Young Law Group Beefs Up Initiative Prosecuting Alleged Pharmaceutical Industry Kickbacks and Fraudulent Medicare and Medicaid Billings Prior to Obama-care

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Young Law Group, P.C., a leader in whistleblower law and false claims litigation, is beefing up its focus on alleged pharmaceutical industry kickbacks and alleged fraudulent billings to Medicare and Medicaid by health care providers prior to Obama-care expansion. With implementation of expanded health care, it is crucial to address alleged fraud afflicting the nation’s health care system.

Medicare fraud is outrunning enforcement, a Center for Public Integrity study finds. “Federal agencies reported an estimated $115.3 billion in improper payments in fiscal year 2011, and more than half that figure was attributed to Medicare and Medicaid, according to the Government Accountability Office,” the Center for Public Integrity reported on July 1, 2013.

This YLG initiative also responds to Department of Justice achievements prosecuting false claims act violations in the pharmaceutical industry and other areas in the healthcare industry such as hospitals, physicians, pharmacies, long-term care facilities, and home health care.

In a news release on May 13, 2013, in one of the largest drug safety settlement to date with a generic drug manufacturer, the Department of Justice announced “that Ranbaxy USA Inc., a subsidiary of Indian generic pharmaceutical manufacturer Ranbaxy Laboratories Limited, pleaded guilty to felony charges relating to the manufacture and distribution of certain adulterated drugs made at two of Ranbaxy’s manufacturing facilities…and that Ranbaxy agreed to pay a criminal fine and forfeiture totaling $150 million and to settle civil claims under the False Claims Act and related State laws for $350 million” regarding government allegations that Ranbaxy fraudulently billed Medicare, Medicaid, and the Veterans Administration.

The massive settlement came about following whistleblower Dinesh Thakur’s unfailing efforts to alert first British and then American regulators of Ranbaxy’s alleged practices. When British regulators demurred on enforcement, Thakur approached the Food and Drug Administration, which took action resulting in the DOJ settlement and guilty plea. He receives $50M as part of the recovery under U.S. whistleblower law.

Ranbaxy settlement benefits are already flowing to states: New Jersey received $3.75M and Idaho is getting $400,000 according to a news report by northjersey.com on June 18, 2013. (northjersey.com/news/212029001_N_J__gets__3_75_million_in_drug_fraud_settlements.html)

In June, the Department of Justice announced litigation on behalf of the Food and Drug Administration in U.S. District Court for Western Louisiana (5:13-cv-1983) alleging that Sage Pharmaceuticals, Inc. allegedly violated federal law by manufacturing and distributing unapproved and misbranded pharmaceuticals.

“In many instances, these DOJ enforcement actions are yielding significant benefits for the public, notably recovery of more than $10.3 billion since January 2009 in cases involving fraud against federal health care programs thanks to whistleblowers,” Eric. L. Young said.

“A whistleblower like Dinesh Thakur deserves everyone’s thanks for alerting regulators to these alleged frauds,” Young continues. “It is particularly heartening that India is now putting whistleblower protections in place through the Securities and Exchange Board of India (Sebi). Indian pharmaceutical manufacturers produce ever increasing quantities of generic pharmaceuticals, which are and will be sold in America, and factories in Paonta Sahib, Batamandi, and Dewas, India have been among the most concerning for U.S. regulators.”

“U.S. Attorneys are also doing their part,” Young points out. U.S. Attorney Preet Bharara in the Southern District of New York filed suits in late April alleging that Swiss pharmaceutical manufacturer Novartis (ADR) engaged in multimillion dollar kickbacks to physicians from 2002 through 2011 inducing doctors to prescribe Novartis drugs that were paid for by Medicare and Medicaid, joining a False Claims Act qui tam lawsuit initially filed by Young Law Group, and a related complaint alleging kickbacks to twenty or more pharmacies in exchange for their switching transplant patients from competitor drugs to NOVARTIS’s drug, Myfortic.

As for billing Medicare and Medicaid for allegedly improper medical procedures, Barbara L. McQuade, U.S. Attorney for the Eastern District of Michigan, just announced a $4m settlement (case 0812339 settled July 10, 2013) in the U.S. District Court for the Eastern District of Michigan with Jackson Cardiology Associates and its owner, cardiologist Jashu Patel M.D., and Allegiance Health, a hospital, all located in Jackson, MI due to Dr. Julie A. Kovach’s whistleblower allegations that Dr. Patel and cardiologists at Jackson Cardiology Associates billed Medicare and Medicaid for allegedly inappropriate cardiac procedures.

“The complaint alleges that Dr. Patel and cardiologists employed by Jackson Cardiology Associates performed medically inappropriate cardiac procedures, including invasive catheterizations at Allegiance Health. Specifically, the evidence showed that Dr. Patel ordered catheterizations for patients based on findings from nuclear stress tests that he improperly read as positive. The government found that three-quarters of these patients had no significant heart blockages,” McQuade said in a press release (justice.gov/usao/mie/news/2013/2013_7_10_jpatel_HCF.html).

Dr. Kovach is entitled to a portion of the recovery.

Allegiance Health issued a statement saying it disagrees with the allegations and that it admits no wrongdoing. (prnewswire.com/news-releases/allegiance-health-reaches-agreement-on-allegations-by-department-of-justice-214992051.html)

The Department of Justice Complaint regarding Ranbaxy is Case 1:13-cr-00238-JFM, (justice.gov/iso/opa/resources/240201352412262032481.pdf)
The Justice Department settlement agreement is (justice.gov/opa/pr/2013/June/13-civ-695.html); attachments include (justice.gov/iso/opa/resources/5752013524122655233258.pdf), (justice.gov/iso/opa/resources/2932013524122712703563.pdf), and (justice.gov/iso/opa/resources/4692013524122723558271.pdf); U.S. Attorney Preet Bharara’s complaint regarding physicians is Case Number 11 Civ.0071 and his complaint regarding pharmacies is Case Number 11 Civ. 8196.

Young Law Group specializes in representing whistleblowers ("relators") throughout the United States and internationally in qui tam lawsuits brought under the False Claims Act. The False Claims Act allows private individuals to sue companies that are defrauding the federal government and to recover funds on the government's behalf.

Whistleblowers may be entitled to 15 percent to 30 percent of civil recoveries resulting
from a qui tam lawsuit.

Contact: Young Law Group by email by clicking on Mr. Young's name on the right or visit our website.

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Eric L. Young

James J. McEldrew, III
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