$59 Million Whistleblower Reward in Pfizer Medicaid False Claims Act Settlement

William LaCorte, a physician in Louisiana, has earned a $59 million whistleblower reward after Pfizer agreed to pay $784 million to settle allegations of false claims to Medicaid for Protonix, a heartburn medication.  The complaint alleged that Pifzer’s subsidiary, Wyeth, failed to pay rebates to Medicaid to account for price discounts that Wyeth had provided to other customers.

Dr. LaCorte is no stranger to high-stakes whistleblower litigation.  He received $38 million in whistleblower rewards from prior qui tam or whistleblower lawsuits against other pharmaceutical companies, including one in which Merck agreed to pay $250 million to settle allegations that it offered hospitals better terms than Medicaid for its heartburn medicine, Pepcid.

Because of whistleblowers like Dr. LaCorte, the government recovered $2.8 billion in settlements last year under the False Claims Act, which allows individuals to commence whistleblower lawsuits on behalf of the government and share in any recovery.  In return, the government paid whistleblower rewards totaling $597 million.

Pharmaceutical cases tend to result in the largest whistleblower rewards.  For example, a former sale representative for Endo Pharmaceuticals recently collected a $33.6 million whistleblower reward after the company agreed to pay $140 million to settle allegations that it engaged in off-label marketing of Lidoderm, a pain medication.  In 2012, the government distributed $300 million in whistleblower rewards when GlaxoSmithKline agreed to pay $2 billion to settle allegations of off-label marketing and illegal kickbacks involving a number of its drugs.

The key to a successful whistleblower case is having evidence of fraud or false claims submitted to Medicare or Medicaid.  Mere allegations or suspicions of fraud are not enough.  A successful whistleblower case requires evidence.  And that creates some risks for potential whistleblowers.  Gathering the evidence to support Medicare or Medicaid fraud claims may expose whistleblowers to allegations that they violated HIPAA privacy restrictions, company confidentiality policies, and even criminal statutes such as the Federal Computer Fraud and Abuse Act.

If you have evidence of healthcare fraud or false claims submitted to Medicare or Medicaid, then you should consult with an experienced whistleblower lawyer immediately to protect your rights.  You may be entitled to a substantial reward and legal protections as a whistleblower.  But you also need legal advice to comply with your own obligation to maintain the privacy of confidential information.

To schedule a free and confidential consultation with an experienced whistleblower lawyer, call John Howley, Esq. at (212) 601-2728.