Healthcare Fraud

Every year, state and local governments, corporations, unions, and other organizations that provide and pay for healthcare lose millions if not billions of dollars as a result of fraudulently inflated prescription drug and other health-related expenses. The risk to public and private payors of losing substantial sums of money as a result of healthcare fraud is real, and all entities that incur healthcare-related costs need to take an active role in protecting themselves.
 
In the healthcare industry, corporate misconduct takes myriad forms. Such risks include pharmaceutical manufacturers committing antitrust violations, improperly marketing their products, failing to disclose the risks associated with their products or manipulating their drug prices coupled with the difficulty of managing prescription drug benefit plans and relationships with pharmacy benefit managers and third party administrators. 
 
Kirby McInerney provides the experience and dedication that our clients need to actively protect their interests this arena.  By taking legal action against corporations that attempt to profit at the expense of payors by engaging in illegal market manipulation, we help our clients to effectively ameliorate the financial risks posed to them by the possibility of healthcare fraud.
 
Examples of KM’s experience in healthcare fraud litigation include:
 

• In re Pharmaceutical Industry Average Wholesale Price Litigation, MDL No. 1456 (D. Mass.); City of New York, et al. v. Abbott Laboratories, et al., No. 01-cv-12257 (D. Mass).  Representation of the State of Iowa, the City of New York, and 43 New York State counties in a lawsuit against forty defendant drug manufacturers asserting that they manipulated their average wholesale price data to inflate prices charged to government drug benefits payors.  The case resulted in a recovery of over $225 million for the New York and Iowa Medicaid programs.

 

• In re Effexor Antitrust Litigation, No. 11-cv-05661 (D. N.J.).  Court-appointed Discovery Committee Co-Chair for a putative class of direct purchasers of brand name and generic equivalents of extended release venlafaxine hydrochloride capsules against drug manufacturers.  Among the claims, Defendants are alleged to have delayed market entry of generic versions and entered into reverse payment settlements.  This case is ongoing.

 

• Schuette, Attorney General of the State of Michigan, ex rel. The State of Michigan v. McKesson Corporation, et al., No. 11-629-CZ (Ingham Cty. Cir. Ct.).  Representation of the State of Michigan in a lawsuit filed in Michigan State Court against McKesson Corporation, Hearst Corporation, and First DataBank asserting that defendants fraudulently schemed to increase the average wholesale prices of hundreds of brand name drugs thereby causing false claims to be submitted to the Michigan Medicaid program.  McKesson paid approximately $155 million to settle claims by Michigan and a number of other states.

 

• In re Prograf Antitrust Litigation, No. 11-md-02242 (D. Mass.).  Representation of a class of direct purchasers of Prograf in an antitrust action against Astellas Pharma US.  Prograf is a branded prescription immunosuppressant used in organ transplant patients.  The case alleged that the defendant filed a baseless citizen petition with the FDA, with the sole intent of foreclosing market entry by generic competitors, which improperly extended its monopoly and kept Prograf prices at supra-competitive levels.  The case resulted in a recovery of $98 million.

 

• City of New York v. The Purdue Pharma Company, et al., No. 04-cv-03499 (S.D.N.Y.).  Representation of the City of New York against Purdue Pharma for federal and state antitrust violations, state Medicaid fraud, and other state statutory and common law claims arising out of Purdue Pharma’s alleged filing of fraudulent patents with the U.S. Patent & Trademark Office in respect of their blockbuster painkiller drug, OxyContin (oxycodone-cr). The case alleged that Purdue Pharma engaged in this fraud to create and maintain an unlawful monopoly for oxycondone-cr and to impose monopoly prices.  The case resulted in a recovery of over $1 million for the City Medicaid Program.

 

• City of New York v. Glaxosmithkline Plc, et al., No. 04-cv-02134 (E.D. Pa.).  Representation of the City of New York against GlaxoSmithKline to recover overcharges incurred in connection with the City's purchases for Paxil.  The case alleged violations of the Federal and State antitrust laws and fraudulent and deceptive conduct before the U.S. Patent Trademark Office and the United States Food and Drug Administration.  The case resulted in a recovery of over $1 million for the City Medicaid Program.