Blue Cross Blue Shield (BCBS) has agreed to pay $2.8 billion to settle an antitrust class action lawsuit brought by hospital systems, physicians, and other healthcare providers. The plaintiffs alleged that BCBS and its affiliates underpaid them for services and reimbursements. This proposed settlement, filed in an Alabama federal court... Read More »
Biotech Company Biogen to Pay $900M to Settle Doctor Kickback Allegations
Biotech company Biogen has agreed to a $900 million settlement to resolve claims that it violated Federal laws guarding against kickback payments.
The whistleblower lawsuit was brought forward by Michael Bawduniak, a former employee of Biogen. Bawduniak filed the lawsuit in 2012 under the False Claims Act, a federal regulation that allows whistleblowers to sue companies on behalf of the government if they suspect misuse of funds including fraud and illegal kickback schemes.
In some cases, the government may intervene in whistleblower cases. However, in this case, the government did not and Bawduniak moved forward with the case alone alongside his lawyer. According to Bawduniak’s lawyer, Thomas Greene, this is the largest whistleblower recovery in the past 150 years to be settled without the intervention of the government.
According to the lawsuit, Bawduniak accused the company of persuading doctors to prescribe the company's multiple sclerosis drug in exchange for kickback payments. The lawsuit details that from at least January 2009 to March 2014, the company knowingly made “sham” payments to doctors in the form of speaking fees, consulting fees, and even payments for meals. In exchange, doctors prescribed Biogen manufactured medication including Avonex, Tysabri, and Tecfidera. In doing so, the company violated the federal Anti-Kickback Statute.
As part of the settlement, Biogen will owe over $843 million to the federal government. Another $56 million will be spread across 15 states that overbilled Medicaid and Medicare insurance programs. Bawduniak will also receive a portion of the settlement funds.
After announcing the settlement, Biogen shared that it can go back to focusing on “our patients and strategic priorities." However, the company maintains that the settlement is not an admission of guilt. The company’s statement adds, “Biogen believes its intent and conduct was at all times lawful and appropriate and Biogen denies all allegations raised in this case."
U.S. Attorney for Massachusetts, Rachael Rollins, shared, “We thank Mr. Bawduniak for uncovering this behavior and bringing it to light,” Rollins said. “This matter is an important example of the vital role that whistleblowers and their attorneys can play in protecting our nation’s public health care programs.”
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