On September 5, 2014 the United States District Court for the Eastern District of Pennsylvania denied Merck’s motion to dismiss Plaintiffs’ antitrust claims. In doing so, the court held that Plaintiffs had sufficiently alleged claims for violations of the Sherman Act. First, Plaintiffs demonstrated that Merck, as the sole manufacturer of the MMR vaccine, had monopoly power in the market. Second, Plaintiffs sufficiently alleged that Merck willfully maintained such monopoly power through falsifying data related to the efficacy of the MMR vaccine. Accordingly the court held that “taking the facts in the light most favorable to Plaintiffs, Defendant’s fraudulent misrepresentations about Defendant’s own product, coupled with the unique facts of the this case (e.g., the 100% monopoly of the market and arguable statutory and contractual duties to disclose information) create the basis for an antitrust claims that Defendant willfully maintained monopoly power through exclusionary tactics.”
History of the case:
In 2012 an antitrust case was filed in the United States District Court for the Eastern District of Pennsylvania. The lawsuit, Chatom Primary Care, P.C. v. Merck, was filed as a class action against Merck for unlawfully monopolizing the U.S. market for Mumps Vaccine by misrepresenting the true efficacy of its vaccine. Specifically, the lawsuit states Merck fraudulently misrepresented and marketed its Mumps Vaccine as having an efficacy rate of 95% or higher. Plaintiffs allege that in reality, Merck knew and concealed that the Mumps Vaccine was far less than 95% effective.
Plaintiffs allege:
· Merck used improper testing techniques and falsified its data to show fraudulent efficacy rates, even after significant mumps outbreaks in 2006 and 2009.
· As the only company licensed by the U.S. to sell the Mumps Vaccine, Merck has illegally monopolized the market with its inflated 95% or greater efficacy rate, which has deterred and excluded competitors from entering the marketplace.
· Merck created a high inelasticity of demand in the marketplace. The government, health care professionals or consumers have no other option to obtain the Mumps immunization.
· Because Merck was free to charge an artificially inflated price and free competition was limited in the marketplace, antitrust laws were violated.
Dignity Health has agreed to pay the government $37 million to settle allegations that more than a dozen of its hospitals knowingly submitted false claims to Medicare and TRICARE, the U.S. Department of Justice announced Thursday.
The government alleged that Dignity, admitted patients who could have been treated as outpatients, which would have been less expensive, according to the DOJ.
In a statement released Thursday, San Francisco-based Dignity noted that the settlement agreement, “finds no improper conduct or admission of wrongdoing on the part of the health system” and “reflects Dignity Health's desire to resolve the investigation and avoid the expense of continued litigation.”
“The billing disputes reflect widespread confusion in the health care industry on unclear federal standards for approving coverage of patient admissions,” according to the Dignity statement. “As a result, it is often challenging for physicians to ensure their documentation adequately reflects their decision making in order to comply with complex regulations when making their best medical judgments.”The government alleged that 13 Dignity hospitals in Arizona, California and Nevada billed Medicare and TRICARE, from 2006 to 2010, for inpatient care for some patients who had elective cardiovascular procedures such as stents and pacemakers. Those claims should have been billed as outpatient surgeries, the government contends. It also alleged that from 2000 to 2008, four Dignity hospitals billed Medicare for patients undergoing elective, minimally invasive kyphoplasty procedures—used to treat certain spinal compression fractures—that also should have been billed as outpatient procedures.
The government also alleged that 13 Dignity hospitals admitted patients who didn't medically need to be admitted and could have been cared for as outpatients or in an observation setting.
“Hospitals that attempt to boost profits by admitting patients for expensive and unnecessary inpatient hospital stays will be held accountable,” said Special Agent in Charge Ivan Negroni of the HHS' Office of Inspector General San Francisco office, in a statement. “Both patients and taxpayers deserve to have medical decisions made solely on what is best for the patient, based on medical necessity.”
The allegations were first brought forward in a whistle-blower lawsuit filed in the U.S. District Court for the Northern District of California under the False Claims Act by Kathleen Hawkins, a former Dignity employee. In successful lawsuits, whistle-blowers are entitled to a percentage of the money recovered by the government. Hawkins will receive about $6.25 million, the DOJ said.
The United States on Monday joined a lawsuit accusing New York City and Computer Sciences Corp of defrauding Medicaid into making millions of dollars of improper reimbursements by exploiting a computerized billing system that the company designed.
According to the complaint filed in U.S. District Court in Manhattan, the defendants took advantage of the system's automatic defaulting capabilities, enabling the city to boost the amount and speed of reimbursements for services provided to infants and toddlers with developmental delays.
The U.S. attorney for Manhattan, Preet Bharara, said the fraud led to the city and Computer Sciences' submitting tens of thousands of false claims to Medicaid from 2008 to 2012.
Originally filed by a whistleblower, Vincent Forcier, the lawsuit seeks restitution, civil penalties and triple damages for violations of the federal False Claims Act.
That law allows whistleblowers to sue on the government's behalf and share in recoveries. The government is not required to get involved in False Claims Act lawsuits, but sometimes intervenes in cases it considers stronger.
"We are in the process of reviewing the complaint," said Richard Adamonis, a spokesman for Computer Sciences, which is based in Falls Church, Virginia.
New York state plans to bring a related case against Computer Sciences, court records show. A spokeswoman for New York Attorney General Eric Schneiderman declined to comment.
The lawsuit concerns early intervention program services, which are provided to children under 3 years old who have developmental delays, or medical conditions such as autism and low birth weight that are associated with such delays.
According to the government, the city and Computer Sciences engaged in three fraud schemes.
In two, the defendants allegedly circumvented Medicaid's "secondary payor" requirement that they exhaust private insurance coverage before submitting claims.
The third scheme allegedly involved the defendants' changing diagnostic codes that were used by medical providers to a generic code that they knew would result in payment by Medicaid.
Actos Bladder Cancer Overview
Actos class action lawsuits and individual cases are being filed nationwide after it’s been found that taking Actos (pioglitazone) may have caused bladder cancer in up to 40% of patients who took it for more than one year. Takeda Pharmaceuticals released Actos to help improve glucose (blood sugar) control in Type 2 diabetic adults.
Takeda Pharmaceuticals states that Actos (pioglitazone) helps your body better use the insulin you make. Actos is also supposed to help stop your liver from making more glucose or sugar when it doesn’t need to. The Actos class action lawsuit and Actos bladder cancer lawsuits allege that Takeda Pharmaceuticals knew about the risks of developing bladder cancer for diabetics who took Actos for more than one year and didn’t warn patients or doctors of the risk.
Actos Bladder Cancer Symptoms
The Actos class action lawsuit investigation does not dispute the claims by Takeda Pharmaceuticals that Actos can help treat type-2 diabetes. Actos lawyers and Actos bladder cancer attorneys are investigating claims that long-term treatment with Actos may cause cancerous tumors in the bladder as a side effect of using Actos.
A 10-year study showed that diabetics who took Actos (pioglitazone) for more than a year had not just a slightly elevated risk of cancerous bladder tumors, but, increased their risk of bladder cancer by 40%. Recently a lawsuit was filed by an Actos user who only used the type 2 diabetes treatment for four months before developing bladder tumors and being diagnosed with bladder cancer.
There are multiple symptoms of bladder cancer and those taking Actos should be aware of each of them. These bladder cancer symptoms include:
Painful or frequent urination
Urinary tract infection(s)
Blood in your urine
Hundreds of Actos lawsuits have been filed nationwide. Actos lawyers are investigating all possible injuries connected to Actos side effects.
An Actos Class Action Lawsuit may be filed when many people have experienced the same, or a very similar injury. This could be financial damages, medical expenses, time away from work due to being in the hospital, or even time away from work while caring for an injured or sick loved one who took Actos. Sometimes a class action lawsuit may not be the best strategy for someone injured by Actos. In that case, an attorney representing you or your loved one personally may be the best course of action.
If you are represented individually because you or a loved one has shown signs of bladder cancer due to Actos you may have a much better chance of being compensated for your injuries, medical treatment and pain and suffering due to Actos (pioglitazone). Individual Actos lawsuits may also be able to compensate the spouse or significant other who took care of their loved one while being treated for bladder cancer or other serious side effects of Actos like congestive heart failure, severe cardiovascular problems, lactic acidosis or bone fractures. In addition Actos attorneys are filing wrongful death lawsuits against Takeda Pharmaceuticals if your loved one died from an alleged Actos side effect
Detroit, MI: A preliminary $395 settlement has been reached in a consumer fraud class action pending against Hyundai Motor Corp. and Kia Motors alleging gas mileage rating were overstated by the automotive manufacturers. The settlement will affect some 600,000 of Hyundai’s 2011-13 models and about 300,000 of Kia‘s 2011-13 models in the US.
In November 2012, Hyundai and Kia Motors agreed to restate expected gas mileage for 1.1 million vehicles in North America, following an investigation by the Environmental Protection Agency. The automakers admitted they after overstated mileage claims on vehicle window stickers for 900,000 vehicles in the United States. The settlement impacts about 600,000 of Hyundai’s 2011-13 models and about 300,000 of Kia‘s 2011-13 models in the U.S. Hyundai’s settlement is valued at up to $210 million, while Kia’s is valued at $185 million.
The 2012 restatement reduced Hyundai-Kia’s fleetwide average fuel economy from 27 to 26 mpg for the 2012 model year. Individual ratings, depending on the car, will fall from 1 mpg to 6 mpg. Most vehicles saw combined city-highway efficiency drop by 1 mpg, the Detroit News reports. Exact figures will depend on how many customers elect to participate in the settlement’s one-time lump sum payment option or remain in the lifetime reimbursement program, the automakers said.
The settlement will resolve more than 50 lawsuits filed across the country to address the issue. Hyundai agreed to add the option of taking a lump sum payment. The proposed cash amount, which varies by vehicle model and ownership type, will result in an average payment of $353 to Hyundai owners and lessees. For example, an owner of a 2012 Elantra would receive a lump sum payment of $320 minus any previous reimbursement payments. For Kia owners, the proposed average cash lump-sum amount will be about $667.
Hyundai and Kia owners can also elect other options such as a dealership credit of 150 percent of the lump sum amount, or a credit of 200 percent of the cash amount toward the purchase of a new Kia or Hyundai.
A federal judge is expected to review the proposed settlement for preliminary approval in early 2014. If approved, settlement notices will be sent to individual class members. Initial details of the settlement are available at hyundaimpginfo.com or www.kiampginfo.com.
Trinity Industries, the highway guardrail maker accused of selling systems that can malfunction during crashes and slice through cars, was found by a jury to have defrauded the federal government.
The case was brought under the False Claims Act by Joshua Harman, a competitor who discovered that the company made changes in 2005 to its rail head — the flat piece of steel at the front of the system — without telling the Federal Highway Administration, as is required. The company sold the guardrails to state governments that, in turn, received federal reimbursement.
A Texas jury on Monday awarded $175 million that will, under federal law, be tripled to $525 million. The money will be split between the United States Treasury and Mr. Harman, who, although a competitor to Trinity, is considered a whistle-blower. After discovering the design change during litigation in 2011, he filed the case on behalf of the government.
Beyond the jury verdict itself, the judge hearing the case will determine exactly how many “false claims” apply in the case to Trinity. Statutory penalties for each instance of a false claim range from about $5,000 to $12,000, and Trinity would be responsible for such payments.
At the heart of the dispute was a design change Trinity made in 2005 to its ET-Plus rail head, which could cause a guardrail system to fail, according to some state regulators and the federal lawsuit. Those changes were not disclosed to the Federal Highway Administration for seven years, despite requirements that any such changes be reported immediately. Trinity has said that the failure was inadvertent.
While states are ultimately responsible for their highway equipment, the federal agency plays a crucial role, providing guidance on which products are eligible for federal reimbursement dollars. The agency has continued to approve the ET-Plus even as state officials have raised concerns.
The guardrail system works by collapsing when hit head-on, absorbing the impact of a vehicle and guiding the railing out of its path. The rail head or end terminal, which is often marked with yellow and black stripes, is supposed to slide along the guardrail itself, pushing it to the side.
But the redesigned Trinity product narrowed the channel behind the head, which can cause it to jam instead of sliding along the rail, some state officials said. When that happens, the rail can pierce an oncoming vehicle like a harpoon, endangering occupants.
At least 14 other lawsuits blame the guardrails for five deaths and more injuries. Trinity is a major guardrail supplier nationwide. According to internal company documents, the change was expected to save about $2 on every rail head.
A small saving for a lot of people who were devastated by the faulty rails!
A Minnesota man who alerted the U.S. Department of Defense (DoD) to a Humvee manufacturing change that could potentially put soldiers at risk won nearly $1 million after settling his whistleblower lawsuit. David McIntosh lost his job at M.K. Battery in 2007. This came after he called defense officials to warn them the manufacturing process on Humvees gun turrets had changed. Mr. McIntosh said the change cut the life span on the battery that turned the turret by about half, which could result in fatal consequences for soldiers involved in a gun fight in Iraq.
Mr. McIntosh tried to persuade his employer to tell the Army about the change. He finally realized the company was not going to report the matter. After 14 months had elapsed, he called the Defense Department himself. Subsequently, he was fired for insubordination. M.K. Battery has denied that the batteries fail to meet the required specifications, but interesting and perhaps telling, the company saw fit to settle with Mr. McIntosh.
