The average Joe buys the occasional Powerball ticket hoping to win a few million bucks. T. Mark Jones, a pharmacist from Key West, decided to roll up his sleeves and become a whistleblower. His investigation of Big Pharma’s overbilling schemes saved taxpayers $3 billion dollars and earned $597,000,000.00 in whistleblower award money. Some say “crime doesn’t pay” but a Civil War anti-fraud statute helps honest Americans make money by reporting fraud and criminal behavior that hurts taxpayers.
According to published reports, Jones was a pharmacist in Key West who dedicated his career to helping dying AIDS patients. Unlike many of today’s chain store pharmacies, Jones would travel to the homes of patients who were in the last stages of life. Business was good, if not overly profitable, until a giant pharmacy company – National Medical Care – moved into town. Jones was soon broke and had to move his family into his parents home.
Curious how National Medical Care operated, Jones began investigating on his own. His efforts, and those of a few other pharmacists, soon revealed the ugly side of Big Pharma. Corruption, kick backs and overbilling.
Jones and his small pharmacy company began filing whistleblower suits. Under the federal False Claims Act people with “original source” (inside) information can file a lawsuit in the name of the government if they have knowledge of a fraud against the government or a taxpayer program. Many states have similar laws. Since much of healthcare is financed Medicare (federal) and Medicaid (state & federal) programs, anyone who defrauds the program can potentially be sued under the false claims laws.
Why would a whistleblower do this? Many simply want to do the right thing. Fraud and corruption hurts everyone. No one likes paying taxes and knowing that your tax dollars are being wasted is enough for many people to come forward.
The False Claims Act also offers cash awards. A whistleblower is generally entitled to a portion of whatever is collected by the government. Typically awards are around 20% but can be as high as 30%.
By helping the government fight Medicare overfilling, Jones and his partners helped fight fraud and leveled the playing field so that all pharmacists could properly compete for business. They also earned themselves over a half billion dollars for their efforts.
Last week we reported on a story of a whistleblower complaint against a big pharmacy conglomerate in trouble for dispensing drugs without a prescription. This week’s story is about overbilling fraud. It’s easy to see that fraud against the government can take many forms. And its not limited to the pharmacy industry. Doctors, mortgage lenders, paving contractors, defense contractors and others have all been successfully prosecuted under false claims laws. Each case started with a concerned citizen or worker who decided to become a whistleblower.
To qualify as a whistleblower, one must have non public, “original source” information about a fraud to taxpayers or a taxpayer funded program such as Medicare. If you wish to become a whistleblower and think you have a false claims case, give us a call. We represent whistleblowers and help them stop fraud and collect the largest award possible.
Mahany & Ertl – America’s Fraud Lawyers. Offices in Milwaukee, Wisconsin; Detroit, Michigan; Minneapolis, Minnesota; Portland, Maine and San Francisco, California. Services available in many jurisdictions.
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Posted by Brian Mahany, Esq.