The opioid crisis continues to make headlines – and government officials continue to take note. In late February, Attorney General Jeff Sessions announced that the federal government is stepping up its efforts to attack the opioid epidemic through the Department of Justice Prescription Interdiction and Litigation Task Force. The unit will use both civil and criminal legal mechanisms to gain better control over opioid prescription abuse.
The False Claims Act is one resource to fight the crisis
Among the many tools that will be involved in the new effort is the False Claims Act. Whistleblowers who have information about prescription fraud and pharmaceutical fraud will continue to play an important role in combating the opioid problem in America.
We recently reported a story about a whistleblower claim involving an alleged pill mill in chiropractic clinics. The task force will look closely at physicians who prescribe opioids, pain management clinics and drug testing facilities for potential health care fraud. Common issues in these types of claims include “upcoding,” unlawful referrals, and other violations of the Anti-kickback Statute to increase profits.
However, the opioid problem is not necessarily confined to laboratories, pharmacies, hospitals and physicians. Whistleblowers often bring forward evidence of fraud involving drug companies. Pharmaceutical fraud may involve a wide range of issues, including:
- Unlawful kickbacks for purchasing specific drugs from a manufacturer
- Drug companies encouraging sales through off-label marketing programs
- Misreporting the cost of drugs to drive higher reimbursement from Medicare, Medicaid or Tricare
- Using deceptive accounting principles in pricing
Whistleblowers can initiate a lawsuit on behalf of the government
Private individuals who have information about fraud in any government contract may file a lawsuit. Whistleblowers are entitled to share in a percentage of any settlement or verdict. Often, the process is generated to stop the fraud as the motivating factor. Opioids are frequently the subject of drug overdoses in Wisconsin. Nationwide, 180 people die every day from an overdose. It has become the number one cause of death for Americans under the age of 50.