Top FCA Civil Settlements 2008-Present
Healthcare
The federal and state governments spend approximately $1.4 trillion every year on Medicare and Medicaid. With so much money flowing to these and other government healthcare programs—including Tricare, the Children’s Health Insurance Program (CHIP), the Veterans Health Administration (VHA) program, and the Indian Health Service (IHS) program—it’s no wonder that fraud is rampant in the healthcare industry. The following table lists the top 50 healthcare-related settlements under the False Claims Act (FCA) and its state counterparts since 2008.
Settlements that are highlighted involved Baron & Budd attorneys.
| Year | Federal/State | Defendant(s) | Settlement Amount | Relator Share | Category | Allegations |
|---|---|---|---|---|---|---|
| 2012 | Both | GlaxoSmithKline | 2,000,000,000 | $150,000,000 | Off-Label Marketing, Drug Pricing, Kickbacks | Pharmaceutical manufacturer marketed drugs for unapproved uses, paid kickbacks to induce prescriptions, and engaged in false price reporting practices |
| 2013 | Both | Johnson & Johnson | 1,720,000,000 | $167,700,000 | Off-Label Marketing, Kickbacks | Pharmaceutical manufacturer marketed drugs for unapproved uses and paid kickbacks to nursing home pharmacies to induce prescriptions |
| 2009 | Both | Pfizer | 1,000,000,000 | $102,365,512 | Off-Label Marketing, Kickbacks | Pharmaceutical manufacturer marketed drugs for unapproved uses and paid kickbacks to providers to induce prescriptions* |
| 2012 | Both | Abbott Laboratories | 800,000,000 | $84,127,704 | Off-Label Marketing | Pharmaceutical manufacturer marketed drug for unapproved uses* |
| 2009 | Both | Eli Lilly | 800,000,000 | $78,870,878 | Off-Label Marketing | Pharmaceutical manufacturer marketed drugs for unapproved uses |
| 2016 | Both | Wyeth, Pfizer | 784,600,000 | $98,058,190 | Drug Pricing | Pharmaceutical companies reported to the government false drug prices, avoiding paying rebates to the government |
| 2019 | Both | Reckitt Benckiser | 700,000,000 | $86,700,000 | Off-Label Marketing | Pharmaceutical manufacturer fraudulently marketed its opioid product as less divertable and less abusable than competitor drugs* |
| 2020 | Both | Novartis | 690,843,282 | $109,416,772 | Kickbacks, PAP Fraud | Pharmaceutical manufacturer paid copays of government healthcare beneficiaries and paid kickbacks to providers to induce prescriptions |
| 2008 | Both | Merck | 649,000,000 | $103,202,095 | False Billing, Kickbacks | Pharmaceutical manufacturer failed to pass along required discounts to Medicaid and paid kickbacks to doctors to induce prescriptions |
| 2011 | Both | Merck | 628,364,000 | No Relator | Off-Label Marketing | Pharmaceutical manufacturer marketed drug for treating rheumatoid arthritis before that use was approved by the FDA |
| 2018 | Both | Amerisource Bergen | 625,000,000 | $93,089,441 | Drug Pricing, Kickbacks | Pharmaceutical company double-billed for the same vial of cancer drugs and paid kickbacks to induce doctors to buy the drugs |
| 2012 | Both | Amgen | 612,174,030 | $90,000,000 | Off-Label Marketing, Kickbacks, Drug Pricing | Pharmaceutical manufacturer marketed drugs for unapproved uses, paid kickbacks to induce prescriptions, and engaged in false price reporting practices* |
| 2010 | Both | GlaxoSmithKline | 600,000,000 | $96,016,800 | Adulterated Drugs | Pharmaceutical manufacturer failed to ensure that drugs were not contaminated with microorganisms |
| 2009 | Federal | New York State, New York City | 540,000,000 | $10,000,000 | False Billing | State & city failed to properly supervise school districts and counties, causing ineligible claims to be submitted for Medicaid reimbursement |
| 2010 | Both | AstraZeneca | 520,000,000 | $45,286,051 | Off-Label Marketing, Kickbacks | Pharmaceutical manufacturer marketed drug for unapproved uses and paid kickbacks to doctors to promote and prescribe drug off-label |
| 2017 | Both | Mylan Specialty | 465,000,000 | $38,767,137 | Drug Pricing | Pharmaceutical manufacturer misclassified EpiPen as a generic drug to avoid paying rebates owed to Medicaid |
| 2015 | Both | DaVita | 450,000,000 | Unknown | False Billing | Pharmaceutical company created unnecessary waste in administering drugs, then billed government for avoidable waste |
| 2008 | Both | Cephalon | 375,000,000 | $46,469,978 | Off-Label Marketing | Pharmaceutical manufacturer marketed drugs for unapproved uses |
| 2015 | Both | Novartis | 370,000,000 | $66,383,268 | Kickbacks | Pharmaceutical manufacturer paid kickbacks to pharmacies and pressured pharmacies to emphasize drug's benefits and understate its side effects |
| 2016 | Both | Tenet Healthcare | 368,000,000 | $84,430,000 | Kickbacks | Hospitals paid clinics for referrals of Medicaid patients |
| 2018 | Both | Actelion | 360,000,000 | No Relator | PAP Fraud | Pharmaceutical manufacturer used foundation to pay copays of government healthcare beneficiaries |
| 2013 | Both | Ranbaxy | 350,000,000 | $48,687,254 | Adulterated Drugs | Pharmaceutical manufacturer failed to ensure that drugs were stable and sold adulterated drugs |
| 2017 | Both | Shire Pharmaceuticals | 350,000,000 | $59,902,000 | Kickbacks | Manufacturer paid kickbacks to induce providers to use or overuse their Dermagraft skin product |
| 2014 | Both | DaVita | 350,000,000 | $65,000,000 | Kickbacks | Dialysis company paid kickbacks to physicians to induce referrals to its clinics |
| 2016 | Both | Olympus Corp. | 310,800,376 | $51,102,573 | Kickbacks | Medical equipment company paid doctors in exchange for sales of equipment which were reimbursed by government healthcare programs |
| 2020 | Both | Indivior | 300,000,000 | Unknown | Off-Label Marketing | Pharmaceutical manufacturer fraudulently marketed its opioid product as less divertable and less abusable than competitor drugs |
| 2017 | Both | Celgene | 280,000,000 | $72,595,499 | Off-Label Marketing | Manufacturer promoted two cancer drugs, Thalomid and Revlimid, for uses not approved by the FDA |
| 2010 | Federal | Dey Inc. | 280,000,000 | $67,200,000 | Drug Pricing | Pharmaceutical manufacturer submitted claims for payment to government health care programs based on inflated drug prices |
| 2010 | Federal | Abbott Laboratories, B. Braun Medical Inc., Roxane Laboratories | 280,000,000 | $88,400,000 | Drug Pricing | Pharmaceutical manufacturer submitted claims for payment to government health care programs based on inflated drug prices |
| 2018 | Federal | DaVita Medical Holdings | 270,000,000 | $10,199,100 | Drug Pricing | Healthcare company provided inaccurate information that caused Medicare Advantage Plans to receive inflated payments |
| 2009 | Both | Quest Diagnistics Inc., Nichols Institute Diagnostics | 268,200,000 | $45,000,000 | Defective Products | Diagnostic test kit manufacturer received Medicare & Medicaid reimbursement for defective test kits |
| 2015 | Federal | Various Hospitals | 257,650,000 | $38,000,000 | Medical Necessity | Hundreds of hospitals implanted cardiac devices in patients in violation of Medicare coverage requirements |
| 2013 | Both | Wyeth Pharmaceuticals | 257,400,000 | $39,000,000 | Off-Label Marketing | Pharmaceutical manufacturer marketed drug for unapproved uses |
| 2019 | State | Abbott, Aventis, B. Braun, Forest, GlaxoSmithKline, Johnson & Johnson, Janssen, McNeil-PPC, Ortho Biotech, Ortho-McNeil, Novartis, Pfizer, Pharmacia, TAP Pharmaceutical Products | 242,000,000 | No Relator | Drug Pricing | Pharmaceutical manufacturers submitted claims for payment to government health care programs based on inflated drug prices |
| 2011 | State | Quest Diagnostics | 241,000,000 | $69,890,000 | Drug Pricing, Kickbacks | Laboratory testing company submitted inflated claims for payment and paid kickbacks to physicians in exchange for referrals |
| 2010 | Both | Novartis | 237,500,000 | $25,675,035 | Off-Label Marketing | Pharmaceutical manufacturer marketed drugs for unapproved uses |
| 2015 | Both | Millennium Health | 237,000,000 | $34,050,000 | Medical Necessity, Kickbacks | Drug testing laboratory conducted medically unnecessary tests and paid kickbacks to physicians in exchange for referrals |
| 2019 | State | Xerox | 235,942,000 | No Relator | Medical Necessity | Medicaid claims administrator failed to properly review claims to determine if they met requirements for reimbursement |
| 2008 | Both | Amerigroup | 225,000,000 | $56,250,000 | Insurance Discrimination | Medicaid managed health care plan systematically avoided enrolling pregnant women and unhealthy patients to increase profit |
| 2010 | Both | Allergan | 225,000,000 | $37,827,000 | Off-Label Marketing | Pharmaceutical manufacturer marketed drug for unapproved uses |
| 2018 | Both | Health Management Associates | 223,470,802 | $17,400,000 | Drug Pricing, Kickbacks | Hospital chain submitted inflated claims for payment and paid kickbacks to physicians in exchange for referrals |
| 2017 | Federal | United Therapeutics | 210,000,000 | No Relator | PAP Fraud | Defendant used a foundation as a conduit to pay copays of Medicare patients |
| 2019 | Both | Walgreens | 209,200,000 | $32,340,000 | Medical Necessity | Pharmacy dispensed insulin pens to patients who did not need them, altering records so patients received more than they needed |
| 2019 | Both | Insys Therapeutics | 195,000,000 | Unknown | Kickbacks | Pharmaceutical manufacturer paid kickbacks to providers to induce them to prescribe opoid painkiller |
| 2012 | Federal | McKesson | 187,000,000 | Unknown | Drug Pricing | Pharmaceutical manufacturer fraudulently inflated drug prices to increase Medicare reimbursement |
| 2012 | State | McKesson | 175,172,195 | Unknown | Drug Pricing | Pharmaceutical manufacturer fraudulently inflated drug prices to increase Medicaid reimbursement |
| 2014 | Both | Endo Pharmaceuticals | 171,900,000 | $33,592,089 | Off-Label Marketing | Pharmaceutical manufacturer marketed drug for unapproved uses* |
| 2021 | Federal | Purdue Pharma, Sackler Family | 3,025,000,000 | No Relator | Off-Label Marketing, Kickbacks | Pharmaceutical company and its owners promoted opioid products for uses that were unsafe and medically unnecessary; company paid kickbacks to doctors in exchange for prescriptions |
| 2021 | Both | Taro Pharmaceuticals, Sandoz, Apotex | 447,200,000 | No Relator | Drug Pricing | Pharmaceutical companies conspired to fix the prices of generic drugs, resulting in higher prices for the government and patients |
| 2019 | State | Numerous pharmaceutical companies | 678,000,000 | No Relator | Financial Fraud | Pharmaceutical companies reported to the government false drug prices, avoiding paying rebates to the government |
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