In another huge win for courageous medical professionals who decide to come forward with valuable information of employer misconduct, two ophthalmologists in the Philadelphia area recently achieved victory in bringing a False Claims Act (FCA) claim through a $13 million settlement with Allergan, their former employer. The opthamologists’ claims related to widespread illegal kickbacks allegedly made by Allergan to doctors to induce them to prescribe drugs and thereby fraudulently win reimbursement from the federal government for their products. Typically, persons who bring FCA claims are personally entitled to between 15% and 30% of the final settlement recovered, meaning the ophthalmologists could each walk away with millions of dollars in whistleblower awards.
The Ophthalmologists’ Allegations Against Allergan
In their FCA lawsuit, the two former employees of Allergan laid out allegations showing how the company participated in a scheme to provide kickbacks to physicians who signed up for the “Allergan Access” program by prescribing Allergan’s eye-care products. While the doctors were not necessarily provided with cash kickbacks for signing up for the Allergan program, they were provided with free products, office supplies, and samples in exchange for directing patients to their products.
Although the company argued that these actions did not violate federal anti-kickback rules, the federal courts disagreed. Furthermore, as a result of Allergan’s actions, the ophthalmologists argued that the physicians and/or their employers who received these kickbacks thereby presented false claims for reimbursement to the federal government under federal healthcare programs as the claims were not necessarily in the interests of patients based on the fact that they were influenced by the physician’s bias.
The Long Road to Victory
Notably, the federal government did not elect to initially intervene in the action to support the ophthalmologists when it was filed in 2009. In many successful FCA cases, the federal government will join in the case to assist in prosecution, but this case stands as a powerful reminder that the failure of the government to do so will not prevent plaintiffs with valuable information regarding FCA misconduct to achieve victory and take home millions in whistleblower awards.
Pursuing Your Own False Claims Act Whistleblower Award
If you have information relating to Medicare and/or Medicaid fraud being carried out by your employer or another party, you too may be eligible for a significant FCA whistleblower award by bringing this information forward to the government. At Kreindler & Associates, we provide comprehensive guidance for potential whistleblowers throughout the entire process of bringing your claim forward. Our experienced healthcare fraud attorneys will work with you every step of the way to determine your appropriate course of action, protect you from retaliation, and collect your much-deserved reward. If you suspect that someone is committing Medicare or Medicaid fraud, contact us today for an evaluation of your allegations.
