Better than winning the lottery

Have you ever dreamed of winning a $50 million lottery jackpot? For only $1 you can buy into the dream with a Powerball ticket, but the odds of winning big are roughly 1 in 80 million. Thus, most of us just keep on dreaming.

Pharmaceutical companies, however, have their own dreams. They dream of becoming rich – filthy rich. But they don't play the lottery. The odds and return are too low. They find it much more palatable to lie, cheat and steal from the taxpayers than to play lousy odds. By committing fraud, they can easily net 10 times more than what they could ever hope to win in a major lottery – and the odds are on their side!

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The sad truth is that in a short amount of time, a single company can methodically cheat Medicare out of $500,000,000.00. That's right, half a billion dollars!

Recently, Apothecon, a subsidiary of Bristol-Myers Squibb, reached an agreement with the Department of Justice to repay one-half a billion dollars in money it stole from Medicare and Medicaid.

Much of the fraud took place in a single scheme lasting less than three years. Apothecon reaped extraordinarily large profits by paying illegal kickbacks to hospitals and doctors who prescribed its line of drugs to patients who may or may not have needed those drugs.

To disguise the fact that it was paying kickbacks, Apothecon's records showed that they were paying doctors huge amounts of money to perform "non-existent" consulting work, sit on so-called advisory boards, or – get this – travel to luxurious resorts for "meetings." With hospitals and doctors on their payroll, this Bristol-Myers Squibb subsidiary was virtually assured of gaining a large market share. Having captured the market, the pharmaceutical company could ask whatever prices it wanted. The costs were seamlessly passed on to you and me.

A second scheme cheated Medicaid. Pharmaceutical companies are required by law to sell their drugs to Medicaid for the same price as they sell them to their best customers. But that law does not apply to certain resellers using a generic brand or placing a private label on the drugs purchased from the manufacturer. The law does not, however, allow the pharmaceutical company merely to place a private label on the drug to be exempt.

Seeing an opportunity, Apothecon chose the route of deceit. It created a fictitious private label disguised to look like an exempt reseller. It then used phony invoices to make it appear that a reseller was the one supplying drugs to its best customers, when, in fact it was Apothecon. Everyone was happy, except the taxpayers paying too much for drugs. The pharmaceutical company made its best customer happy with steep discounts and lined its pockets by hundreds of millions by overcharging Medicaid.

Even though the Medicaid rules clear state that this type of "private label" scheme is illegal, the companies wanted lottery-sized profits that were only available if they cheated – so that's what they did.

Here is the good news. When they realized what was going on, seven brave souls dared to stand up against this giant corporation, Bristol-Myers and its subsidiaries, and report the fraud. Because the government has a program designed to reward whistleblowers with a percentage of the money recovered, these individuals were rewarded with a lottery-sized reward of $100 million to split.

Next time you think of playing the lottery, why not consider taking your winnings from stopping companies like these? Your chances of reaping a big reward are far better, and you will have the satisfaction of doing something that benefits others as well. Not only will you reduce all of our taxes and insurance rates, but you may be able to claim a lottery-sized reward without even having to buy a ticket!