Fighting the Opioid Crisis with the False Claims Act

Katz, Marshall & Banks partner Michael Filoromo and associate Matthew LaGarde co-authored an article for the Bloomberg Law Insights section titled, “Leveraging the False Claims Act to Combat Opioid Misuse.”

The opioid crisis in the United States has wreaked havoc on communities across the country, causing researchers and legislators to look at the causes and possible solutions to curbing the widespread abuse of opioids.

Mr. Filoromo and Mr. LaGarde explain how the federal False Claims Act (FCA) has and is being used in the fight the opioid epidemic.  Under the FCA, an individual can file suit on behalf of the U.S. government against individuals or entities that present to the government false claims for payment.  Whistleblowers who participate in cases ending in a successful verdict or settlement are entitled to a whistleblower award between 15 and 30 percent of the action’s proceeds.

Marketing opioids for off-label use, failing to include adequate warnings and directions on opioid products, or accepting kickbacks in exchange for prescribing opioids may all constitute false claims under the FCA.  Mr. Filoromo and Mr. LaGarde note that recent initiatives by the Department of Justice and the Department of Health and Human Services strongly suggest that compliance with laws relating to the proper marketing and prescription of opioids is a key factor in the government’s decision to reimburse the drug companies who make opioids and the physicians who prescribe them. 

The authors highlight a recently unsealed FCA case, Guzman v. Insys Therapeutics, in which the Justice Department joined suits by individuals who reported a kickback scheme designed to persuade doctors to prescribe the highly addictive painkiller Subsys.  The Insys case demonstrates the role that the FCA and whistleblowers can play in combating the opioid crisis.

Read the full article here.