service whistleblower programs.

The bounty program is limited to insider trading cases. The SEC recently sent to Congress proposed legislation to expand the authority of the program to permit bounties for any judicial or
administrative action brought by the Commission under the securities laws that result in monetary sanctions exceeding $1,000,000.