Bert Louthian, a South Carolina attorney who focuses on whistleblower lawsuits, said today that he supports government inspectors who recently told lawmakers, according to Fox News, that more needs to be done to prevent doctors from prescribing psychiatric drugs that are not approved to treat dementia in afflicted nursing home residents.
Fox News reported that the U.S. Department of Health and Human Services found that 83 percent of Medicare claims for antipsychotic medications – normally used to treat people with schizophrenia or bipolar disorder – were prescribed for patients with dementia. Almost 305,000 nursing home residents were prescribed antipsychotics.
The medications have been linked to an increased risk of death in seniors, which has led the U.S. Food and Drug Administration (FDA) to repeatedly caution against prescribing such drugs for easing aggressive behaviors associated with dementia, according to Fox News.
“There have been multiple warnings to practitioners against the health risks of using antipsychotic medications for people with dementia, both from the federal government and the drug companies who warn against it on their labels,” said Louthian.
“Now it’s time for people to step forward and prevent a serious health crisis by alerting the public to such continued misuse..
Louthian said that “off-label use,” or the use of drugs beyond the scope for which they are approved, is a nationwide problem that is beginning to receive widespread attention through qui tam litigation, or whistleblower claims.
“Pharmaceutical companies are increasingly being held accountable for promoting the use of their drugs for off-label uses,” the South Carolina lawyer said. “That is a violation of the False Claims Act because payment for off-label use of prescription medications by Medicare or Medicaid is not eligible for reimbursement..
The False Claims Act pertains to any kind of fraudulent claim in the U.S., including tax fraud, health care fraud (such as false Medicaid or Medicare claims), Social Security fraud or corporate fraud that involves overbilling the government or submitting false information to regulatory agencies.
Another major area of qui tam litigation is occurring among medical practices that are billing Medicare for services that aren’t authorized, Louthian said.
“What we have seen is they will tack on a $25 charge here or a $50 charge there thinking that nobody will notice – and Medicare doesn’t notice because oversight and enforcement appear to be practically nonexistent – until an employee of the medical practice comes forward,” Louthian said. “It doesn’t sound like much, but it adds up, and there can be a hefty per occurrence monetary penalty..
Lawyers who are well-versed in qui tam litigation and whistleblower claims can assist workers in bringing the fraud to light without fear of retaliation from their employers.
“Being a whistleblower is not necessarily a role that people are comfortable playing,” Louthian said. “While they may reap financial rewards from a successful qui tam lawsuit due to treble damages and other penalties – which may add up even though the fraud they see may appear to be small — they also must face a lengthy legal process that can be stressful and overwhelming,” Louthian said.
“But when you’re talking about protecting innocent people from harms caused by off-label or other abuses, people need to summon the courage to bring the truth to light..