Columbia, S.C. (PRWEB) November 01, 2012
Bert Louthian, a Columbia attorney who focuses on “whistleblower” lawsuits, said today that two multimillion-dollar settlements and an ongoing federal investigation against the drug store giant CVS illustrate the importance of private citizens’ coming forward to stop fraud.
“In addition to the fines that CVS Caremark Corp. will pay, the elimination of ongoing Medicare and Medicaid fraud will save untold millions of taxpayer dollars, all because concerned citizens stepped forward,” said Louthian of the Louthian Law Firm, P.A., in Columbia, S.C.
“We congratulate the U.S. attorneys and other federal investigators involved with these cases and, more importantly, the regular citizens who saw something wrong and decided not to shrug it off,” he said.
The U.S. Department of Justice (DOJ) announced on Oct. 15 that RxAmerica, a unit of CVS Caremark Corp., had agreed to pay $5.25 million to settle allegations that it reported false information on prescription drug prices to the Medicare program. RxAmerica made false submissions to the Centers for Medicare & Medicaid Services (CMS) regarding prices for certain generic prescription drugs available through Plan Finder, a web-based tool CMS offered, the DOJ said.
In April 2011, CVS Pharmacy Inc. agreed to pay the federal government and 10 states $17.5 million to resolve False Claims Act allegations, the DOJ said. The claim against CVS alleged that it submitted inflated prescription claims to the government by overbilling state Medicaid programs for prescription drugs dispensed to Medicaid beneficiaries who were also eligible for benefits under a primary third-party insurance plan (excluding Medicare as the primary payor).
CVS Caremark operates more than 7,000 CVS Pharmacy drug stores in 41 states -- including South Carolina -- and the District of Columbia.
The 2011 settlement grew from allegations brought to the government by a CVS pharmacist in St. Paul, Minn., in a whistleblower action filed under the qui tam, or whistleblower, provisions of the False Claims Act and state False Claims Act statutes, the DOJ says.
The Oct. 15 settlement is one of the first False Claims Act lawsuit settlements involving Medicare’s Prescription Drug Program, known as Part D, according to the DOJ. It resolves allegations made in two separate complaints against RxAmerica filed under the False Claims Act’s qui tam or whistleblower provisions, which permit a private individual to file suit for false claims to the United States and share in any recovery.
CVS does not admit guilt in either settlement.
Meanwhile, the DOJ is investigating claims that CVS Caremark wrongly refilled prescriptions through its ReadyFill program and billed insurers without the knowledge or the approval of its customers, the Los Angeles Times reported. The California Board of Pharmacy says it has received numerous complaints from individual Californians. The probe will consider allegations of Medicare fraud and whether CVS violated its 2011 settlement agreement with the DOJ.
Typically, False Claim Act lawsuits allege health care fraud (such as false Medicaid or Medicare claims), Social Security fraud or corporate fraud that involves overbilling the government or submitting false information to regulatory agencies.
“Since the False Claims Act was revised in 1986 to make it easier for citizens to file qui tam actions, the government has recovered about $6 billion, and the people who have acted as whistleblowers have earned about $1 billion in rewards,” Louthian said.
The Louthian Law Firm provides free, confidential assessments of claims for people who think a corporation, individual or health care provider is defrauding the government of money. “Anyone who has this kind of information about a fraud against our government should come forward,” Louthian said.
About The Louthian Law Firm
The Louthian Law Firm, P.A., of Columbia, S.C., has been obtaining fair compensation for personal injury victims since 1959. The firm was founded by Herbert Louthian, who has more than 50 years of trial experience and is licensed to practice in all courts in South Carolina. In addition to cases involving whistleblower claims, the Louthian Law Firm also handles cases involving nursing home abuse, personal injury cases involving medical malpractice; car, truck and motorcycle accidents; and other serious and catastrophic injuries throughout South Carolina. The firm’s office is located in the Marlboro Building, Suite 300, 1116 Blanding Street, Columbia, SC 29201 (local phone (803) 454-1200). For a free, confidential case evaluation, contact the firm by phone at (866) 410-5656 or through its online contact form.