Consumer Fraud

Small Key West pharmacy exposes billions in health care fraud

osha whistle Small Key West pharmacy exposes billions in health care fraud  A small pharmacy in the Florida Keys earned the distinction of being the top whistleblower in the country for its role in exposing prescription drug fraud that costs state and federal governments billions of dollars in taxpayer funds.

According to a report published by the National Law Journal, a small Key West pharmacy named Ven-A-Care has reported several fraudulent overcharging practices that resulted in state and federal governments recovering more than $2.5 billion from pharmaceutical companies.

According to the consumer watchdog group Public Citizen, Ven-A-Care blew the whistle on Boehringer Ingelheim when it found the company overcharging government health care programs for a number of drugs. The litigation led to a 2010 settlement in which the federal government recovered $280 million. That same year, Ven-A-Care tips led to the government collecting another $280 million from Mylan for overcharging government programs for Albuterol and a number of other drugs.

All in all, Ven-A-Care has helped government programs recover more than $2.5 billion from 2001 to 2011, according to a study report published by the National Law Journal, and the small Key West pharmacy is poised to collect even more in coming years. According to Public Citizens, nearly half of all whistleblower settlements worth $1 million or more from November 2, 2010 to July 18, 2012 were brought about by Ven-A-Care.

The National Law Journal estimates that Ven-A-Care’s whistleblower suits have earned the company and its lawyers $340 million.

Four partners opened the pharmacy in 1987, specializing in the intravenous delivery of drugs to AIDS patients. Ven-A-Care’s founders filed their first false claims lawsuit in the early 1990s after discovering drug pricing irregularities. That suit was settled in 2000.

Whistleblowers have become one of the federal government’s most valuable tools in its ongoing efforts to crack down on corporate wrongdoing and recover money lost to overbilling and other fraudulent activities. Whistleblowers who provide information that proves instrumental in a successful recovery of government funds are entitled to 15 to 30 percent of the total amount recovered.

Health care is one industry that is particularly rampant with financial fraud, and it’s fallen at the center of recent bipartisan efforts in Washington to fight back at a time when Medicare and Medicaid budgets face shortfalls.

“It should come as no surprise that states facing Medicaid budget shortfalls are finally deciding to root out fraud that likely has cost their taxpayers billions of dollars over the years,” Sammy Almashat, a Public Citizen researcher, said in a prepared statement. “What this new report unequivocally shows is that those states that have chosen to hold the pharmaceutical industry accountable have largely seen their enforcement efforts pay for themselves.”

Sources:

Miami Herald
Public Citizen
National Law Journal