pharmaceutical fraud in a qui tam world patrick j. o’connell chief, civil medicaid fraud office of...
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Pharmaceutical Pharmaceutical Fraud Fraud
in a Qui Tam World in a Qui Tam World
Patrick J. OPatrick J. O’’ConnellConnell
Chief, Civil Medicaid Fraud Chief, Civil Medicaid Fraud Office of the Attorney General Office of the Attorney General
How to Get A Million Dollars and Never Pay Taxes!
• 1. First, Get a Million Dollars
• 2. When the IRS asks why you did not pay your taxes, you say: “I forgot”.
Get Yourself a Case
• 1. MFCU
• 2. Qui tam statute
• 3. Types of pharma cases:• Pricing or “AWP”• Rebate• Off Label Marketing• PBM• Misrepresentation of efficacy or side effects
Chapter 36, Texas Human Resources Code
-Automatic Trebles -Fees and Costs
-Penalties from $1,000-$10,000 Per unlawful act
-Automatic exclusion from program for minimum of 10 years
Get Some Lawyers
• In-house Lawyers and Staff
• Relator Lawyers and Staff
• Outside Lawyers and Staff
• Coordination with Other States Through NAMFCU
Get Some Money
• Experts
• Travel
• Videographers
• Court Reporters
State of Texas ex rel Ven-a-Care of the Florida Keys vs. Dey, Warrick &
Roxane• Filed Sept. 2000• Lawyers for Good Guys: 6• Lawyers for Bad Guys: 10+• > 130 Depositions• > 1,000,000 pages of documents• Travel to California, Tennessee, Ohio, New York, New
Jersey, Connecticut, Alabama• Sanctions against each company for discovery abuse• Largest sanction ever awarded in Travis County for
perjury in civil matter• Finally settled Nov. 2005• Recovery of $55.6 million, including $12.7 million in fees
and costs
State of Texas vs. Abbott Labs, Baxter & B. Braun
• Filed May, 2004• Settled with Baxter and B. Braun for $12.3
million• Texas Lawyers: 3• Relator Lawyers: 3• Abbott Lawyers: 15+• Current Fees and Costs: $5 million +• Mandamus to Ct. App. twice• Mandamus to Tex. Supreme Ct. twice• Removed and Remanded
Results
Results
• Since 1999, recoveries of $217 million
• Texas recoveries of $127 million– Federal: $58 million– State: $50 million– Relator: $19 million
Be Careful What You Wish For!
• Current Caseload: 175
• Current Unsealed Cases: 4
• Current Lawyer Staffing: 10
• Requested Staff Increase Approved By Legislature: 27
• Requested Appropriation Approved for Biennium: $10.5 Million