Pharmacist Whistleblower Recovers Over $120 Million
In Medicaid Fraud False Claims Act Settlements
Walgreens Pays $35 Million · CVS Pays $37 Million
Omnicare, Largest Nursing Home Pharmacy, Pays $50 Million
Omnicare Switching Settlement · Omnicare Kickbacks Settlement

U.S. Department of Justice Joins Chicago Pharmacist’s Qui Tam Case Alleging Johnson & Johnson Paid Kickbacks For Nursing Homes Prescriptions

The United States Department of Justice filed a complaint in Boston federal court today alleging that pharmaceutical manufacturer Johnson & Johnson committed Medicaid fraud by paying Omnicare pharmacies kickbacks for recommending that nursing home patients use Risperdal® and other Johnson & Johnson drugs. Omnicare is the nation’s largest pharmacy for nursing homes. The case against Johnson & Johnson was initiated by a Chicago pharmacist, Bernard Lisitza, who was fired by Omnicare after he challenged the Risperdal® kickbacks and other improper practices.   

According to the government’s complaint, Johnson & Johnson paid tens of millions of dollars in kickbacks to Omnicare, the nation’s largest pharmacy for nursing homes. The kickbacks were disguised as “market share rebate” agreements, which paid the pharmacy for successfully recommending Johnson & Johnson drugs. Lisitza first identified these “market share rebates” as kickbacks in a 2003 qui tam complaint filed by his attorneys, Behn & Wyetzner, Chartered of Chicago, Illinois.

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Whistleblowers

Pharmacists have initiated a number of highly successful qui tam actions under the False Claims Act. As the front line professionals responsible for dispensing medications to Medicaid beneficiaries, pharmacists are particularly well suited to discover and report Medicaid fraud. The Walgreens settlement marks another successful result of actions taken by pharmacists to protect taxpayer funds.

The pharmacist became a qui tam relator after discovering the drug switching in processing transfers of prescriptions from Walgreens pharmacies. According to his qui tam Complaint, the pharmacist discovered the Medicaid fraud after noting that a Walgreens prescription was for ranitidine capsules rather than tablets, the industry standard. The pharmacist relator stated that Walgreens pharmacists told him that the pharmacy chain had set up its system to fill all ranitidine prescriptions as capsules regardless of what a physician had specifically prescribed.

The same pharmacist relator also successfully pursued a qui tam action against CVS pharmacies for Medicaid fraud arising from drug switching, which resulted in a $37 million settlement.

The initial qui tam case by the relator pharmacist was against his prior employer, Omnicare Inc., the nation's largest pharmacy for nursing homes. That Medicaid fraud case resulted in a $50 million settlement of False Claims Act allegations.

A pharmacist's report to the government led to a $50 million settlement by Omnicare, Inc., the nation's largest pharmacy for nursing homes, to resolve federal and state charges that it defrauded Medicaid by switching generic drugs. The Omnicare case was the first to challenge generic drug switching, and served to strengthen Medicaid's price containment programs for generic drugs. The relator discovered the conduct which led to this settlement while he was a pharmacist at Omnicare. The pharmacist relator was represented by Behn & Wyetzner, Chartered.

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The Attorneys

Michael I. Behn is an experienced trial lawyer and former federal prosecutor who concentrates his practice in the civil prosecution of fraud. He founded the Chicago law firm, Behn & Wyetzner, Chartered and is a member of the Whistleblower Action Network. Mr. Behn primarily represents citizens who have reported fraud against the government, under the qui tam provisions of the state and federal False Claims Acts.

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Linda Wyetzner is a seasoned trial lawyer and negotiator, with 20 years' experience representing employees in disputes with their employers.

Ms. Wyetzner founded the Chicago law firm of Behn & Wyetzner, Chartered, and is a member of the Whistleblower Action Network. She primarily represents citizens who have reported fraud under the qui tam provisions of the federal and state False Claims Acts.

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Walgreens Settlement

CBS News Report

By paying $35 million, Walgreens, the self-proclaimed "Pharmacy America Trusts®" settled allegations by pharmacist whistleblower Bernard Lisitza that it unlawfully defrauded Medicaid by switching prescriptions for ranitidine, the generic form of the brand-name drug Zantac®, and fluoxetine, the generic form of Prozac®. The Walgreens case was pursued by Lisitza as a “relator” under "qui tam" provisions of federal and state False Claims Acts, after he uncovered the conduct and reported the problem to the government. Relator Lisitza pursued the case with the assistance of his attorneys, Michael I. Behn and Linda Wyetzner, of Behn & Wyetzner, Chartered, in Chicago.

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