Medicare marketing fraud including medical device Medicare marketing fraud and drug company Medicare marketing fraud is increasing as medical device and pharmaceutical executives and representatives use fraudulent schemes and marketing techniques to manipulate doctors, surgeons, pharmacists, and other health care providers. These fraudulent marketing schemes are designed to increase the use of off label marketing of medications and the use or over use of unsafe medical devices and drugs to obtain Medicare payments.
If you are a medical doctor, physician, neurologist, health care administrator, pharmacist, nurse, or other medical provider and are aware of pharmaceutical representative Medicare marketing fraud or medical device Medicare marketing representative fraud, it is important that you step forward to blow the whistle on fraudulent off label Medicare drug marketing practices and fraudulent Medicare medical device marketing, feel free to contact Pharmaceutical Off Label Medicare Marketing Fraud Whistleblower Lawyer Jason Coomer via e-mail message or our submission form about a potential pharmaceutical Medicare marketing fraud whistleblower lawsuit, off label pharmaceutical Medicare marketing fraud Lawsuit, or other Medicare Marketing Fraud Whistleblower Qui Tam Lawsuit.
Pharmaceutical representatives, medical device marketing representatives, and marketing fraud are manipulating physicians to use more expensive and less safe drugs and medical devices. From providing false information to using young attractive and charismatic drug representatives and free gifts, drug companies and medical device companies are using advanced drug marketing schemes and techniques to push physicians to use new drugs and products to obtain as much Medicare money as possible. When these marketing techniques are used to push a dangerous drug or to push a drug or medical device for off-label purposes, it can be dangerous for the patient's health as well as can be the basis for a qui tam lawsuit or other lawsuit if the Medicare Marketing Fraud can be documented.
Free gifts, lunches, dinners, and drug samples from drug companies are common place in the World of the successful physician. Sales people and marketing representatives commonly seek to use free meals, drinks, marketing giveaways, and drug samples, to obtain the attention of a medical doctor and these free gifts can often influence a physician to use a new, more expensive, and less safe drug. A recent article, Prescribing Under the Influence By E. Haavi Morreim, thoughtfully discusses the potential influence direct or indirect that free meals and gifts from drug representatives and medical device representatives can have on physicians. These freebies combined with false marketing materials on a drug or medical device can often manipulate a medical doctor into prescribing drugs for off-label purposes, using an inferior or unsafe produce, or over prescribing a drug or medical device.
Another technique that drug companies use to push their new drugs and implants include hiring attractive and charismatic drug representatives to push physicians through an advanced script that falsely presents a new medication or medical device as better and more safe than it actually is. The drug representatives are usually highly articulate and are able to use the skewed research from the drug marketing departments combined with befriending or flirting with the physician to push the doctor to use their company's new product regardless of safety or expense.
These advanced fraudulent scripts are often presented as well accepted scientific research including cites or references from authentic sounding publications. They are also often well thought out by drug marketing executives and medical device marketing executives then given to and rehearsed by the attractive and charismatic drug representatives or medical device representative for the sole purpose of manipulating the medical doctor into prescribing more of the drug for off-label purposes or the medical device.
Through experience the drug marketing departments have also devised Medical Doctor Profiling schemes that they can use to determine what best motivates a particular physician and use this information combined with advanced marketing techniques to manipulate the physician without the medical doctor even realizing that they are being manipulated. These techniques include understanding that some medical doctors are research oriented while others are politically motivated, financially motivated, career motivated, or relationally motivated. By understanding a medical doctor's predispositions, interests, and motivations, a drug marketing department or medical device marketing department can use or manipulate a medical doctor based on their profiled information. Examples of these drug marketing department and medical device marketing department profiling and manipulations include
Research Motivated Medical Doctor - The Marketing Departments will often create research with skewed data from the drug company to push the research motivated physician that relies strongly on science and research to make their decisions. The marketing representatives will also often invite the research motivated physician to publish in selected publications or to speak at sponsored medical conferences.
Politically and Career Motivated Medical Doctor - Marketing Departments will often create professional and social events, activities, and opportunities to advance the physician's ability to expand their political activities and career.
Relationally Motivated Medical Doctor - Drug marketing departments will not only find marketing representatives that are attractive and charismatic, but will also find drug representative with similar interests as well as hire family members or friends of the relationally motivated physician.
The above techniques and many more are all methods that drug marketing departments and medical device marketing executives use to gain the attention of and influence on medical doctors. These marketing techniques combined with fraudulent marketing research and other fraudulent practices can often work to manipulate a medical doctor into prescribing drugs for off label purposes as well as using unsafe medical devices or over using medical devices.
Through Medicare Marketing Fraud Whistle Blower Lawsuits, Off Label Medicare Marketing Fraud Qui Tam Lawsuits, and other Medicare Health Care Fraud Lawsuits, hundreds of billions of dollars have been recovered from dishonest pharmaceutical companies, medical device companies, health insurance companies, health providers, individuals and organizations that have committed Medicare health care fraud and stolen large amounts of money from the government.
It is extremely important that Whistle Blowers continue to expose fraudulent marketing practices, billing practices and unnecessary treatments that cost hundreds of billions of dollars. Off Label Drug Marketing Fraud Lawyer Jason Coomer works on Off Label Pharmaceutical False Claims Act Lawsuits and commonly works with other Pharmaceutical Medicare Marketing Fraud Whistleblower Lawyers, Medicare Medical Product Marketing Fraud Qui Tam Whistleblower Lawyers, and Medicare Health Care Fraud Whistleblower Lawyers.
Health Care Expenses in the United States have increased to be over Two Trillion ($2,000,000,000,000.00) Dollars each year. This amount continues to rise as pharmaceutical companies have made large profits. One of the reasons that the pharmaceutical companies are making such large profits is that they have begun aggressive marketing campaigns that not only promote drugs for the medication's intended purpose, but aggressive push doctors to prescribe drugs for off label purposes.
From a taxpayer stand point, health care fraud costs taxpayers between $60 billion and $100 billion each year. This cost increases dramatically when you include other forms of health care fraud including insurance fraud and fraud on patients.
The Department of Justice has been cracking down on Fraud and False Claims including Medicare Fraud, Tricare Fraud, Nursing Home Fraud, Hospice Fraud, and other Health Care Fraud. Below is an update on recent Department of Justice recoveries.
Pfizer to pay record $2.3B penalty over promotions Repeat offender Pfizer paying record $2.3B settlement for illegal drug promotions By Devlin Barrett, Associated Press Writer On Wednesday September 2, 2009, 3:47 pm EDT
"WASHINGTON (AP) -- Federal prosecutors hit Pfizer Inc. with a record-breaking $2.3 billion in fines Wednesday and called the world's largest drug maker a repeating corporate cheat for illegal drug promotions that plied doctors with free golf, massages, and resort junkets."
Announcing the penalty as a warning to all drug manufacturers, Justice Department officials said the overall settlement is the largest ever paid by a drug company for alleged violations of federal drug rules, and the $1.2 billion criminal fine is the largest ever in any U.S. criminal case. The total includes $1 billion in civil penalties and a $100 million criminal forfeiture.
WASHINGTON – The United States secured $1.34 billion in settlements and judgments in the fiscal year ending Sept. 30, 2008, pursuing allegations of fraud against the federal government, the Justice Department announced today. This brings total recoveries since 1986, when Congress substantially strengthened the civil False Claims Act, to more than $21 billion.
"Now, more than ever, it is crucial that taxpayer dollars aren't lost to fraud," said Gregory G. Katsas, Assistant Attorney General for the Department’s Civil Division. "The billion dollars collected this year is only part of the story. By rooting out fraud and vigorously pursuing it, the Department, with the help of concerned citizens who report fraud in hotline calls and in qui tam complaints, undoubtedly saves the country many times that amount in aborted schemes and misconduct."
Assistant Attorney General Katsas also paid tribute to Senator Charles Grassley of Iowa and Representative Howard L. Berman of California who sponsored the 1986 amendments to the False Claims Act, the government's primary weapon to fight government fraud. "Without this important legislation strengthening the Act and, in particular, the qui tam provisions which encourage private citizens to uncover government fraud, such recoveries would not have been possible."
Almost 78 percent of this year’s recoveries are associated with suits initiated by private citizens (known as "relators") under the False Claims Act's qui tam provisions. These provisions authorize relators to file suit on behalf of the United States against those who have falsely or fraudulently claimed federal funds. Such cases run the gamut of federally funded programs from Medicare and Medicaid to defense procurement contracts, disaster assistance loans and agricultural subsidies. Persons who knowingly make false claims for federal funds are liable for three times the government’s loss plus a civil penalty of $5,500 to $11,000 for each claim.
Relators recover 15 to 25 percent of the proceeds of a successful suit if the United States intervenes in the qui tam action, and up to 30 percent if the government declines and the relator pursues the action alone. In fiscal year 2008, relators were awarded $198 million. (This figure does not include relator shares awarded after Sept. 30, 2008.)
As in the last several years, health care accounted for the lion's share of fraud settlements and judgments–$1.12 billion. This number includes both qui tam claims and those initiated by the United States. The Department of Health and Human Services reaped the biggest recoveries, largely attributable to its Medicare program and the federal/state Medicaid program which funds health care for the needy. Recoveries were also made by the Office of Personnel Management which administers the Federal Employees Health Benefits Program, the Department of Defense for its TRICARE insurance program, the Department of Veterans Affairs and others.
The largest health care recoveries came from pharmaceutical companies and related entities. Settlements with Cephalon Inc., Merck & Co. and CVS Caremark Corp. accounted for more than $640 million. In addition to federal recoveries, these pharmaceutical fraud cases returned $430 million to state Medicaid programs.
The Civil Division’s investigation of the pharmaceutical industry is part of a Department-wide effort. Typical allegations include "off-label" marketing, which is the illegal promotion of drugs or devices that are billed to Medicare and other federal health care programs, for uses that were neither found safe and effective by the Food and Drug Administration nor supported by the medical literature; paying kickbacks to physicians, wholesalers and pharmacies to induce drug or device purchases; establishing inflated drug prices knowing that federal health care programs use these prices to reimburse providers, then marketing the "spread" between the federal reimbursement and the provider’s lower cost to induce drug purchases; and knowingly failing to report the company’s true "best price" for a drug to reduce rebates owed to the Medicaid program.
Lilly Pharmaceuticals - $438 million under the False Claims Act In January of 2009, Eli Lilly agreed to pay a total of $1.4 billion to resolve Federal, state and criminal charges in relation to the off-label marketing of the drug Zyprexa. Of this sum, $438 million went to satisfy Federal False Claims Act charges, $361 million was divided among the states, and $515 million was paid as a criminal fine.
Taketa-Abbott Pharmaceutical Pharmaceutical Products Inc. -- $559,483,560 under the False Claims Act In October 2001, TAP Pharmaceutical Products Inc. agreed to pay $875 million to resolve criminal charges and civil liabilities in connection with fraudulent drug pricing and marketing of Lupron, a drug sold for the treatment of prostate cancer. Of this amount, $559,483,560 was recovered under the False Claims Act. In addition, TAP pled guilty to a conspiracy to violate the Prescription Drug Marketing Act and paid a $290 million criminal fine, the largest criminal fine ever in a health care fraud prosecution. Under the Lupron scheme, TAP gave doctors kickbacks by providing free samples with the knowledge that the physicians would bill Medicare and Medicaid $500 per dose. At the time the Lupron fraud was discovered, Lupron accounted for 10% of the money spent on prescription drugs under Medicare Part-A. As part of the settlement, TAP entered into what prosecutors called a "sweeping" corporate integrity agreement.
Schering Plough -- $255,000,000 under the False Claims Act In August of 2008, Schering-Plough agreed to pay a total of $435 million to resolve criminal charges and civil liabilities in connection with illegal sales and marketing programs for brain tumor medication Temodar, and Intron-A which is used in the treatment of bladder cancer and hepatitis C. The Schering settlement also covers best price violations related to Claritin RediTabs (an antihistamine), and K-Dur, which is used in the treatment of ulcers.
Serono-- $567,000,000 under the False Claims Act In October of 2005, Serono agreed to pay $704 million to settle a fraud case involving Serostim, a human growth hormone product used to fight AIDS-related wasting. The charges involved kickbacks to doctors for prescribing Serostim, kickbacks to specialist pharmacies for recommending Serostim, illegal off-label marketing of the drug, and non-FDA approved diagnosis equipment designed to spur more Serostim prescriptions. Serostim cost as much as $20,000 for a three-month regime. Of the total $704 million settlement, $567 million is earmarked to settle federal and state civil claims ($305 million federal), with $136.9 million paid as a related criminal fine.
If you are aware of a large health care company or individual that is defrauding the United States Government out of millions or billions of dollars, contact Health Care Fraud lawyer Jason Coomer. As a Texas Health Care Fraud Lawyer, he works with other powerful qui tam lawyers that handle large Health Care Government Fraud cases. He works with San Antonio Health Care Fraud Lawyers, Dallas Health Care Fraud Lawyers, Houston Medicare Fraud Lawyers, and other Texas Health Care Fraud Lawyers as well as with Health Care Fraud Lawyers throughout the nation to blow the whistle on fraud that hurts the United States.
If you are a pharmaceutical whistleblower that is aware of fraudulent off label drug marketing practices, drug price fixing, drug kickbacks, or other pharmaceutical fraud by a pharmaceutical marketing department, health care provider, or drug company, feel free to contact Pharmaceutical Off Label Drug Marketing Fraud Whistleblower Lawyer Jason Coomer via e-mail message or our submission form about a potential pharmaceutical whistleblower, off label pharmaceutical marketing fraud, or other pharmaceutical whistleblower qui tam lawsuit.
Pfizer has paid a total of $2.75 billion in off-label penalties since 2004 which is a little more than 1 percent of the companys revenue of $245 billion from 2004 to 2008.
JUSTICE DEPARTMENT ANNOUNCES LARGEST HEALTH CARE FRAUD SETTLEMENT IN ITS HISTORY
Pfizer To Pay $2.3 Billion For Fraudulent Marketing
WASHINGTON – American pharmaceutical giant Pfizer Inc. and its subsidiary Pharmacia & Upjohn Company Inc. (hereinafter together “Pfizer”) have agreed to pay $2.3 billion, the largest health care fraud settlement in the history of the Department of Justice, to resolve criminal and civil liability arising from the illegal promotion of certain pharmaceutical products, the Justice Department announced today.
Pharmacia & Upjohn Company has agreed to plead guilty to a felony violation of the Food, Drug and Cosmetic Act for misbranding Bextra with the intent to defraud or mislead. Bextra is an anti-inflammatory drug that Pfizer pulled from the market in 2005. Under the provisions of the Food, Drug and Cosmetic Act, a company must specify the intended uses of a product in its new drug application to FDA. Once approved, the drug may not be marketed or promoted for so-called “off-label” uses – i.e., any use not specified in an application and approved by FDA. Pfizer promoted the sale of Bextra for several uses and dosages that the FDA specifically declined to approve due to safety concerns. The company will pay a criminal fine of $1.195 billion, the largest criminal fine ever imposed in the United States for any matter. Pharmacia & Upjohn will also forfeit $105 million, for a total criminal resolution of $1.3 billion.
In addition, Pfizer has agreed to pay $1 billion to resolve allegations under the civil False Claims Act that the company illegally promoted four drugs – Bextra; Geodon, an anti-psychotic drug; Zyvox, an antibiotic; and Lyrica, an anti-epileptic drug – and caused false claims to be submitted to government health care programs for uses that were not medically accepted indications and therefore not covered by those programs. The civil settlement also resolves allegations that Pfizer paid kickbacks to health care providers to induce them to prescribe these, as well as other, drugs. The federal share of the civil settlement is $668,514,830 and the state Medicaid share of the civil settlement is $331,485,170. This is the largest civil fraud settlement in history against a pharmaceutical company.
Pfizer Broke the Law by Promoting Drugs for Unapproved
By David Evans
(excerpt from article)
Below is an excerpt from an excellent article written by David Evan on off-label marketing that provides a good explanation as to how and why pharmaceutical companies through their pharmaceutical sales representatives and marketing departments are pushing off-label drug uses for profits.
"Across the U.S., pharmaceutical companies have been pleading guilty to criminal charges or paying penalties in civil cases when the U.S. Department of Justice finds that they deceptively marketed drugs for unapproved uses, putting millions of people at risk of chest infections, heart attacks, suicidal impulses or death.
$7 Billion in Penalties
Since May 2004, Pfizer, Eli Lilly & Co., Bristol-Myers Squibb Co. and four other drug companies have paid a total of $7 billion in fines and penalties. Six of the companies admitted in court that they marketed medicines for unapproved uses.
In September 2007, New York-based Bristol-Myers paid $515 million -- without admitting or denying wrongdoing -- to federal and state governments in a civil lawsuit brought by the Justice Department. The six other companies pleaded guilty in criminal cases.
In January 2009, Indianapolis-based Lilly, the largest U.S. psychiatric drug maker, pleaded guilty and paid $1.42 billion in fines and penalties to settle charges that it had for at least four years illegally marketed Zyprexa, a drug approved for the treatment of schizophrenia, as a remedy for dementia in elderly patients. "
The pharmaceutical industry has been extremely successful in making large profits by marketing off-label uses of their drugs. Recently, drug representatives, marketing executives, and other whistleblowers have come forward to expose fraudulent practices ranging from fraudulent pricing issues to sales and aggressive marketing practices. Qui tam pharmaceutical fraud cases are expected to continue well into the future as the penalties for off-label marketing have not been enough to prevent big pharmaceutical companies from making large profits on fraud off-label marketing practices.
Health Care Expenses in the United States have increased to be over Two Trillion ($2,000,000,000,000.00) Dollars each year. This amount continues to rise as many unnecessary procedures and treatments are performed as well as unscrupulous health care provided fraudulently billing for medical services that are never performed committing billing fraud, insurance fraud, double billing, and other health care fraud that costs hundreds of billions of dollars.
From a taxpayer stand point, health care fraud costs taxpayers between $60 billion and $100 billion each year. This cost increases dramatically when you include other forms of health care fraud including insurance fraud and fraud on patients.
In 1972, the United States Congress passed the anti-kickback statute which made it illegal for providers, including doctors, to knowingly and willfully accept bribes or other forms of remuneration in return for generating Medicare, Medicaid or other federal healthcare program business. The federal anti-kickback law's main purpose was to protect patients and federal health care programs from fraud and abuse by curtailing the corrupting influence of money on health care decisions. The legislation prevents payoffs to those who have the power to influence health care decisions. This prohibition removes potential economic incentives that could influence health care providers to refer or recommend medical goods and services that are medically inappropriate, medically unnecessary, of poor quality, or even harmful to a vulnerable patient population. This legislation protects federal health care programs from difficult to detect kickback referrals and services as well as works with other laws to provide incentives for whistle blowers that are aware of medical providers that are wrongfully taking money to benefit from disclosing these unlawful kickbacks.
The Anti-Kickback statute prohibits any person or business entity from making or accepting payment to induce or reward any person for referring, recommending or arranging for the purchase of any item or service for which payment may be made under a federally-funded health care program. The statute prohibits kickbacks, bribes, inducements, rewards, and other economic incentives that induce physicians to refer patients for services or recommend purchase of medical supplies that will be reimbursable under government health care programs.
Health Care Provider claims for reimbursement to federal health care programs for services or medical supplies that are the result of bribes, kickbacks, or other economic incentives are false claims and are subject to potential Federal Health Care Program False Claim Lawsuits including Federal Anti-Kickback Statute Lawsuits, Federal Health Care Program Referral Claim Lawsuits, and Federal Health Care Program Medical Supply Bribery Claim Lawsuits.
Failure of a health care provider to comply with the Anti-Kickback Statute is a precondition to participation in federal health care programs and violations of the Anti-Kickback Statute can result in loss of funding, payments, and reimbursements from Medicare, Medicaid, and other Federal Health Care Programs.
For more on the Anti-Kickback Statute, please go to the following webpage, Whistleblower Anti-Kickback Statute Qui Tam Lawsuits.
Through Whistleblower Lawsuits, Qui Tam Lawsuits, and other Health Care Fraud Lawsuits, hundreds of billions of dollars have been recovered from individuals and organizations that have committed health care fraud and stolen large amounts of money from the government.
It is extremely important that Whistleblowers continue to expose fraud schemes, off-label marketing schemes, illegal kickbacks, fraudulent billing practices and unnecessary treatments that cost hundreds of billions of dollars. If you are aware of a large health care company or individual that is defrauding the United States Government out of millions or billions of dollars, feel free to contact Off-label Pharmaceutical Marketing Fraud lawyer Jason Coomer. As a Texas Medicare Fraud Lawyer, he works with other powerful qui tam lawyers that handle large Off-label Drug Marketing Fraud Whistleblower Qui Tam lawsuits. He works with San Antonio Qui Tam Pharmaceutical Marketing Fraud Lawyers, Dallas Qui Tam Lawyers, Houston Medicare Fraud Lawyers, and other Texas Health Care Fraud Lawyers as well as with Health Care Fraud Lawyers throughout the nation to blow the whistle on fraud that hurts the United States.
Through Whistle Blower Lawsuits, Qui Tam Lawsuits, and other Health Care Fraud Lawsuits, hundreds of billions of dollars have been recovered from dishonest pharmaceutical companies, health insurance companies, health providers, individuals and organizations that have committed health care fraud and stolen large amounts of money from the government.
It is extremely important that Whistle Blowers continue to expose fraudulent marketing practices, billing practices and unnecessary treatments that cost hundreds of billions of dollars. Off Label Drug Marketing Fraud Lawyer Jason Coomer works on Off Label Pharmaceutical False Claims Act Lawsuits and commonly works with other Pharmaceutical Whistleblower Lawyers, Qui Tam Whistleblower Lawyers, and Health Care Fraud Whistleblower Lawyers.
If you are a pharmaceutical whistleblower that is aware of fraudulent off label drug marketing practices by a pharmaceutical marketing department, feel free to contact Pharmaceutical Off Label Drug Marketing Fraud Whistleblower Lawyer Jason Coomer via e-mail message or our submission form about a potential pharmaceutical whistleblower, off label pharmaceutical marketing fraud, or other pharmaceutical whistleblower qui tam lawsuit.