By CHRISTIAN WADE | THE CENTER SQUARE
Connecticut Attorney General William Tong is leading 33 states attorneys general, including Alaska Attorney General Treg Taylor, in urging the U.S. Supreme Court to overturn a pair of lower court rulings that could have broad implications for whistleblowers, and the government’s ability to go after public fraud.
In a 15-page legal brief, Tong and the other AGs are calling on justices to uphold a pair of federal whistleblower lawsuits accusing pharmacy operators of over billing government health insurance programs for prescription drugs.
At issue is whether private companies can shield themselves from fraud lawsuits by claiming an “objectively reasonable” interpretation of the federal False Claims Act, which allows citizens to file lawsuits on behalf of the government.
Lawsuits filed by whistleblowers against Safeway Inc. and SuperValu Inc., accused the retail pharmacy chains of defrauding Medicare and Medicaid by billing them using “artificially high” pricing schemes, while charging most consumers lower prices for out-of-pocket costs through discount programs.
But in a 2-1 opinion, the Seventh U.S. Circuit Court of Appeals in Chicago sided with the companies, saying they were acting under a “reasonable” interpretation of the law when they billed the government higher prices than those charged to uninsured consumers.
In its April ruling, the appeals court agreed the companies had overcharged the government, but ruled they can’t be held responsible for fraud because their billing practices were supported by an “objectively reasonable” interpretation of the whistleblower law.
The whistleblowers appealed the ruling to the Supreme Court, which agreed to combine the cases and review the lower court rulings.
In their legal brief, Tong and other AGs argue the Seventh Circuit’s ruling “turns the law on its head” and puts states at risk of losing Medicaid and Medicare funds to fraud if they don’t issue adequate guidance to companies operating under their jurisdiction.
“Rather than encouraging providers to seek available clarification about the legality of their practices, the Seventh Circuit’s rule rewards providers that put on blinders, take the public’s money, and ask questions (or seek forgiveness) later,” the AGs wrote in the legal brief.
In a statement, Tong said the lower court’s rulings “gut the essence” of the False Claims Act and will “jeopardize the integrity of state Medicaid operations.”
He said under the Connecticut False Claims Act — which was modeled on the federal law, the state has recovered over $181 million in misspent public healthcare dollars since 2009, when it went into effect.
“Having a strong interpretation of the False Claims Act is vital for the protection of taxpayer dollars, which is why my fellow attorneys general and I are strongly urging the Supreme Court to right this wrong,” he said.
Joining Tong are attorneys general from Alaska, California, Colorado, Delaware, District of Columbia, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Vermont, Washington and Wisconsin.
This is your brain…This is your brain on Davis-Bacon Drugs. Any questions?
Treg Taylor For Governor!
If we can’t punish the drug companies, at least protect the people who bring this process into the light.
How about the gouging and probable deaths from pharmacies refusing to fill a six dollar prescription for ivermectin. The prescription written and prescribed by family doctors totally ignored. This should never happen ever again.
Every pharmacy needs to be sued.
I am sorry that you know of a person that died from COVID-19 and for the people that died that you didn’t know as well. My brother died a long and terrible death from COVID-19. He died as he lived without fear, an ex-Marine, but it was one of the most terrible things I’ve witnessed. The pandemic has been an overwhelming source of grief for Alaskans, Americans and the entire world.
There were probably no ‘probable’ deaths due to not filling a script for ivermectin, sorry to say. Research has come a long way for combating these types of viruses, as well as developing vaccines, and some sort of ‘profile’ of who might become very ill if contracting the disease.
How, exactly, would you know if there were no deaths due to the failure of pharmacists to fill legally prescribed meds? Enlighten us.
Also, enlighten us on your vast scope of medical knowledge involving a rapidly changing situation. I’m pretty well read and have immunocompromised family members. I’m motivated to keep up, but you seem to know things the rest of us don’t.
The first casualty in this war on the American people was truth. So many state and media sponsored lies have been told about Covid the truth will probably never be known.
More, the issue was and remains the politicization of health care on a Soviet scale. In even one prescription was not filled due to a pharmacist political beliefs, it’s 1000 too many.
Lastly, you threw all potential credibility out the intellectual window when you tried to attach this to ACA and greedy drug companies.
Mrs. – you do know that the “vaccines” do not prevent infection, nor do they prevent transmission, and there is no conclusive study that confirms it will keep you out of the hospital should you become infected. Also, the anti-viral medications such as Paxlovid have had very mixed efficacy rates when used to treat Covid. Unfortunately, these are the facts today.
It’s about time that the government hold the feet to the fire of the non-pharmacist element of the professional pharmacists of America, such as pharmacy benefits stock investment-type businesses that put the money into overseas bank accounts, invest in money from the sky, misrepresent the profession in monopolistic drugstore chains that own prescribing professionals, health insurance companies, suppliers, and hold vested interests in ownership of drug manufacturers.
But, first, it would be very useful if politicians took the time to try to understand the whole concept of access to life-saving and maintenance medications in light of the original ACA — affordable, quality care accessible to everyone. This indiscriminate lobbying for emphasis on quick fixes has been disastrous, with implication to every single person in America.
I was at my dentist whose business office has seen my records and those family members for more than 30 years (the first dentist sold her practice to the dentist I see now). She was preparing to remove decay from a small cavity in an upper left first molar, after it had been identified several weeks ago when I didn’t have dental insurance. I asked her if she was sure it was that one, and she pointed to the X-ray and replied in the affirmative. As she gave a puff of air and focused the light she assured me that is what she saw with her eyes, while I questioned whether it was the one in the lower jaw. It was a small cavity, and I explained that I thought it was the lower tooth and had associated some symptom with that one. As much as we have the ability to sense mild effects in one area, research shows that relief of pain is affected by up to 30% placebo effects.
When the issues of health care are dealt with on a subjective basis, hearsay, nebulous platitudes, vague promises, and unprincipled greed (or principled virtuous types– doesn’t much matter the type of greed), no one gets a fair shake.
The ACA was extensively discussed before its passage ten years ago and some of its basic foundational features have been whittled away by forces of offshore shell company lobbying, backdoor exceptions, and loopholes that in some ways it doesn’t even resemble the original intent.
These lawsuits such as picking on Safeway for this or that, Martin Shrelki, or blaming Walgreens for the opiate epidemic without identifying where they went wrong and how they could do the correct thing in the spirit of the original tenets of the Act further serves to fragment the systemic cracks that are showing themselves. Without a measure of decency, and limitations on the underpinnings of capitalism– unchecked avarice– often fiercely defended against as the misapplied word of the dreaded otherness as ‘socialism’, this type of situation will worsen, rampantly out of hand.
Where can I send a check, Mrs. N, tp but some of that snake oil you’re selling. Maybe you can buy a couple of houses in Topanga Canyon.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and the highest-paid federal bureaucrat, received 23 royalty payments. (Fauci’s 2021 taxpayer-funded salary: $456,028).
Francis Collins, NIH director from 2009-2021, received 14 payments. (Collins’ 2021 taxpayer-funded salary: $203,500)
Clifford Lane, Fauci’s deputy at NIAID, received 8 payments. (Lane’s 2021 taxpayer-funded salary: $325,287)
Where exactly is that “unchecked avarice”.
Ohhh. Greed. Evil greed. Took you long enough.
Curious why your dentist didn’t just treat you for free? That dentist of 30 years a greedy SOB? Speaks to your character you’d associate with such a person for 30 years.
Funny thing. I have a dentist in Juneau. Liberal, leftist Juneau who will always treat patients regardless of their insurance or current monetary situation. The details can be worked out later by people of good character.
I know this personally.
I’d suggest you start reevaluating the people you surround yourself with. Greedy bastards by your accounting.
The problem with making emotional, illogical arguments is they can be shredded with basic common sense.
I look at Native Health and the monopolies they have in the Bush.
I have seen the bills for years that friends have for paying the over the counter price for a first round of antibiotics from the Native Hospital in Bethel, vs the refill cost, including shipping from Bernies Pharmacy in Anchorage. …… Delivered from Bernies to Bethel Post office, $18, same exact pill and quantity from Native Health in Bethel was over $120 .
I have been arguing price gouging for years. The State should have audited it’s reimbursement for Medicaid and Medicare prescription drugs years ago, when it comes to native health in the Bush.
What’s the difference between inflated billing and phony billing? One’s legal and one’s not.
Standard 5-yr curriculum plus; 2 semesters algebra and trigonometry, 3 semesters calculus, 2 semesters physics, 2 semesters each biology 1 & 2, 4 semesters general chemistry, 2 semesters human anatomy and physiology, 2 semesters biochemistry, 4 semesters organic chemistry, 1 semester microbiology, 1 semester pathogenic microbiology, 1 semester genetics, 1 semester English, 1 semester communication, 1 semester State history, 1 semester music appreciation, 4 semesters German language, 2 semesters human pathophysiology, 1 semester political science, 2 semesters sociology, 2 semesters psychology, 1 semester botany, 1 semester natural products, public health, and pharmacognosy, 2 semesters statistics, 1 semester drug information and literature, 4 semesters pharmacology, 1 semester pharmacy business, 2 semesters pharmaceutical science and preparations, 2 semesters biopharmaceutical chemistry and OTCs, 2 semesters pharmacy law, 1 semester business and organizations, 1 semester pharmaceutical calculations, 2 semesters preps, 7 semesters therapeutics, all while working 20 hrs a week, then 7 months clinical rotations, and after registration 1 yr residency at the VA plus a few years working here and there … and the 15 hrs of continuing education required yearly, for licensure and immunization certification, all only possible to emerge with no debt with the full support of my husband and his minimum wage jobs.
Hmmm.. where are Alabama, Arizona, Arkansas, Florida, Idaho, Mississippi, Oklahoma, Wyoming and others? Looks like lots of red states are siding with the pharmacy chains.
Comments are closed.