The Federal Government and Several States Including Texas Are Making Large Recoveries Through Medicaid Drug Marketing Fraud Whistleblower Lawsuits and Medicaid Drug Price Fraud Whistleblower Lawsuits by Medicaid Drug Marketing Fraud Whistleblower Lawyer, Medicaid Price Fraud Whistleblower Lawyer, Drug Formulary Fraud Lawyer, & Medicaid Drug Kickback Whistleblower Lawyer
In January 2012, the State of Texas and a Medicaid drug marketing fraud whistleblower squared off against Johnson and Johnson, Inc. and several related companies in Travis County District Court. In the case, the State of Texas alleged that the large drug company systematically targeted the Texas Medicaid System and fraudulently misrepresented their drug, Risperdal, with false and misleading marketing information. Further, that the defendants intentionally targeted opinion leaders in the medical community with financial incentives and misleading information in an effort to have the drug placed into treatment guidelines, model state treatment programs, formularies, Texas Vendor Drug Programs, and the Texas Medicaid preferred drug lists.
Attorneys for the State of Texas and Medicaid Marketing Fraud Whistleblower argued that they had reviewed millions of documents and could prove that the large drug company intentionally pushed Risperdal as a safer alternative to the typical medications despite rulings from the Food and Drug Administration that these assertions were not supported by scientific research. Further, that the defendants orchestrated a fraudulent marketing scheme to seed medical literature with misleading information and influence key medical decision makers to increase Risperdal in the Texas Medicaid Program as well as used this information to push their drug as the established treatment in state Medicaid programs throughout the United States as well as in the Federal Medicare program.
As a result of this Texas lawsuit, the drug maker, Johnson and Johnson, Inc., agreed to settle the Texas Medicaid fraud case for $158 million. Johnson and Johnson, Inc. has also agreed to a settlement where the drug company will will pay more than $1 billion in civil and criminal penalties to the federal government and individual states to settle an investigation into the marketing practices of its anti-psychotic drug Risperdal. Johnson and Johnson, Inc. has also been hit in Medicaid fraud cases in South Carolina and Louisiana and was ordered to pay more than $250 million each.
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In a recent Medicaid Drug Fraud Whistleblower lawsuit, the Texas Attorney General Office argued that Johnson and Johnson, Inc. fraudulently manipulated the Texas Medication Algorithm Project (TMAP) in order to establish their drug as the standard of care in the medical industry included getting the drug placed on Medicaid Preferred Drug Lists, Hospital Formularies, and other standards of care. TMAP is a decision-tree medical algorithm that was designed as a basis for psychiatric management guidelines for doctors treating certain mental disorders within Texas' publicly-funded mental health care system, along with manuals relating to each of them. By fraudulently manipulating the Texas Medication Algorithm Project, drug companies can push their drug as the established treatment and reap huge profits from state Medicaid programs, Medicare, and insurance policies.
These fraudulent Medicaid drug marketing schemes can be extremely hard to identify as the drug manufacturers typically have large and sophisticated marketing and research departments filled with public relations experts and backed by huge resources to use to push a drug. Through these experts and sophisticated marketing techniques, the drug manufacturers are able to seed medical research, manipulate decision makers, hire experts to support their research, and target government health care programs. These marketing schemes are designed to expand drug sales beyond FDA approved uses into off-label uses and to avoid scrutiny of independent research.
Further, these drug company marketing departments have also devised Physician and Medical Professional Profiling schemes that they can use to determine what best motivates a particular physician opinion leader and use this information combined with advanced marketing techniques to manipulate the well placed 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 company marketing department or medical device marketing department can use or manipulate a well placed medical doctor based on their profiled information and push opinion leaders in targeted medical communities and states to use a specific drug or medical device.
As such, physician Medicaid fraud whistleblowers, drug company Medicaid fraud whistleblowers, neurologist Medicaid fraud whistleblowers, health care administrator Medicaid fraud whistleblowers, pharmacist Medicaid whistleblowers, and other medical professional whistleblowers are needed to blow the whistle on Billions of dollars in Health Care Fraud.
Drug Company Influence on Standards of Care and Hospital Formularies Through Marketing Fraud, Fraudulent Research, and Manipulation
Many health care professions have become aware of the strong influence that drug companies now have in determining community standards of care for medication use in patients. These drug companies push drug samples into many hospitals and often use powerful forms of manipulation including biased research, influencing key medical doctors, and kickbacks to get their drugs placed on hospital formularies.
Because of the immense power and influence of drug companies, it is becoming common to have drug marketing executives and representative to be able to influence what drugs whole communities. In many situations the drug companies are more powerful than individual doctors that are forced to follow hospital formularies. This drug company manipulation of the medical community can be extremely dangerous because it takes important medical decisions out of the hands of individual medical doctors and allows the drug companies to push potentially dangerous drugs for off-label drug uses and in inappropriate situations.
The drug industry's main goal is to make a profit. Each drug company is trying to sell as much of their drug as they can regardless of the potential danger to patients or if there are cheaper more effective alternatives available. If the marketing executives and drug representatives can get their drug placed on a hospital formulary or make it the standard of care in a community, they are able to make lots of money. Once this is accomplished there are economic incentives to keep expanding the use of the drug to keep expanding off-label uses.
Recently several large drug companies have been caught fraudulently marketing drugs for off-label purposes. These drug companies have had to pay Billions of dollars for Medicare Marketing Fraud Off-Label Lawsuits, Medicaid Marketing Fraud Off-Label Lawsuits, and other health care fraud lawsuits. Despite these large fines, Drug Companies have continued this practice because they are making profits of Hundreds of Billions of Dollars.
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State Attorney General Offices are also targeting retail pharmacy chains that seek to manipulate drug prices to their advantage. These drug price Medicaid fraud whistleblower lawsuits include pharmacy chains that fail to perform required a drug utilization review and attempt to defraud government health care programs. Many of these State Attorney General Offices are working with drug price fraud whistleblower Ven-A-Care. This pharmacy drug price fraud whistleblower has been working on drug fraud cases since 1994 and has held state and federal governments recover more than $2 billion and has won roughly $380 million for itself in the process.
On February 1, 2011, a Travis County, Texas jury found that a global pharmaceutical manufacturer had misrepresented drug prices to the state's Medicaid program and said the drug company should pay the state and federal government $170.3 million. These Drug Price Medicaid Fraud Lawsuits are becoming more common as evidence is coming to light that the $700 Billion a year drug industry includes some large drug companies that are defrauding Medicaid, Medicare, the VA, Tricare, and other governmental benefit programs out of vasts amounts of money.
Several governmental officials have made it clear that those who defraud the Medicaid program, Medicare, the VA, Tricare, CHIP and other government benefit programs will be held accountable for their actions. Recent changes in the False Claims Act and other Qui Tam laws have created stronger protections and economic incentives for whistleblowers with knowledge of drug price fraud and other forms of Medicare Fraud and Medicaid Fraud. As such, it is important for drug price fraud whistleblowers, pharmaceutical representative whistleblowers, medical device sales representative whistleblowers, drug marketing representative whistleblowers, and other drug executive whistleblowers to blow the whistle on drug fraud pricing schemes.
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For more on this topic, please go to the following webpages:
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