5 ms·

The US also has Qui Tam lawsuits, meaning on behalf of the king, one of the more well known versions are whistleblower cases. Though the whistleblower only rec

The US also has Qui Tam lawsuits, meaning on behalf of the king, one of the more well known versions are whistleblower cases. Though the whistleblower only receives a rather small percent (10% is common, but varies), these lawsuits are some of the largest judgments in history, in particular as related to illegal kickbacks in the healthcare and pharmaceutical industries. The common facts are the business is engaging in illegal activities, the worker raises the issue to the employer and then as you might expect the employer instead of addressing the illegal activity instead retaliates against the employee (loss of hours, loss of wages, outright firings, etc...). https://en.m.wikipedia.org/wiki/Qui_tam https://en.m.wikipedia.org/wiki/Qui_tam Here's a list of some of the largest, $16.5B by Bank of America; $3B GlaxoSmithKline (illegal kickback); $2.2B Johnson&johnson (illegal kickback); pfizer $2.3B (illegal claims); Merck (illegal kickbacks); HCA has 2 of the top 10 totaling near $1.5B (illegal billing, up coding; illegal kickbacks); and on and on it goes https://www.google.com/amp/s/www.qui-tam-attorney.com/amp/10-largest-qui-tam-whistleblower-rewards.html https://www.google.com/amp/s/www.qui-tam-attorney.com/amp/10...

JetSpiegel 9y ago
Non-AMP second link: https://www.qui-tam-attorney.com/amp/10-largest-qui-tam-whistleblower-rewards.html https://www.qui-tam-attorney.com/amp/10-largest-qui-tam-whis...
- luciditywaver 9y ago
  Thank you!
lotsofpulp 9y ago
Can you believe the people of Florida rewarded the chief of HCA for defrauding the taxpayers of America, by electing him to be their governor!
- will_brown 9y ago
  I live in Florida, so I am all to familiar with the Lex Luther looking SOB. But it's fitting for a state that prescribes 10x more oxycodone pills than all other states combined and whose largest industry is Medicare fraud.
  - somecontext 9y ago
    For some context if anyone is curious: to my incredible surprise, the claims in this comment are not obviously made in exaggeration. In particular, many news articles quote the "10 times" claim, eg http://www.npr.org/2011/03/02/134143813/the-oxy-express-floridas-drug-abuse-epidemic http://www.npr.org/2011/03/02/134143813/the-oxy-express-flor... -- perhaps originating in a claim made by US Attorney Wifredo A. Ferrer: "According to recent estimates, Florida prescribes ten times more oxycodone pills than all other states combined." https://www.justice.gov/archive/usao/fls/PressReleases/2011/110708-01.html https://www.justice.gov/archive/usao/fls/PressReleases/2011/... The claim however does not seem to be true, even in 2010 before Florida took a variety of opioid-related actions. For example, California has approximately twice the population of Florida, but probably no(t much) less than half the oxycodone prescription rate. It was hard to find specific numbers, but for example it appears that at its worst (in 2010) some people claim Florida prescribed 650 million pills per year; at the same time, Pennsylvania definitely prescribed over 200 million pills per year. (Pennsylvania has approximately half the population of Florida.) The closest approximation to the claim that I can find that might have been true is "in 2010, Florida prescribed ten times fewer oxycodone pills than all other states combined". If the factor of ten is exact, then this would still imply that Florida's prescription rate is higher than the other states, as Florida has less than one-tenth of the population of the other states. In any case, it appears that Florida's prescription rate is now around or below the national average.
mirimir 9y ago
Yes. But generally, there must have been injury to the government.
- will_brown 9y ago
  The idea of government injury is often invisible. Here is a specific example, and likely 3 of the 6 examples I listed have above are similar factually (anti-kickback): 1. Russians began opening pharmacies in Russian neighborhoods throughout the UD (yes, Russian neighborhoods are a thing); 2. The pharmacies would deliver drugs to the medicare patients and in those deliveries included certain gifts anything from Russian newspapers, magazines, to sometimes Russian caviar; 3. As they do CVS identified the success and bought the network of pharmacies; 4. After the sale a lawsuit was brought, because a pharmacist at just one of these pharmacies mentioned that these additions to the drug deliveries violated anti-kickback laws and as a result the pharmacy took retaliatory action (I believe day shift to night shift and reduced hours) The US government would never have known if it weren't for the pharmacist, and it's the exact behavior prohibited by the Anti-kickback Statute, but I'd challenge you to articulate the injury to the government (in fairness I know you could, but I think you see the strong counter arguments).
  - mirimir 9y ago
    Sure. But the intention is to protect the Medicare and Medicaid programs. And hey, IANAL.
    - will_brown 9y ago
      Of course the intent of these laws are to protect Medicare, but you didn't articulate how Medicare was harmed in my real life example. Whether or not the Pharmacy put extra gifts in with the Rx delivery Medicare was not effected. Moreover, the gift has no bearing on Medicare, patients, physicians or reimbursements. To highlight the distinction, say a Dr. prescribed a drug to be filled at the pharmacy, and the patient never actually got it filled, but the pharmacy filed the claim for the Rx with Medicare anyway to get paid for the drug as if the patient had gotten it filled, the harm to the Government is obvious, they just paid a claim for a drug that was never actually dispensed. In fact, when that actually happens, the pharmacy usually double dips, and rips the label off the unfilled drug, sells it to another patient and still gets paid on the claim as if the original Medicare patient picked it up. Anyway sometimes the harm is obvious and sometimes its invisible, but it all illegal.

JetSpiegel 9y ago

Non-AMP second link: https://www.qui-tam-attorney.com/amp/10-largest-qui-tam-whistleblower-rewards.html https://www.qui-tam-attorney.com/amp/10-largest-qui-tam-whis...

luciditywaver 9y ago
Thank you!

lotsofpulp 9y ago

Can you believe the people of Florida rewarded the chief of HCA for defrauding the taxpayers of America, by electing him to be their governor!

will_brown 9y ago
I live in Florida, so I am all to familiar with the Lex Luther looking SOB. But it's fitting for a state that prescribes 10x more oxycodone pills than all other states combined and whose largest industry is Medicare fraud.
- somecontext 9y ago
  For some context if anyone is curious: to my incredible surprise, the claims in this comment are not obviously made in exaggeration. In particular, many news articles quote the "10 times" claim, eg http://www.npr.org/2011/03/02/134143813/the-oxy-express-floridas-drug-abuse-epidemic http://www.npr.org/2011/03/02/134143813/the-oxy-express-flor... -- perhaps originating in a claim made by US Attorney Wifredo A. Ferrer: "According to recent estimates, Florida prescribes ten times more oxycodone pills than all other states combined." https://www.justice.gov/archive/usao/fls/PressReleases/2011/110708-01.html https://www.justice.gov/archive/usao/fls/PressReleases/2011/... The claim however does not seem to be true, even in 2010 before Florida took a variety of opioid-related actions. For example, California has approximately twice the population of Florida, but probably no(t much) less than half the oxycodone prescription rate. It was hard to find specific numbers, but for example it appears that at its worst (in 2010) some people claim Florida prescribed 650 million pills per year; at the same time, Pennsylvania definitely prescribed over 200 million pills per year. (Pennsylvania has approximately half the population of Florida.) The closest approximation to the claim that I can find that might have been true is "in 2010, Florida prescribed ten times fewer oxycodone pills than all other states combined". If the factor of ten is exact, then this would still imply that Florida's prescription rate is higher than the other states, as Florida has less than one-tenth of the population of the other states. In any case, it appears that Florida's prescription rate is now around or below the national average.

mirimir 9y ago

Yes. But generally, there must have been injury to the government.

will_brown 9y ago
The idea of government injury is often invisible. Here is a specific example, and likely 3 of the 6 examples I listed have above are similar factually (anti-kickback): 1. Russians began opening pharmacies in Russian neighborhoods throughout the UD (yes, Russian neighborhoods are a thing); 2. The pharmacies would deliver drugs to the medicare patients and in those deliveries included certain gifts anything from Russian newspapers, magazines, to sometimes Russian caviar; 3. As they do CVS identified the success and bought the network of pharmacies; 4. After the sale a lawsuit was brought, because a pharmacist at just one of these pharmacies mentioned that these additions to the drug deliveries violated anti-kickback laws and as a result the pharmacy took retaliatory action (I believe day shift to night shift and reduced hours) The US government would never have known if it weren't for the pharmacist, and it's the exact behavior prohibited by the Anti-kickback Statute, but I'd challenge you to articulate the injury to the government (in fairness I know you could, but I think you see the strong counter arguments).
- mirimir 9y ago
  Sure. But the intention is to protect the Medicare and Medicaid programs. And hey, IANAL.
  - will_brown 9y ago
    Of course the intent of these laws are to protect Medicare, but you didn't articulate how Medicare was harmed in my real life example. Whether or not the Pharmacy put extra gifts in with the Rx delivery Medicare was not effected. Moreover, the gift has no bearing on Medicare, patients, physicians or reimbursements. To highlight the distinction, say a Dr. prescribed a drug to be filled at the pharmacy, and the patient never actually got it filled, but the pharmacy filed the claim for the Rx with Medicare anyway to get paid for the drug as if the patient had gotten it filled, the harm to the Government is obvious, they just paid a claim for a drug that was never actually dispensed. In fact, when that actually happens, the pharmacy usually double dips, and rips the label off the unfilled drug, sells it to another patient and still gets paid on the claim as if the original Medicare patient picked it up. Anyway sometimes the harm is obvious and sometimes its invisible, but it all illegal.