DOJ Targeted Industries

In the late 1990s, concerns were raised by the healthcare industry that the United States Justice Department was being overly aggressive with its use of the civil False Claims Act investigations and actions. In response, then-Deputy Attorney General Eric Holder circulated a memorandum to his Justice Department colleagues, providing “guidance” on the proper use of the False Claims Act in civil healthcare matters. Of particular note, Holder stressed that the False Claims Act should be reserved for egregious conduct of defrauding government healthcare programs.

Today, nearly two decades later, the Holder memorandum remains a guiding document for the Department and, by extension, the qui tam community. In practice, this means that the Justice Department and experienced qui tam counsel focus their efforts on healthcare fraud schemes that are specifically geared to illegally drain government healthcare dollars. Such schemes tend to be business-plan frauds, conjured up from the highest levels of some of the country’s largest healthcare providers. In turn, recent enforcement actions have involved, for example, large pharmaceutical and medical device manufacturers, and they were the source of some of the largest recoveries in recent years. By way of example, in fiscal year 2012, the federal government recovered nearly $2 billion in cases alleging false claims for pharmaceutical and medical devices under federally insured healthcare programs and, in addition, returned $745 million to state Medicaid programs. These cases include recoveries from GlaxoSmithKline LLC and Merck – two of the three top settlements of 2012.

REAL PEOPLE making real change Hospital Fraud Wins

Kathleen Hawkins

Dignity Health
$37 million

Kathleen Hawkins, RN MSN, had been employed by Defendant, Catholic Healthcare West (CHW) for approximately 6 years when she decided she had had enough of trying to change the hospital system from within.

CHW, a California not-for-profit corporation that operated hospitals in California, Arizona, and Nevada, was at the time the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in California.

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Joe Strom

Johnson & Johnson
$184 Million

Joe Strom contacted us in 2005. We were very grateful that he did. We immediately formed an all-star legal team and a process to stop a very harmful pharmaceutical marketing strategy. It was this process we set into motion that ultimately returned hundreds of millions of dollars to the U.S. Treasury, and a portion of that, very well-deserved, into Joe’s bank account.

Joe told us a very troubling story about the off-label promotion of a pharmaceutical drug for patients who already suffered from chronic heart failure.

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Description
Description

“I collaborated with Nolan, Auerbach and White on a broad variety of cases where whistleblowers stepped forward to disclose tactics employed by large companies to influence physicians' medical decision-making in patient care. They and their medical consultants, have consistently leveraged biomedical research and best medical evidence to advance patient safety, optimize clinical outcomes, and control precious resource utilization.”

— Fred Polsky M.D.,, Former Medical Director, CMS Zone 7 Integrity Contractor

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