K&M Notable Qui Tam and Whistleblower Cases

Serving Clients Nationwide in Qui Tam Cases, Fraud and Whistleblower Law

The following are notable cases that Kenney & McCafferty have handled dealing with qui tam, fraud and whistleblower claims. Please contact Kenney & McCafferty today to discuss your own specific situation.

United States ex rel. Lisitza and Kammerer, et al. v. Johnson & Johnson, et al., Civ. No.: 07-10288, 05-11518 (D. Mass)

Johnson & Johnson (“J&J”), agreed to pay more than $2.2 billion in civil and criminal fines and penalties to settle allegations under the False Claims Act.  Of that amount, $149 million is designated to claims brought by whistleblower Bernard Lisitza, who was represented by Kenney & McCafferty, P.C. in conjunction with Michael Behn, Linda Wyetzner and William Thomas of Behn & Wyetzner.  Lisitza, a pharmacist and former employee of Omnicare, Inc., the nation’s largest long-term care pharmacy, alleged that from 1999 through 2004, J&J participated in a “kickbacks for switches” scheme wherein the company induced Omnicare’s consultant pharmacists to purchase, promote, and switch patients from physician approved medications to J&J drugs including, most notably, the potentially dangerous atypical antipsychotic drug Risperdal.   

The following documents may be read in their entirety:

United States ex rel. Thompson et al. v. Par Pharmaceuticals Company, Inc. et al., Civil Action No. CV-09-3526 (D. NJ)

Par Pharmaceuticals Company has agreed to pay $45 million in criminal and civil fines, penalties and damages to settle allegations that the company willfully defrauded Medicare, Medicaid, and other government funded health care programs connection with the launch of a long term care sales force to promote Megace ES for off-label uses, including weight loss in elderly patients.  Whistleblower Christine Thompson, who filed a qui tam action against Par arising from this marketing misconduct, is represented by Kenney & McCafferty. 

To read the complaint filed on behalf of Ms. Thompson, click here.

United States ex rel. Osiecki et al. v. Amgen, Inc., et al., Civil Action No. CV-05-5025 (EDNY)

Amgen, Inc. has agreed to pay $762 million in criminal and civil fines, penalties and damages to settle allegations that the company willfully defrauded Medicare, Medicaid, and other government funded health care programs in connection with its promotion of its multi-billion dollar drug Aranesp for off-label uses, including Anemia of Cancer, which endangered the lives of patients across the country, among other allegations.  Whistleblower Jill Osiecki, who filed a qui tam action against Amgen arising from this marketing misconduct more than eight years ago, is represented by Kenney & McCafferty.  To read more about the settlement, click here.

To read a statement by Ms. Osiecki, click here.

To read the complaint filed on behalf of Ms. Osiecki, click here.

To read the Settlement Agreement, click here.

United States ex rel. Thorpe, et al. v. GSK, et alDistrict of Massachusetts, Civ. No.: 11-10398

GlaxoSmithKline agreed to pay $3 Billion in criminal and civil fines, penalties and damages to settle allegations that the company defrauded Medicare, Medicaid and other government funded health care programs in connection with its market practices for Advair, Wellbutrin, Paxil, Lamictal, Zofran, Imitrex, Lotronex, Flovent and Valtrex and Avandia.  The settlement is the largest qui tam settlement in U.S. history.  The settlement is the largest qui tam settlement in U.S. history. 

Gregory Thorpe and Blair Hamrick, the first whistleblowers to file a qui tam action against GSK arising from this marketing misconduct nearly a decade ago, are represented by Kenney & McCafferty.  To read more about the settlement, click here.

To read the complaint filed on behalf of Thorpe and Hamrick, click here. Exhibits accompanying the complaint may be found here.  Additionally, Thorpe’s internal report to compliance executives at GSK may be found within the Exhibits at 0000015-0000027.

To read the Complaint-in-Intervention filed by the United States, click here

To read the Settlement Agreement, click here.

United States ex rel Steven Woodward et al. v. Eli Lilly & Co., Eastern District of Pennsylvania, Case No. 06-5526, 

United States ex. rel. Jaydeen Vicente et al. v. Eli Lilly & Co., Eastern District of Pennsylvania, Case No. 07-1791.

Eli Lilly agreed to pay more than $1.4 Billion in criminal and civil fines, penalties and damages arising from allegations made in multiple whistleblower lawsuits including the 2 above-referenced suits filed by KM. The qui tam suits alleged that the pharmaceutical giant defrauded Medicare, Medicaid, and other government-funded health care programs in connection with its marketing practices for it blockbuster atypical antipsychotic, Zyprexa. The settlement was the largest qui tam settlement in U.S. history. To read more about the Zyprexa case, click here.

United States ex rel Stefan Kruszewski, MD v. Pfizer, Inc., Eastern District of Pennsylvania, Case No. 07-cv-4106.

Pfizer, Inc. agreed to plead guilty to criminal conduct and to pay $2.3 billion in criminal and civil fines, penalties and damages to settle allegations made in multiple whistleblower lawsuits that the pharmaceutical giant defrauded Medicare, Medicaid and other government-funded health care programs in connection with its market practices for four of its drugs. The settlement is the largest qui tam settlement in U.S. history. As part of the record settlement, Pfizer agreed to pay $300 million to resolve allegations that it engaged in off-label marketing of its blockbuster atypical antipsychotic Geodon, which generated over $1 billion dollars in sales in 2008. The allegations were first made in a qui tam lawsuit filed by Brian Kenney and Tavy Deming on behalf of Harrisburg psychiatrist, Dr. Stefan Kruszewski.  To read more about the Pfizer settlement, click here.

United States. ex rel. Ronald Rainero v. Pfizer, Inc., District of Massachusetts, Case No. 07-CA-11728

Pfizer, Inc. agreed to plead guilty to criminal conduct and to pay $2.3 billion in criminal and civil fines, penalties and damages to settle allegations made in multiple whistleblower lawsuits that the pharmaceutical giant defrauded Medicare, Medicaid and other government-funded health care programs in connection with its market practices for four of its drugs. The settlement is the largest qui tam settlement in U.S. history. As part of the record settlement, Pfizer agreed to pay $100 million to resolve allegations that it improperly marketed its antibiotic Zyvox. That case was filed by Ronald Rainero, The allegations were first made in a qui tam lawsuit filed by Brian Kenney and the Sheller law firm on behalf of Ronald Rainero,  a former Pfizer sales manager from New Jersey. To read more about the Pfizer settlement,  United States ex. rel. Lucia Paccione v. Cephalon Inc., Eastern District of Pennsylvania, Case No. 036268.

KM's first filed qui tam complaint led to the federal and numerous state governments' recovery of $425 Million in a Civil Settlement and Criminal Fine, making it the largest recovery ever against a biotechnology company. The case involved unlawful off-label marketing by Cephalon of drugs including Gabitril, Actiq, and Provigil. Click here to read more about the Cephalon settlement.

United States ex rel Stefan Kruszewski, MD v. AstraZeneca Pharmaceuticals, LP., Eastern District of Pennsylvania, Case No. 06-4004.

On April 28, 2010, AstraZeneca agreed to pay $520 million in civil fines, penalties and damages to settle allegations that the company defrauded Medicare, Medicaid and other government-funded health care programs in connection with its marketing and promotional practices for the blockbuster atypical antipsychotic Seroquel. This is the largest settlement of off-label marketing claims brought under theFalse Claims Act to date that involved civil-only fines. The $520 million settlement resolves a qui tam lawsuit filed by whistleblower Dr. Stefan Kruszewski, one of two relators to file a case. Dr. Kruszewski was represented by Brian Kenney and Tavy Deming of the Kenney & McCafferty law firm.  To read more about the AstraZeneca settlement, click here.

U.S. ex rel. Lisitza and Kammerer v. Johnson & Johnson, U.S. District Court, District of Massachusetts, Case Nos.: 07-10288, 05-11518.

The nation’s largest nursing home pharmacy, Omnicare Inc. of Covington, Kentucky, paid $98 million, to settle Medicaid fraud charges by the United States and multiple states.  The settlement resolved allegations that the company solicited or paid a variety of kickbacks from Johnson & Johnson (J&J), in exchange for agreeing to recommend that physicians prescribe Risperdal, a J&J antipsychotic drug, to nursing home patients.  The lawsuit was filed under the False Claims Act by whistleblower Bernard Lisitza. Lisizita, a Chicago-area pharmacist, was represented by Michael Behn and Linda Wyetzner of Behn & Wyetzner, and Brian P. Kenney of Kenney & McCafferty, P.C.  To read more about the Omnicare settlement, click here.

United States ex rel Williams, et al. v. Renal Care Group, et al., Middle District of Tennessee, Case No. 3:09-00738.

On May 27, 2011 the United States District Court for the Middle District of Tennessee entered an order awarding $82.6 million to the Unbited States. In ruling for the government and KM clients Williams and Martinez, Judge Haynes stated that RCG and its parent company Fresensius Medical Care Holdings, Inc. "exhibited reckless disregrad of legal mandates" in their billing practices. The case alleges that RCG created a false billing system for its medical equipment.  To read more about the RCG judgment, click here.

U.S. ex rel. Lisitza and Kammerer v. Johnson & Johnson, U.S. District Court, District of Massachusetts, Case Nos.: 07-10288, 05-11518.

On February 25, 2011, U.S. District Judge Richard Stearns ruled that Johnson & Johnson, the world’s largest maker of health-care products, must defend a lawsuit by the United States Justice Department claiming the company illegally paid kickbacks to increase sales of its antipsychotic drug, Risperdal, to nursing home patients.  The Justice Department joined complaints under the False Claims Act filed by whistleblowers Bernard Lisitza and David Kammerer, who sued under the False Claims Act.  Lisizita, a Chicago-area pharmacist, is represented by Michael Behn and Linda Wyetzner of Behn & Wyetzner, and Brian P. Kenney of Kenney & McCafferty, P.C.  To read more on the ruling, click here.

United States ex rel. Laura Rupert & Robin Herzog v. CareSource Management Group, Co., et al., Southern District of Ohio, Case No. C2-06-961.

On January 31, 2011, CareSource agreed to pay $26 million to settle allegations the Dayton-based company defrauded Medicaid by submitting false data and receiving reimbursements from Medicaid for health care services it did not provide.  It was alleged that CareSource knowingly failed to provide screening, assessment, and case management for children with special health care needs and adults.  The $26 million settlement resolves a qui tam lawsuit filed by whistleblowers Laura Rupert and Robin Herzog.  Rupert and Herzog were represented by Brian Kenney and Pam Brecht of Kenney & McCafferty as well as Rick Morgan and Mary Jones of Morgan Verkamp in Cincinnati, Ohio.  To read more about the CareSource settlement, click here.

United States ex rel Kayla Thornton et al. v. Hewlett Packard Corporation et al., Northern District of Texas, Case No. 3:08-cv-1180.

On November 10, 2010, Hewlett-Packard Corporation agreed to pay $16.25 million to settle allegations made in multiple whistleblower lawsuits that the technology giant defrauded the Schools and Libraries Program of the Universal Service, also known as the “E-Rate Program.” The case which was filed as a qui tam action in 2005 by the Kenney & McCafferty law firm, resolves allegations that during the 2002-2005 time period Hewlett-Packard was involved in: (1) conspiring to rig the competitive bidding of E-Rate contracts; and (2) subverting the competitive bidding processes for E-Rate contracts by illegally providing gratuities, including meals, trips, and event tickets to school district representatives in Dallas and Houston, Texas in order to improperly influence the bidding process.To read more about the Hewlett-Packard settlement, click here.

United States ex rel Williams, et al. v. Renal Care Group, et al., Middle District of Tennessee, Case No. 3:09-00738.

On March 22, 2010 the United States District Court Judge William J. Haynes, Jr. issued an order awarding the United States $19,366,705 plus prejudgment interest on unjust enrichment claims against Renal Care Group (“RCG”), RCG Supply Company (“RCGSC”) and Fresenius Medical Care Holdings, Inc. as the successor-in-interest to RCG and RCGSC.  This award to the United States arises from claims made in a whistleblower complaint alleging fraudulent Medicare and Medicaid billing practices by RCG and RCGSC that violated the False Claims Act.  Philadelphia-area law firms Kenney & McCafferty and Egan Young filed the Complaint.  To read more about the RCG settlement, click here.

United Statesex rel Amanda Richards et al. v. Advanced Pain Centers, et al., Eastern District of Missouri., Case No. 04:08-cv-66.

On March 9, 2010, The U.S. attorney's office for the Eastern District of Missouri announced a civil settlement with Abdul Naushad, his wife, Wajiha Naushad, and the clinics, which do business as Advanced Pain Centers. The settlement also resolves claims against Naushad's billing company, Ultimate Practice Solutions, and its owner Azeem Meo, of Carmel, Ind. Federal attorneys alleged that the defendants submitted false claims to Medicare, Missouri Medicaid and TRICARE for spinal decompression services. The claims were for one-on-one physical therapy services.  To read more about the Advanced Pain Centers settlement, click here.

United States of America and the State of Texas ex rel. Kim Marlowe Porter et al. v. VPA, Inc. et al., Docket No. 2:05CV73823

United States ex rel. Wally S. Mahar, M.D., State of Michigan ex rel. Wally S. Mahar v. Visiting Physicians Associates, Civil Action No. 03-73158

Visiting Physicians Associates agreed to pay the United States $9.5 million to settle claims arising out of the above two suits for fraudulently billing Medicaid and Medicare for Home Health Care services.

United Statesv. E-Star, Inc., Case No. 07-156.

The United States recovered over $60 million dollars from an international conglomerate and its employees for an elaborate stock and tax fraud scheme involving the sale of stock on the Taiwanese stock exchange.

United States ex rel Kelly v. Biotrax Inc., Fresensius Medical Care AG, Eastern District of Pennsylvania, Case No.  96-1441.

Fresensius, an international medical services provider, pays an $18 million judgment to settle qui tam actions for numerous improper testing schemes relating to dialysis centers, echo cardiograms and other testing services.

United States ex rel Hendricks v. Northwestern Human Resources, Inc., Eastern District of Pennsylvania, Case No.  97-4203.

Pennsylvania's largest provider of social services pleas guilty to a federal felony and agrees to pay approximately $7.8 million dollar to settle criminal and civil actions judgment for failure to comply with state and federal medicare regulations relating to staffing, coding, billing, and cost report issues .

United States ex rel Weissman v. Mediq Imaging Services, Inc. et al, Eastern District of Pennsylvania, Case No.  95-238.

One of first anti-kickback case successfully prosecuted under the False Claims Act for a mobile imaging company paying kickbacks in return for ordering tests, results in approximate 4.5 million judgment.

United States ex rel Basore v. Plummer Precision Optics, et al, Eastern District of Pennsylvania, Case No.  97-2197.

Weapons manufacturer's failure to test, falsification of reports and falsification of custom's reports leads to approximate $3 million dollar judgment, sale of company, and debarment.

United States ex rel George Brouder v. Polaroid Corporation, District of Massachusetts, Case No.  CV 12427.

Polaroid agrees to pay $3.2 million for providing false bid data to the General Services Administration and TINA violations.

United States ex rel Folle v. Option Care et al, District of Nevada.

Option Care, a pharmacy chain, agrees to pay $1.4 million to settle claim that is defrauded Medicare/Medicaid in billings related to Synogis.

United States ex rel Lisa Fager v. Jackson County Ambulance Services, Southern District of Illinois, Case No.  4005.

Ambulance Company pays 1.4 million settlement as a result of fraudulent coding for services.

United States ex rel Moculzski v.Kidspeace Corporation, Eastern District of Pennsylvania, Case No.02-1846.

Kidspeace, a provider of social services agrees to pay $1.9 million to settle false claim action for failure to comply with state and federal regulations relating to staffing, coding and busing issues.

Feman v Fresensius Medical Care AG, District of New Jersey, Case No.98 - CV- 02292.

Former employee successfully sues for retaliation for investigating False Claim under subsection 3729(h) of the False Claims Act despite never having filed a False Claims action.

United States v Columbia University, Southern District of New York, Case No.486.

University settles claim for fraudulent coding for services by physicians in surgery department, wrongful termination case settled.

United States ex rel Nancy Bernard v Best Care Home Health Inc, District of Minnesota, Case No.99-1207.

Home health care agencies pay claims to settle fraudulent coding and staffing issues.

United States v Health Ventures, Inc., Eastern District of Pennsylvania , Case No.CV 3432.

National nursing home operator liable for million plus judgment as a result of qui tam relating to improper cost reports and improper coding.

United States ex rel Quaicoe v Center for Pain Management, Southern District of Texas, Case No.2000-238.

Pain management clinic sued for coding violations and not providing proper services.

United Statesex rel Denton v Health Ventures, Inc., Eastern District of Pennsylvania, Case No.CV 3432.

National nursing home operator liable for improper coding and staffing issues.

United States ex rel Hoffman v Kessler Hospital et al, District of New Jersey , CA No. 96 -1933.

Fraud related to improper coding and improper provision of lymphedema pumps and other services results in criminal prosecution and civil fines against medical doctor running the program.

United States ex rel Strelow v National Medical Care, Inc. et al, Eastern District of Pennsylvania, Case No. 96- 7423.

Improper coding and unbundling of CPT Codes leads to multi-million dollar settlement.

United States ex rel Speer v Princeton Biomedical Lab Inc et al, Eastern District of Pennsylvania, Case No.98 -CV- 2947.

Unbundling of CPT lab codes leads to judgment against and debarrment of provider.