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A Whistleblower’s Tale: Big Pharma and Fraud

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Man’s Dream Evaporates as Big Pharma Steps into the Picture

T. Mark Jones had a dream, and an admirable one at that, that he and his partners turned into a reality.  Jones, a registered nurse, delivered HIV treatment starting in the late 1980s to patients near death who did not want to die in a hospital or other healthcare facility.  However, when a pharmaceutical chain entered the picture in 1991 and opened an AIDS clinic in the Key West area, his dream job began to unravel.  Unfortunately, his job became obsolete and he was eventually forced to move his wife and kids into his parents’ home in order to survive.  But Jones’ fortune took a turn for the better when he discovered the pharmaceutical chain’s nefarious practices and blew the whistle.

Big Pharma Prescribed Medications for Biggest Bucks

What Jones discovered was that his rival, National Medical Care Inc., then owned by W. R. Grace and Co., planned to prescribe medications to those patients who would generate the most money.  He and his two partners decided to investigate the company and found that it was overbilling Medicare, and cheating U.S. taxpayers.  But what they also found was that National Medical Care Inc. wasn’t the only big pharma company engaged in this practice.

Company Born to Fight Big Pharma Ripoffs

As a result of their first investigation, Mark T. Jones and his two partners opened a new business–one dedicated to helping save the federal government and taxpayers millions of dollars in Medicare costs.  Ven-a-Care operates from Key West, where Jones’ first business began, and has filed dozens of lawsuits against big pharma since 1995.  Overall, the company has saved $3 billion in Medicare costs for the U.S. government.  As a result of Ven-a-Care’s original whistleblowing discovery against National Medical Care Inc., NMC plead guilty to criminal charges.  In addition, 24 other large pharmaceutical companies have settled civil lawsuits and in 2003, Congress passed the Medicare Modernization Act which saves taxpayers an estimated $15.7 billion per decade.

Big Pharma’s Scheme, Uncovered

The scheme in which NMC was engaged involved the company selling medicines to hospitals and pharmacies at one price and then falsely reporting higher amounts to independent publishers of pricing data.  The federal government relies on such published prices to know what amounts to pay for reimbursements to pharmaceutical companies providing drugs to Medicare patients.  But the scheme didn’t end there–NMC was also urging physicians to prescribe more and pharmacies to buy more prescription drugs, which allowed the company to spread its market share and increase sales.  Unfortunately, the company wasn’t alone in its nefarious practices, as the number of other lawsuits against big pharma show.  However, thanks to whistleblowers like Ven-a-Care, the federal government and taxpayers have saved $24.2 billion since 1998.

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    Armitage, as its Executive Director and General Counsel, effective Oct.

    This is generally not done out of selfishness but thoughtlessness; unless of course you needed hospital attention.
    good lawyer for personal injury is much more serious and not at all comparable.

  2. Nelly Jen says:
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