Are Pharmaceutical Companies Responsible for the Opioid Crisis?

The city of Philadelphia believes so. City officials are looking to hold the pharmaceutical companies accountable for their part in the crisis by suing them under a city false claims act.

The lawsuit seeks to have the pharmaceutical companies pay for the city of Philadelphia's expenses for the treatment of residents addicted to opioids and suffering from opioid abuse disorder. "City agencies have incurred tremendous and avoidable costs trying to combat this crisis," City Solicitor Sozi Pedro Tulante said at a press conference. "Because it is our duty to protect the public from further harm, I believe we have no other choice than to file this lawsuit." The expenses are estimated in the millions of dollars.

City officials estimate that one-third of Philadelphia residents have received an opioid prescription within the last 12 months. That's 469,000 people. Accorrding to Dr. Thomas Farley, the city's health commissioner, "There's a legitimate use for prescription opioids in medical care, but nothing can justify this flood of prescribing these drugs."

Philadelphia has trained and equipped first-responders to treat opioid overdoses, funded addiction treatment programs, and increased funding for the city's criminal justice and prison systems. 

Now, city officials are demanding Philly gets its money back. It will be interesting to see if other municipalities follow suit.

When do I need counsel?

Of course, since you are asking a lawyer when you need a lawyer, I am going to tell you “as soon as possible”! But really, there are many reasons why you will want to find a knowledgeable, experienced FCA attorney very early in the process if you think you are witnessing fraud against the government.

First, it’s a good idea to have a free consultation with us and make sure that you are correct in what you suspect. Sometimes, there are things companies do wrong that, although against the rules, don’t really belong in an FCA case. We can help you sort out what is an FCA issue, what should be taken to a different sort of attorney, or maybe reported to a hotline.

Second, assuming that you have an FCA issue, we will want to advise you about what evidence you may want to gather to prove your case.  Making such decisions on your own is fraught with peril, and could even land you with criminal or civil liability if you make the wrong move. For example, there may be documents you want to bring, but there are important guidelines about what you can and cannot bring to show us. This is a complicated issue, and we very much encourage you to speak with us before you make any decisions about what to take. Similarly, some would-be relators contemplate making a recording of the workplace. Again, this is not a simple issue and we would prefer to have the opportunity to discuss it with you before you make any actual recordings.

Third, by the time they are contemplating an FCA action, many relators are on the verge of being let go. If they are terminated, there are important steps you will want to take to preserve your rights. You may also be asked to sign a release in order to receive a severance package – the issue of releases is very complex, varies from district to district, and can result in our being unable to help you. Do not sign away any of your rights without consulting an experienced qui tam attorney!

For all of these reasons and more, if you think you are a witness to fraud against the government at any level, we encourage you to take advantage of our free consultations.

Final Score: Georgia 25 - Alabama 0

No, I'm not predicting the outcome of the National Championship (although I do expect a similar result). I'm talking about recoveries under the respective state false medicaid claims act statutes. In 2017, the Georgia Medicaid Fraud Control Unit entered into 16 settlement agreements, recovering over $25 million in Georgia Medicaid funds. That's more than twice as much as Nick Saban's annual salary ($11.125 million)! 2016 was an even bigger year, returning over $122 million for just one settlement alone (a year in which Georgia was almost certainly the national champion for state false claims act recoveries).

Alabama, unfortunately, is one of just 14 states that does not have a state false claims act. Not only do these states lose out on a 10% increase in any federal FCA recovery, but in Alabama, state prosecutors can only bring criminal (and not civil) actions in cases of fraud or abuse of the state’s Medicaid Program. Even the former state attorney general recognized the benefits that an FCA would bring to a state needing to fund a substantial Medicaid program with a projected $85 million budget deficit. Unfortunately the latest iteration of an FCA bill died in committee, as others had before it.

There are no downsides to state False Claims Acts, unless you're a corrupt healthcare provider.

Go Dawgs!

Relator’s Interview Part V: FAQs

How do I prepare?

We will have a preparation session with you, telephonically or in person, where we will review the type of things discussed in this blog series (but specifically focused on your case). Other than that, you may want to review your complaint and disclosure statement. That’s about it – this isn’t a memory test! Just get a good night’s sleep and come in ready to respond as fully as possible.

Do I bring anything?

Nope. In your prep session, we will go over the documents you will be reviewing with the team, and I will bring a copy for your reference, but you need not bring a thing. For some that expect to go longer, for one reason or another, I may suggest you pack a snack. That’s about it.

Who will come with me?

The Relator’s Interview is one of those rare moments when a non-executive, non-celebrity gets to say “Pardon me, I want to consult with my attorney” any time that you like! We will be there with you the whole time – in fact, it would be improper for the team to talk to you without us around.

You will not be able to bring others with you – like spouses, parents, etc. – because of the federal seal. If you need to arrange a ride, let us know so we can strategize how not to leave someone stranded during an all-day interview that they are not allowed to know anything about!

What if I don’t know an answer?

This is an easy one: just say so! As we mentioned before, this is NOT a memory test. There’s no penalty for not knowing the answer – in fact, the team will respect you for not being embarrassed when you are not sure of something and overstating your knowledge.

In a similar vein, if you are not sure what the answer is, but you have a reasonable idea, just be sure that you are clear that you are speculating. This is not a situation where the team will not want to hear your ideas – just be clear that you are guessing and why you have arrived at your “best answer” and don’t imply that you are sharing facts rather than guesses. This goes a long way to making you credible to the team.

Do you have another question you would like to see answered here? Email Julie@FCACounsel.com with your ideas! When we collect enough, we will do another installment.