Attorney General James Announces $8 Million Settlement In Principle With Walgreens Over False Claims Billed To New York's Medicaid Program For Prescription Drugs

  Attorney General Letitia James announced that New York has joined with other states and the federal government to reach an agreement in principle with Walgreen Co. (Walgreens) to settle allegations that Walgreens violated the False Claims Act by billing Medicaid at rates higher than its usual and customary (U&C) rates for certain prescription drugs. As a result, Walgreens, a Delaware corporation headquartered in Deerfield, Illinois, will pay the states and federal government $60 million, all of which is attributable to the states’ Medicaid programs.

“My office will continue to investigate and stop unlawful practices that hurt New York State’s Medicaid Program,” said Attorney General Letitia James. “We will never let companies get away with illegally billing Medicaid with inflated amounts for prescription drugs."

The national federal and state civil settlement will resolve allegations relating to Walgreens’ discount drug program, known as the Prescription Savings Club (PSC).  The investigation revealed that Walgreens submitted claims to the states’ Medicaid programs in which it identified U&C prices for certain prescription drugs sold through the PSC program that were higher than what Walgreens actually charged for those drugs. In doing so, Walgreens’ obtained more money in reimbursements from the States’ Medicaid program for sales of such drugs than it was entitled to receive. 

The investigation resulted from a qui tam action originally filed in 2012 in the United States District Court for the Southern District of New York under the federal False Claims Act and various state false claims statutes. As part of the settlement, New York Medicaid will receive over $8 million in restitution and other recoveries.

A National Association of Medicaid Fraud Control Units (NAMFCU) Team conducted the settlement negotiations with Walgreens on behalf of the states. The Team included representatives from the Offices of the Attorneys General for the states of New York, California, Illinois, Indiana, Michigan and Ohio.

The civil settlement was handled by Special Assistant Attorney General Kathryn Heim Harris of the New York City Regional Office, under the supervision of MFCU Civil Chief Carolyn Ellis. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney.

This is the second false claims act settlement reached with Walgreens. On January 22, 2019, Attorney General James announced that Walgreens is to pay New York over $6.5 million as part of a $209.2 million settlement with the federal government and other states, resolving allegations that Walgreens knowingly engaged in fraudulent conduct when it dispensed insulin pens in full boxes of five pens regardless of the quantity of insulin and/or days’ supply written on the Medicare or Medicaid beneficiaries’ prescription.

Attorney General James and 45 Attorneys General Nationwide Reach $120 Million Settlement with Johnson & Johnson and DePuy Inc. Over Misleading Information about Hip Replacement Devices

DePuy Misled Patients About Longevity, Efficacy of Hip Replacement Devices

  Attorney General Letitia James announced that she and 45 other Attorneys General across the country reached a $120 million Consent Judgment with Johnson & Johnson and DePuy Inc. to resolve allegations that the company unlawfully promoted its metal-on-metal hip implant devices, the ASR XL and the Pinnacle Ultamet.

The Attorneys General allege that DePuy engaged in unfair and deceptive practices in its promotion of the ASR XL and Pinnacle Ultamet hip implant devices by making misleading claims as to the longevity, also known as survivorship, of metal-on-metal hip implants. DePuy advertised that the ASR XL hip implant had a survivorship of 99.2 percent at three years when the National Joint Registry of England and Wales reported a 7 percent revision rate at three years. Similarly, DePuy promoted the Pinnacle Ultamet as having a survivorship of 99.8 percent and 99.9 percent survivorship at five years when the National Joint Registry of England and Wales reported a 2.2 percent 3-year-revision rate in 2009 increasing to a 4.28 percent 5-year-revision rate in 2012. 

“Doctors and their patients need to have accurate and up to date information to ensure that patients are receiving appropriate healthcare,” said Attorney General Letitia James. “Companies should never be allowed to freely mislead the public, especially when there are health concerns involved. This settlement serves as an important message that deceptive and false medical practices will never be tolerated.”

Some patients who required hip implant revision surgery to replace a failed ASR XL or Pinnacle Ultamet implant experienced persistent groin pain, allergic reactions, tissue necrosis, as well as a build-up of metal ions in the blood. The ASR XL was recalled from the market in 2010. DePuy discontinued its sale of the Pinnacle Ultamet in 2013.

As part of the Consent Judgment, DePuy has agreed to reform how it markets and promotes its hip implants. Under the Consent Judgment, DePuy is required to: 

• Base claims of survivorship, stability or dislocations on scientific information and the most recent dataset available from a registry for any DePuy hip implant device.
• Maintain a post market surveillance program and complaint handling program.
• Update and maintain internal product complaint handling operating procedures including training of complaint reviewers.
• Update and maintain processes and procedures to track and analyze product complaints that do not meet the definition of Medical Device Reportable Events.
• Maintain a quality assurance program that includes an audit procedure for tracking complaints regarding DePuy Products that do not rise to the level of a Medical Device Reportable Event but that may indicate a device-related serious injury or malfunction.
• Perform quarterly reviews of complaints and if a subgroup of patients is identified that has a higher incidence of adverse events than the full patient population, determine the cause and alter promotional practices as appropriate. 

Under the settlement New York State will receive $4,663,161.92.

Attorney General James Announces Settlement With Walgreens Boots Alliance Over Medicaid Fraud Allegations For Over-Dispensing Insulin Pens

Walgreens to Pay $209.2 Million to Resolve Allegations it Falsely Billed New York’s Medicaid Program for Insulin Pens

New York State to Receive Over $6.5 Million Share of Insulin Pens Settlement  

  Attorney General Letitia James announced that New York, together with the federal government and other states, has reached a nationwide $209.2 million settlement with Walgreens Boots Alliance (Walgreens) concerning allegations of fraudulent over-dispensing of insulin pens at Walgreens pharmacies. The qui tam action, unsealed today, resolves allegations that Walgreens knowingly engaged in fraudulent conduct when it dispensed insulin pens. When filling insulin prescriptions, Walgreens did not always adhere to the dosage outlined by the prescribing doctor, but rather dispensed insulin pens in boxes containing five pens, regardless of the patient’s needs. This resulted in a pattern where Medicare and Medicaid beneficiaries were routinely receiving more insulin than prescribed and Walgreens was then billing Medicaid for the additional doses. Walgreens, headquartered in Deerfield, Illinois, operates the largest retail pharmacy chain in the U.S., with 8,309 locations across all 50 states. 

“Cheating our state’s Medicaid program will never be tolerated by this office,” said Attorney General Letitia James. “We will continue to root out illegal practices that increase costs of health care and medication for all New York Medicaid recipients, and will hold accountable any provider that engages in these deceptive practices.”

Under the settlement, Walgreens will pay the United States and the States $209.2 million dollars. Of this amount, $89,185,625.10 will go to the state Medicaid programs to resolve civil allegations that Walgreens’ unlawful over-dispensing of insulin pens caused false claims to be submitted to Medicaid health care programs. The State of New York will receive $6,548,679.82 of this amount in restitution and other recovery.

Walgreens admitted, among other facts, that from January 1, 2006 to December 31, 2017:

• When a state Medicaid program denied a claim from Walgreens because the reported days of supply for a full carton of five insulin pens exceeded the Medicaid program’s days of supply limit, it was Walgreens’ practice to dispense and bill for the full carton, and reduce the reported days of supply to conform to the program’s days of supply limit. Thus, Walgreens repeatedly reported days of supply data to state Medicaid programs that were different from, and lower than, the days of supply calculated according to the standard pharmacy billing formula of dividing the quantity of insulin being dispensed by the daily dose; and

• As result of this practice, state Medicaid programs approved and paid a substantial number of claims submitted by Walgreens for insulin pen refills that the programs would not have approved if Walgreens had reported the days of supply for previous fills calculated according to the standard pharmacy billing formula of dividing the quantity dispensed by the daily dose.

In recent years, New York’s Medicaid program paid an average of approximately $425 per box of five insulin pens to pharmacies on behalf of Medicaid beneficiaries.

The investigation was initiated after a whistleblower filed a lawsuit in 2015 in the United States District Court for the Southern District of New York under the qui tam provisions  of the federal False Claims Act and the named plaintiff states’ respective false claims statutes.  The relator in this case will receive a share of the settlement proceeds after full payment by Walgreens.  The case is captioned United States of America et al., ex rel. Adam Rahimi et al. v. Walgreen Boots Alliance, Inc., Civil Action No. 15-CV-5686 (S.D.N.Y.) (Crotty, J.).

The insulin pens investigation and settlement were the result of a coordinated effort between the U.S. Attorney’s Office for the Southern District of New York, and the National Association of Medicaid Fraud Control Units (NAMFCU).  A NAMFCU Team conducted the investigation of Walgreens and participated in the settlement negotiations on behalf of the states, and included representatives from the Offices of the Attorneys General for the states of Indiana, New York, Washington, Texas, Oklahoma and Massachusetts.

Comptroller Stringer: Millions in Unclaimed Wages Available for Workers Cheated Out of Pay

While federal government attacks immigrant communities, Comptroller’s office launches outreach campaign to link potentially impacted employees with wages they deserve.

  New York City Comptroller Scott M. Stringer launched a new campaign today to return over $2.5 million in unclaimed prevailing wage awards to workers cheated out of their pay by unscrupulous contractors on City-funded projects. The Comptroller’s Bureau of Labor Law enforces prevailing wage and benefit rates for construction and building service workers employed by contractors on City public work projects. When companies on these public contracts fail to pay the proper wages and benefits, the Comptroller enforces the law to ensure workers receive the money they are owed through outreach.

The letters notifying workers – many of whom are immigrants –  of their unclaimed awards are on the Comptroller’s letterhead, however anecdotal evidence indicates many are afraid to respond because they fear it is a scam or veiled immigration enforcement. The new campaign will conduct outreach to impacted workers through media outlets to provide reassurance to those with unclaimed prevailing wage awards.

“An honest day’s work deserves an honest day’s pay, and my office has zero tolerance for predatory contractors who steal wages from their workers,” said Comptroller Stringer. “The hateful, anti-immigrant rhetoric coming out of Washington has created a climate of fear, leaving employees too afraid to hold employers accountable when they withhold their pay. While we can’t control the White House, we can fight to protect workers here in New York City. This campaign is our way of making sure that regardless of who you are or your immigration status, if you did the work for a City contractor, you’ll get the pay you deserve.”

Since 2014, Comptroller Stringer’s office has assessed more than $27 million in prevailing wage violations and paid over $12 million to employees who were cheated out of their wages. It has also debarred 50 contractors who took advantage of workers – setting an office record.

Cases From Bronx District Attorney Darcel Clark

BRONX MAN SENTENCED TO 25 YEARS TO LIFE IN PRISON FOR MURDER OF MAN AFTER PETTY ARGUMENT 

  Bronx District Attorney Darcel D. Clark today announced that a Bronx man has been sentenced to 25 years to life in prison for the 2016 fatal shooting of a 33-year-old man. 

 District Attorney Clark said, “The defendant shot and killed the victim after a petty argument. I hope today’s sentence brings some justice to the victim’s family for this senseless murder.” 

 District Attorney Clark said the defendant, Luis Chacon, 39, of 1764 Weeks Avenue, was sentenced today to 25 years to life in prison by Bronx Supreme Court Justice Martin Marcus. Chacon was convicted by a jury of second-degree Murder on October 31, 2018.

 According to the investigation, on July 25, 2016, in front of 1775 Weeks Avenue, the defendant caused the death of Beremy Garcia by shooting him multiple times in the back and head. The defendant used a .357 magnum revolver to shoot the victim. After the shooting, Chacon hid the weapon inside the wheel well of a parked car and fled. He was apprehended nearly three months after the incident in Orlando, Florida.

 Surveillance cameras from a nearby grocery store captured the shooting incident on video and showed Chacon, who has distinctive tattoos on his torso, and he was identified as the shooter. Bullets recovered from the victim were matched to the murder weapon by detectives from the NYPD Firearms Analysis Section

 According to the investigation, Garcia and Chacon were arguing and the defendant left and returned with a gun, shooting at Garcia because he said the victim had disrespected him. Chacon also fired a shot that struck an innocent bystander, Yajaira Duverge, 37, causing her death. The defendant was acquitted of Manslaughter for Duverge’s death.

 District Attorney Clark thanked Detectives Michael Fassert and Orlando Colon of the 46th Precinct Detectives Squad, as well as Detectives Keith Walker and Sean Butler of the Bronx Homicide Task Force.

BRONX DISTRICT ATTORNEY DARCEL D. CLARK ANNOUNCES VACATING OF CONVICTION IN 1989 MURDER; HUWE BURTON SERVED 19 YEARS FOR STABBING HIS MOTHER TO DEATH WHEN HE WAS 16 

Conviction Integrity Unit Reinvestigated; Found Burton’s Confession Unreliable

  Bronx District Attorney Darcel D. Clark today announced that she joined the request to vacate the conviction and dismiss charges against Huwe Burton for the 1989 fatal stabbing of his mother, after a review of the case by the Conviction Integrity Unit determined that Burton’s confession to the murder as a 16-year-old is not reliable based on new expert information about the phenomena of false confessions, as well as contradictions in the proof presented at Burton’s trial. 

 Bronx Supreme Court Justice Steven Barrett granted the motion by the Innocence Project attorneys to vacate the conviction and dismiss the indictment against Mr. Burton, 46, in a hearing today in the Bronx Hall of Justice. 

 District Attorney Clark said, “Mr. Burton served 19 years in prison and since his release in 2009 has led a law-abiding life. He has maintained his innocence for almost 30 years and now we will clear his name of this brutal killing. The interests of the community are best served by dismissing this indictment so he can move on with the rest of his life.”

 “After a request by the Innocence Project attorneys, over a two-year period, the Conviction Integrity Unit worked with them to conduct a comprehensive reinvestigation of the case, which drew headlines during a time of crack cocaine-fueled violence in the city. Now, police and prosecutors use different techniques to interview suspects, and solve and try crimes, and we believe that Mr. Burton might not have been convicted using today’s standards in law enforcement and the criminal justice system. I thank the Innocence Project for giving us the time to thoroughly investigate. The Conviction Integrity Unit will review any application and is prepared to review any conviction where there are legitimate concerns about the reliability of a confession.”

 Innocence Project Attorney Susan Friedman said, “Huwe Burton is an extraordinary individual. The injustice he endured is unimaginable—to be wrongly convicted of murdering his mother, whom he adored. Today, Mr. Burton will finally get some measure of justice. The defense team is extremely grateful to District Attorney Clark and the Bronx CIU for their extraordinary work. We hope this tragic case can serve as a learning moment about the value of new scientific research on false confessions and steps that can be taken to avoid dangerously coercive interrogation techniques. Based on the three false confessions revealed during this investigation, we also hope and expect that the CIU is open to reviewing other cases handled by these detectives if the parties can develop a mechanism to identify them.”

 The Conviction Integrity Unit scoured transcripts and case files, interviewed witnesses and scrutinized the quality of evidence used to convict Mr. Burton. Scientific evidence not available until recently has identified flawed interview techniques as well as other factors, such as youth, that increase the likelihood that a confession is untrue. Based on this new expert information, and on the inconsistencies and contradictions in the proof that was presented at trial, the District Attorney no longer has confidence that Burton’s confession is reliable. Had this new evidence been presented, it is probable that the verdict would have been more favorable to the defendant.

 After a trial in Bronx Supreme Court, Burton was convicted on September 25, 1991 of seconddegree intentional murder and fourth-degree weapon possession for stabbing his mother, Keziah Burton, 59, in her bed in their apartment on Eastchester Road on January 3, 1989. On February 13, 1992, he was sentenced to 15 years to life in prison.

MAYOR DE BLASIO APPOINTS WILLIAM YANG AS EXECUTIVE DIRECTOR OF THE NYC CHILDREN’S CABINET

  Mayor Bill de Blasio today appointed William Yang as the new Executive Director of the Children’s Cabinet. As Executive Director, Yang will continue the Cabinet’s mission to develop opportunities for City agencies to leverage each other’s work for a greater impact on children and families. Created in 2014, the NYC Children's Cabinet is a multi-agency initiative to bolster communication and coordination among City agencies about areas of work that impact child safety and well-being. The Cabinet is chaired by Deputy Mayor for Health and Human Services Dr. Herminia Palacio, comprised of commissioners and directors from 24 City agencies and Mayoral offices, and guided by an Advisory Board which includes appointees from the public, non-profit, and private sectors. Yang will start on February 11.

“The future of New York City rests on the shoulders of our children,” said Mayor de Blasio. “Will’s experience will help make sure the Children’s Cabinet continues leading the efforts that will help us reach our goal to make New York City the fairest big city for everyone, including our youngest New Yorkers.”

“Will brings tremendous expertise in health and human services to the Children's Cabinet and will help us invest in the City’s most important resource.” said First Lady Chirlane McCray. “As the new Executive Director of the Children's Cabinet he will play a pivotal role in the lives of the 1.7 million children in New York and help shape a better future for the entire City.”

“The Children’s Cabinet leverages the collective expertise of all City agencies entrusted with the wellbeing of youth and families to advance innovative multiagency initiatives,” saidDeputy Mayor for Health and Human Services Dr. Herminia Palacio. “Will has the leadership, ideas and experience to support and grow the Cabinet’s crucial work. I am thrilled by his appointment, and look forward to working with him on new approaches to provide every child the opportunities and support they need.”

“New York City has been making historic strides in creating new and expanded opportunities for children,” said Darren Bloch, Senior Advisor to the Mayor and Director of the Office of Strategic Partnerships. “Under Will’s leadership, the Children’s Cabinet will ensure City agencies are collaborating even more to break down silos and find the best approaches to helping young New Yorkers and their families.”

“As a new father myself, I am humbled by this opportunity to help strengthen New York City families,” said Children’s Cabinet Executive Director William Yang. “I’ve spent my career using innovative tools and methods to improve the health and well-being of children and families, and I look forward to helping ensure the City’s resources enable every child to succeed. I’m proud to join administration leaders in the effort to meet this important goal.”

Yang joins the Children’s Cabinet from the U.S. Department of Health and Human Services, where in 2012 he founded the federal government’s first internal innovation accelerator, the HHS Idea Lab’s HHS Ignite. In this role, his clients included federal and local leaders driving efforts to better serve and ensure the success of children through adulthood, including the Office of Head Start and Child Care, the Office of Family Assistance, the Office of Refugee Resettlement, the Office of Adolescent Health, as well as the National Institutes of Health. Yang and his team also developed the strategy for the Administration for Children and Families’ flagship initiative, the Office of Economic Independence, which will help human services agencies nationwide mitigate intergenerational poverty.

“I turned to Will to help frame and lead efforts addressing some of the toughest problems and projects we faced in the Department [of Health and Human Services],” said Bryan Sivak, former Chief Technology Officer at the U.S. Department of Health and Human Services.“He has been instrumental in helping our human services leaders understand that system change starts at the State and local levels. I’m confident he will provide the leadership that will help the City advance its goal of a future in which all young New Yorkers have the supports and environment they need to become thriving adults.”

Under Yang’s leadership, the Children’s Cabinet will advance its existing work on early childhood and child welfare, while also expanding to focus on physical and mental health as well as justice-involved, homeless, and otherwise vulnerable adolescents. In 2019, the Cabinet will help develop and launch a new human-centered design project on disrupting intergenerational inequity, funded by the Doris Duke Charitable Foundation, the New York City Community Trust, and the Robert Wood Johnson Foundation. This project is an example of the Cabinet’s strategic goal to employ a diversity of rigorous tools to solve complex societal problems.

NYC Children’s Cabinet Initiatives

·         Partnership between the NYC Children's Cabinet and Robin Hood's Fund for Early Learning (FUEL). In 2018, the NYC Children’s Cabinet received a renewal of their Robin Hood Foundation Fund for Early Learning (FUEL) grant to support early childhood development, targeting the over 100,000 children ages 0-3 living in poverty in New York City. Building upon the “Talk to Your Baby” campaign, the City is leveraging its partnerships to deepen efforts to support children’s lifelong success. Other partners include the Bezos Family Foundation, the Harvard Center on the Developing Child, and the other FUEL grantees. To support early brain-development messaging, the Cabinet will launch a system-wide parent engagement campaign, utilizing the Bezos Family Foundation’s Vroom curriculum.

· Growing Up NYC, a digital platform for NYC parents and caregivers to easily access a vast array of resources for raising a family in New York City.

· Generation NYC, a first-of-its-kind digital platform for New Yorkers ages 13-24 designed to help young New Yorkers navigate the sometimes challenging waters of adolescence and young adulthood by offering tailored resources and opportunities.

· NYC Unity Project. In collaboration with First Lady Chirlane McCray, the Children’s Cabinet played an instrumental role in the development and launch of the New York City Unity Project, the City's multi-agency strategy to deliver unique services to young people who are lesbian, gay, bisexual, transgender, or questioning their sexual orientation or gender identity (LGBTQ).

· NYC Baby Showers, organized by the Children’s Cabinet and the Office of the First Lady, have served as a key element of the Cabinet’s early childhood efforts to promote language acquisition, parent-child attachment and healthy brain development by encouraging parents to talk, read and sing with their babies from birth. This initiative has reached nearly 9,000 families from across the five boroughs.

·Safe Medication Campaign. The Children’s Cabinet’s Child Welfare and Safety Subcommittee supported the launch of the Safe Medication Campaign alongside ACS, DOHMH, HRA, NYPD, and NYC Service. This campaign raised awareness and provided resources to reduce the likelihood that children accidentally ingest medications.

· New York City Performance Partnership Pilot (NYCP3). In partnership with the Center for Youth Employment (CYE), the Department of Youth and Community Development (DYCD) and the Administration for Children’s Services (ACS), the Children’s Cabinet launched NYCP3 to attend to the specific needs of young parents who are also out-of-school and out-of-work, offering family-friendly support to help them achieve their employment and education goals.

About Will Yang

Yang received his Bachelor’s degree from Trinity College in 2006 and his Master’s in Business Administration with a concentration in Healthcare and Innovation from Georgetown University in 2013. He attended the Rhode Island School of Design’s Human Centered Design Public Policy Institute in 2015. He also served as an Innovation Fellow at The University of Maryland’s Academy for Innovation and Entrepreneurship where he co-taught a course for public health students on addressing racial and ethnic disparities.

REP. ADRIANO ESPAILLAT STATEMENT ON DECISION TO TEMPORARILY REOPEN THE GOVERNMENT

  Today, Representative Adriano Espaillat (NY-13) released the following statement in response to President Donald Trump’s announcement to temporarily reopen the government.

“During his speech today, Donald Trump once again made the current state of national affairs about himself, while patting himself on the back for a reckless and pointless 35-day government shutdown that cost the U.S. economy billions of dollars and put 800,000 federal workers and their families under unnecessary financial strain,” said Rep. Adriano Espaillat (NY-13). “I am grateful that a deal has been reached to temporarily reopen the government, but I remain adamant in my opposition to support any legislation that includes funding for a border wall. Walls are divisive and send a message to people around the world that they are not welcome here, and that’s a message contrary to who we are as a nation.”