Lance's Corner

NYSAG Wins Settlement in Drug Companies Price Fixing Antitrust Case

Nov 1, 2024

Per the notice below, the New York State Attorney General (NYSAG) has won two settlements totaling $49.1 million in antitrust price fixing cases brought against multiple drug companies.

Attorney General James Helps Secure $49.1 Million from Drug Companies over Illegal Coordination to Inflate Prices

AG James and 49 Attorneys General Secure First Two Settlements in Ongoing Cases Against 30 Companies for Prescription Drug Price Fixing

New York Attorney General Letitia James today joined a bipartisan multistate coalition of 50 attorneys general in announcing settlements with Heritage Pharmaceuticals (Heritage) and Apotex Inc. (Apotex) totaling $49.1 million for their roles in a massive, long-running scheme to artificially inflate and manipulate prices, reduce competition, and restrict trade for dozens of generic prescription drugs.  The companies in the scheme, some of which increased prices by 1,000 percent, manufactured essential medications to treat diseases ranging from diabetes to cancer to ADHD.  As part of the settlements, both companies have agreed to cooperate in ongoing multistate investigations against 30 corporate defendants and 25 individual executives.  Both companies have also agreed to implement internal reforms to ensure fair competition and compliance with antitrust laws.

“Affordable generic drugs are a lifeline for millions of New Yorkers who rely on them every day to treat everything from diabetes to heart conditions,” said Attorney General James.  “The companies involved in this scheme engaged in a massive conspiracy to illegally coordinate prices, driving up costs for consumers as much as 1,000 percent.  These two settlements will help enable the victims of this scheme to get compensation, and will hopefully ensure this type of illegal price fixing will not happen again.  I thank my fellow attorneys general for their hard work and collaboration to protect consumers from this unfair anticompetitive conduct.”

The settlements are the result of two lawsuits filed by the Office of the Attorney General and a coalition of attorneys general against some of the nation’s largest pharmaceutical companies.  The first complaint, filed in 2016, included Heritage and 17 other corporate defendants, two individual defendants, and 15 generic drugs.  Two former executives from Heritage Pharmaceuticals, Jeffrey Glazer and Jason Malek, have since entered into settlement agreements and are cooperating with the states’ investigations.  The second complaint was filed in 2019 against Teva Pharmaceuticals and 19 of the nation’s largest generic drug manufacturers.  The complaint names 16 individual senior executives as defendants.  The third complaint was filed in 2020 against Sandoz and 18 other of the nation’s largest generic drug manufacturers, in addition to 10 individual defendants.  The lawsuits allege these companies engaged in a broad, coordinated, and systematic conspiracy to fix prices, avoid competition, and rig bids for more than 100 different generic drugs.  The companies maintained an interconnected web of industry executives where these competitors met with each other during industry dinners, "girls’ nights out," lunches, cocktail parties, and golf outings, and communicated via frequent telephone calls, e-mails, and text messages that sowed the seeds for their illegal agreements.  Defendants used terms like "fair share," "playing nice in the sandbox," and "responsible competitor" to describe how they unlawfully discouraged competition, raised prices, and enforced an ingrained culture of collusion.

The drugs included in the scheme span all types, including tablets, capsules, creams, and ointments; and classes, including antibiotics, anti-depressants, contraceptives, and non-steroidal anti-inflammatory drugs.  They treat a range of diseases and conditions from basic infections to diabetes, cancer, epilepsy, multiple sclerosis, HIV, ADHD, and more.  In some instances, the coordinated price increases were over 1,000 percent.  Digoxin, an essential heart medication manufactured by Heritage, tripled in price, causing patients to pay hundreds of dollars more for the drug.

The cases stem from an investigation built on evidence from several cooperating witnesses at the core of the conspiracy, a massive database of over 20 million documents, and a phone records database containing millions of call detail records and contact information for over 600 sales and pricing individuals in the generics industry.  A motion for preliminary approval of the $10 million settlement with Heritage was filed yesterday in the United States District Court for the District of Connecticut in Hartford.  A settlement with Apotex for $39.1 million is contingent upon obtaining signatures from all necessary states and territories and will be finalized and filed in the U.S. District Court.  Consumers who purchased a generic prescription drug manufactured by either Heritage or Apotex between 2010 and 2018 may be eligible for compensation.  To determine your eligibility, call 1-866-290-0182, e-mail info@AGGenericDrugs.com, or visit: www.AGGenericDrugs.com.

Joining Attorney General James in announcing the settlements are the attorneys general of Alaska, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, the District of Columbia, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.  These settlements are the latest example of Attorney General James taking action to stop companies from engaging in anticompetitive conduct and harming New Yorkers.  In May, Attorney General James joined 40 other states and the Department of Justice in suing Live Nation and Ticketmaster for monopolizing the live music industry.  In October 2023, Attorney General James secured $4.5 million from one of the nation’s largest title insurance companies for using illegal no-poach agreements with competitors to keep employees from switching jobs.  Attorney General James has now ended the use of no-poach agreements by the five largest commercial underwriters in the United States, including First AmericanFidelityOld RepublicStewart, and Amtrust.  In 2022, Attorney General James sued a ski resort company in Syracuse for buying its main competitor and shutting it down in order to monopolize the local market.

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc