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Qui Tam Whistleblowers in Line for $37.8 Million

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Washington, DCFive qui tam whistleblowers will be in line for a combined $37.8 million as their share of a settlement stemming from a lawsuit against the manufacturer of Botox Therapeutic. The alleged promotion by Allergan Inc. of Botox Therapeutic for unapproved medical uses through Medicaid resulted in a combined $600 million in civil and criminal penalties.

Private citizens who file lawsuits on behalf of the government alleging fraud are eligible for up to 18 percent of whatever is recovered as the result of a qui tam lawsuit.

The attorney general for the State of Indiana announced that the State itself will receive an amount approaching $636,000 as its share of the larger national settlement.

"Whistleblowers who file suit to expose the illegal off-label marketing of pharmaceuticals are truly benefiting the taxpayers," said Attorney General Greg Zoeller in a statement on September 4. "Their actions help us to stop the overbilling of the Medicaid program and allow us to recover public dollars fraudulently paid out."

According to a press release, Allergan Inc. and Allergan USA Inc. agreed to pay state governments and the federal government a combined $225 million civil settlement to compensate Medicaid, Medicare and other federal health programs for reimbursements wrongly paid for Botox Therapeutic.

In addition, the US Justice Department filed a misdemeanor charge against Allergan for a violation against the Food, Drug and Cosmetic Act, to which Allergan agreed to plead guilty, according to the release. The manufacturer agreed to pay a $375 million criminal fine and forfeiture.

The qui tam whistleblower lawsuit was filed by five private plaintiffs who alleged that Allergan participated in off-label marketing that illegally promoted Botox Therapeutic for headache, pain, overactive bladder and spasticity through the use of kickback schemes, honoraria and dinner workshops targeting physicians. It was alleged that Allergan also coached doctors to improperly code and bill Medicaid and other programs for off-label uses.

The whistleblowers claimed that such activity occurred from 2001 through 2008 and resulted in over-utilization of Botox Therapeutic for non-covered, medically unnecessary purposes—resulting in overbilling and fraudulent claims that Medicaid paid out.

Federal and state governments joined the qui tam whistleblower lawsuit after it was filed. In August Zoeller kicked off a public awareness campaign to inform workers in the healthcare and pharmaceutical industries about their legal right under the False Claims Act to file whistleblower lawsuits if they learn of Medicaid fraud.

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