As a result of the lawsuit, Getnick Law’s client was awarded $34 million, representing 24% of the federal portion of the civil recovery. The settlement was the first major national Medicaid fraud settlement. The announcement generated extensive media coverage in the New York Times and elsewhere. In a media interview after the announcement, Neil Getnick said of the whistleblower: “The interesting aspect of his story is that it is reflective of so many of the whistleblowers that we meet. He became concerned about a practice in his company which he felt skirted the law. And he first attempted to resolve that through the internal compliance program at his company.”
Medicaid Fraud Case Study
Bayer Corporation paid a $251 million civil settlement and a $5.6 million criminal fine to settle a qui tam lawsuit brought by Getnick Law on behalf of a former Bayer marketing executive.
Getnick Law’s FCA Suit Alleges Pricing Scheme
Getnick Law’s lawsuit alleged that Bayer engaged in a fraudulent “private labeling” scheme to avoid paying rebates to Medicaid for two popular drugs, Cipro and Adalat CC. The rebates are required by law to ensure that Medicaid receives the same discounts that drug makers give their commercial customers.
Bayer gave deep discounts to two HMOs on the two drugs and put the HMOs’ drug code numbers on the labels instead of its own. Bayer then pretended that the HMOs were responsible for paying the rebate on this “private label” product even though it knew that the HMOs did not sell drugs to Medicaid or pay rebates. Bayer failed to report the discounted prices to Medicaid thus underpaying its rebates.