Pharmaceutical fraud against the government raises healthcare costs for all. Help stop scams that hurt vulnerable patients!
I suspect pharmaceutical fraud – Let’s chat
If you suspect a pharmaceutical company is cheating Medicare, Medicaid, or another government program, you have the power to try to do something about it. These corporations generally make billions, and when they defraud the government, they are stealing from American taxpayers. It takes courage to stand against such powerful entities, but you don’t have to do it alone.
The team of pharmaceutical fraud attorneys at Carolina Whistleblower Attorneys is here to help you navigate this complex process. We provide free, 100% confidential case evaluations for people who have evidence of or simply suspect wrongdoing and want to understand their options.
You may have the key to stop a multi-million-dollar pharmaceutical fraud scheme. Our team, led by a former U.S. Attorney, has the experience to guide you, the resources to help protect you, and the dedication to fight for what’s right. Let’s talk.
When taking on a multi-billion-dollar pharmaceutical company, you want a legal team with a combination of inside knowledge, immense resources, and unwavering dedication. We can provide exactly that.
When you work with our team, you get skilled whistleblower counsel with the strength to stand with you.
The U.S. government relies on brave individuals with inside knowledge to uncover and stop pharmaceutical fraud against the government. Complex schemes involving kickbacks, off-label marketing, and pricing manipulation are often hidden deep within a company’s operations, invisible to outside auditors. Whistleblowers are some of the government’s most effective weapons in this fight.
In one year, whistleblower lawsuits involving fraud against the government in the healthcare industry resulted in over $1.67 billion in recoveries for the government.3 A significant portion of that fraud was committed by the pharmaceutical industry. When these companies put profits ahead of patients and taxpayers, the consequences are severe:
By coming forward, you can potentially protect patients, hold powerful corporations accountable, recover billions in stolen taxpayer funds – and possibly receive a substantial reward.
The primary legal tool you and your attorneys may use is the federal False Claims Act (FCA). Originally signed into law by President Abraham Lincoln in 1863, the FCA — or “Lincoln Law” — was created to combat fraud by contractors who sold the Union Army faulty cannons, sick mules, and rancid rations during the Civil War.
Today, its purpose remains the same: to provide the government with a way to recover federal funds stolen through fraud. The FCA’s most powerful feature is its qui tam provision. This unique aspect of the law allows a private citizen with knowledge of fraud against the government to file a lawsuit on the government’s behalf.
This private citizen is known as the “relator” — or whistleblower. In a qui tam lawsuit, the relator is represented by their own private attorney and can work in partnership with the government to try to expose the fraud.
If the lawsuit is successful and the government recovers money, the FCA mandates that the relator receive a significant portion of the recovery as a reward. This reward recognizes the professional and personal risks a whistleblower takes to expose the truth.
Pharmaceutical fraud is sophisticated and can take many forms. Our attorneys have seen a wide variety of schemes designed to improperly funnel government money into corporate pockets. If you have witnessed or suspect any of the following activities, you may have a qui tam case.
This is one of the most common forms of pharmaceutical fraud. A kickback is anything of value given to a doctor, hospital, or pharmacy to induce them to prescribe or recommend a specific drug that is paid for by a government healthcare program like Medicare or Medicaid. These schemes corrupt medical judgment. Examples can include:
The U.S. Food and Drug Administration (FDA) approves drugs for specific uses, in specific patient populations, and at specific dosages. When a pharmaceutical company promotes its drug for any unapproved use, it is engaging in “off-label marketing.” This is generally illegal and dangerous because the drug’s safety and efficacy have not been established for that use.
When government programs pay for these off-label prescriptions, it likely becomes a violation of the False Claims Act. Possible examples include:
Federal programs like Medicaid are legally entitled to the “best price” that a drug manufacturer offers to any of its commercial customers. Companies sometimes devise complex schemes to hide the true “best price” from the government to avoid paying the substantial rebates they owe. This can involve:
The integrity of the FDA approval process depends on honest and accurate data from clinical trials. When a company falsifies this data to get a drug approved, it can lead to massive fraud down the line. If a drug is approved based on fraudulent science, every subsequent prescription paid for by Medicare or Medicaid can be considered a false claim. This includes:
You do not need to be a CEO or a high-level executive to be a whistleblower. The FCA allows anyone with non-public knowledge of fraud to file a qui tam lawsuit. Many of the most successful cases are brought by everyday employees who see wrongdoing and choose to act.
The key is that you have credible, specific information that is not already in the public domain. Suspicions are a starting point, and a strong case can then be built on any evidence like emails, internal reports, billing data, or insider testimony.
The False Claims Act was designed with the understanding that blowing the whistle takes courage and whistleblowers should be protected. That’s why the law includes two powerful incentives: the promise of a substantial potential reward and robust anti-retaliation protections.
If your qui tam case is successful, you are generally entitled to a share of the government’s recovery.
Given that pharmaceutical fraud cases often involve hundreds of millions or even billions of dollars, these rewards can be life-changing. Importantly, they are a testament to the value the government places on the information and courage you can provide.
Many potential whistleblowers are afraid of losing their jobs or facing other forms of punishment from their employers. The FCA explicitly forbids this. Section 3730(h) of the Act makes it illegal for an employer to fire, demote, suspend, threaten, harass, or in any other way discriminate against an employee for lawfully reporting fraud.
If an employer violates this provision, the whistleblower is entitled to seek relief, which can include:
These protections are a powerful shield, and you want an experienced legal team advising you from the very beginning on how to use them.
The False Claims Act has been a powerful weapon in the government’s arsenal for combating fraud in the pharmaceutical industry and imposing fines for misconduct. Our lead whistleblower attorney, Bill Nettles, served as the U.S. Attorney for the District of South Carolina, and his office resolved several large pharmaceutical fraud cases:1,4
A whistleblower alleged that Amgen, a California-based company that develops, manufactures, and sells pharmaceutical products, illegally paid kickbacks to long-term pharmacy providers Omnicare, Inc., PharMerica Corporation, and Kindred Healthcare, Inc. for implementing programs designed to switch Medicare and Medicaid beneficiaries from a competitor drug to a drug that it manufactured, Aransep. Amgen resolved the False Claims Act violation allegations by paying the government a $24.9 million settlement.1,4
“By this agreement, we are making important strides in holding drug manufacturers accountable for fraudulent and abusive practices not only in South Carolina but nationwide,” said Bill Nettles, U.S. Attorney for the District of South Carolina at the time of the settlement.
To resolve its part in the alleged scheme of illegally promoting Aransep, long-term care pharmacy PharMerica paid a $2.5 million settlement.1,4
“Public health insurance programs shouldn’t foot the bill for drug company schemes that manipulate doctors and patients to maximize profits,” said (then) South Carolina U.S. Attorney Bill Nettles. “This case is an excellent example of how the government can work together with private whistleblowers to recover money for taxpayers.”
Another long-term care pharmacy, Omnicare, paid the government $4.19 million to resolve FCA allegations of soliciting and receiving kickbacks associated with the Amgen drug Aransep. The whistleblower received $397,925 for bringing the case forward.1,4
“The District of South Carolina has devoted significant resources over the last three years to pursuing claims under the False Claims Act, and this settlement is the latest example of this office’s successful efforts,” said U.S. Attorney for the District of South Carolina at the time, Bill Nettles.
If you are considering blowing the whistle, the steps you take next are critical.
If you think you have seen something wrong that is costing taxpayers and potentially harming patients, you have the power to try to stop it. The journey of a whistleblower begins with a single, confidential conversation.
Contact Carolina Whistleblower Attorneys today for a free, completely confidential case evaluation. Let our experienced team help you explore your options and protect your rights. Contact us today at 1-888-292-8852 or through our online form to tell us your story.
“Bill has the ability to ‘think outside the box’…which makes him extremely effective as an advocate for his clients.” 1 — Attorney who previously worked with Bill
If you’re wondering if it’s a good idea to speak with a whistleblower lawyer about what you know, let us set the record straight.
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