Pharmaceutical fraud comes in many different forms with the same intention, generating massive profits.  It occurs when companies deceive patients, insurers, or the healthcare system that include kickbacks, off-label marketing, billing fraud, trafficking counterfeit medicines, drug switching, misbranding, making false claims, clinical trials manipulating, compounding drug fraud, and much more.

Whistleblowing Under False Claims Act (Qui Tam) – Insiders/Whistleblowers generally take action to expose their company’s wrongdoing and holding perpetrators accountable for their unethical behavior and safeguarding patients and the healthcare system from harm under the False Claims Act (FCA).  Filing a FCA lawsuit against a pharmaceutical company can be a long and complex process, and to do so, will require an attorney.

We provide invaluable guidance to FCA counsels throughout the process, from initial case evaluation to settlement.  The qui tam provision of the FCA provides mandatory awards to whistleblowers who successfully bring suits against pharmaceutical fraudsters on behalf of the government.  The award percentage ranges between 15% to 30%, depending on many different factors.

The Department of Justice intervenes in approximately 18 to 22% of qui tam cases filed. Key factors influencing success are the following:

• Government Intervention – A successful result is more likely when the government joins the case.
• Significance of Information – The significance of the information provided by the whistleblower, the contribution of the person bringing the action, and whether the information was previously known to the government are all factors that influence the outcome.
• Prompt Reporting – Prompt reporting of the fraud is crucial because of statute of limitations.  The FCA statute of limitations is 6 years of the false claim or 3 years after the government because aware of the fraud.  Generally, the government will not intervene in any case that is beyond 10 years of a false claim.