Medicare Part D Plan Fraud

The Medicare Part D Program for senior citizens was enacted in 2003 and went into effect on January 1, 2006. The program provides access to prescription drug coverage for Medicare recipients. Tens of millions of Americans are covered under Part D plans each year. Under the Part D program, seniors pay a premium to Part D plan sponsors in exchange for coverage, or partial coverage, of prescription drugs and access to negotiated pricing of prescription drugs.

Across the United States, there are nearly 1,500 Part D Prescription Drug Plans. However, out of all of the plans offered, the majority of the Part D plan market is controlled by just a few of the largest companies. Because of the significant sums of government money available and the sheer volume of participants in the program, sometimes Part D plan sponsors and/or their Pharmacy Benefit Managers (PBMs) engage in fraudulent practices that result in improper claims for payment to federal programs.  These improper claims can form the basis for claims under the False Claims Act.

Real World Examples of Recent Medicare Part D Fraud False Claims Act Cases:

  • 2012: RxAmerica paid over $5 million to settle False Claims Act lawsuits in which it was alleged that the company misrepresented the cost of prescriptions on the Medicare Prescription Drug Plan Finder on the Centers for Medicare & Medicaid Services' website. The whistleblowers, two of which were represented by the Rabon Law Firm, PLLC, shared in an award of $900,000.

For a free consultation about a potential Medicare Part D fraud case, healthcare fraud, or other potential whistleblower case, please call us or click here to submit your information.

Be Bold. Take the First Step now to Stop Fraud.

Fraudsters that cheat the Government – and the taxpayers – harm us all. Whistleblowers who take action to stop fraud are heros. These heros are rewarded when cases are successful.

Whether your case concerns Healthcare Fraud involving Medicare or Medicaid, Pharmaceutical or Pharmacy Fraud, Military Contractor Fraud, General Government Contracting Fraud under GSA, Small Business Fraud, Grant Fraud, Financial or Banking Fraud, or some other sector of government spending, we are here to help you in your effort help stop fraud.

We'll gladly discuss your case with you at your convenience. Contact us today to schedule an appointment.