THE MOST SUCCESSFUL WHISTLEBLOWER CASE REVEALS MASSIVE MEDICARE FRAUD

Ven-A-Care, a small Key West Fla. company is fighting a campaign against drug companies that overcharge the government and since starting has collected over $2 billion dollars for state and federal governments. In addition, it has won over $380 million for itself in the form of whistleblower awards. The most recent victory was a $170 million verdict against generic drug maker Actavis which was charged with overcharging Medicaid for drugs.Pharmacies and drug providers buy medicines from drug companies and distribute them to Medicaid recipients. Medicaid then reimburses the pharmacies for the cost of the drugs, plus a markup for the cost. But Ven-A-Care owners observed that some companies were routinely charging the pharmacies one price but told Medicaid and Medicare that the price was much higher. Then when the government reimbursed the pharmacies this resulted in a windfall profit. Ven-A-Care sued under a law called the False Claims Act, which allowed it to recover a reward of a percentage of moneys the government collected. This is considered the most successful case for the whistleblower, even brought and is exemplary of a trend in which companies are becoming whistleblowers as opposed to individuals.