1. Pharmaceutical Fraud in a Qui Tam World Patrick J. O’Connell Chief, Civil Medicaid Fraud Office of the Attorney General

3. How to Get A Million Dollars and Never Pay Taxes! 1. First, Get a Million Dollars 2. When the IRS asks why you did not pay your taxes, you say: “I forgot”.

4. Get Yourself a Case 1. MFCU 2. Qui tam statute 3. Types of pharma cases: Pricing or “AWP” Rebate Off Label Marketing PBM Misrepresentation of efficacy or side effects

6. Chapter 36, Texas Human Resources Code -Automatic Trebles -Fees and Costs -Penalties from $1,000-$10,000 Per unlawful act -Automatic exclusion from program for minimum of 10 years

10. Get Some Lawyers

11. In-house Lawyers and Staff Relator Lawyers and Staff Outside Lawyers and Staff Coordination with Other States Through NAMFCU

12. Get Some Money Experts Travel Videographers Court Reporters

13. State of Texas ex rel Ven-a-Care of the Florida Keys vs. Dey, Warrick & Roxane Filed Sept. 2000 Lawyers for Good Guys: 6 Lawyers for Bad Guys: 10+ > 130 Depositions > 1,000,000 pages of documents Travel to California, Tennessee, Ohio, New York, New Jersey, Connecticut, Alabama Sanctions against each company for discovery abuse Largest sanction ever awarded in Travis County for perjury in civil matter Finally settled Nov. 2005 Recovery of $55.6 million, including $12.7 million in fees and costs

14. State of Texas vs. Abbott Labs, Baxter & B. Braun Filed May, 2004 Settled with Baxter and B. Braun for $12.3 million Texas Lawyers: 3 Relator Lawyers: 3 Abbott Lawyers: 15+ Current Fees and Costs: $5 million + Mandamus to Ct. App. twice Mandamus to Tex. Supreme Ct. twice Removed and Remanded

15. Results

16. Since 1999, recoveries of $217 million Texas recoveries of $127 million –Federal: $58 million –State: $50 million –Relator: $19 million

17. Be Careful What You Wish For! Current Caseload: 175 Current Unsealed Cases: 4 Current Lawyer Staffing: 10 Requested Staff Increase Approved By Legislature: 27 Requested Appropriation Approved for Biennium: $10.5 Million