Insurance Dispute Lawyer Blog
Both trial and appellate courts found Janssen Pharmaceutica liable for damages under the Louisiana’s Medical Assistance Programs Integrity Law (MAPIL). The issue was whether the Attorney General could bring this action without alleging actual damages, as MAPIL requires. The courts considered the legislative intent behind the law to determine that Janssen was still liable.
The Attorney General of Louisiana filed suit against Janssen Pharmaceutica for violating the MAPIL, which prohibits people from presenting false or fraudulent claims or misrepresentations to the state medical assistance program funds. The jury concluded that Janssen had violated the law over 35,000 times, resulting in a fee of over $257 million.
The appellate court upheld the trial court’s decision. It would only be able to overturn the trial court if it found the trial court had abused its discretion. In other words, if the trial court’s interpretation of the statute was not reasonable, the appellate court could reverse it. However, this is a very high standard. Previous Louisiana case law required the court to read the relevant subsection of the statute in the context of the remainder of the MAPIL legislation, and the appellate court found that the trial court had done this, and its interpretation was reasonable. Thus, it was reasonable to interpret the statute to mean that if the Attorney General could prove false, misleading, deceitful statements, Janssen would be liable for civil penalties.
Jannsen’s argument was that the Attorney General failed to satisfy the statute’s requirement of alleging damages of $1,000. In contrast, the Attorney General argued that MAPIL is a broader statute. The trial court sided with the Attorney General in large part based on a West Virginia case, where the court stated that when determining an appropriate civil penalty, whenever false or misleading promotional materials concerning health are transmitted to the public or its healthcare providers, those promotional materials cause harm and injury, as a matter of law. Moreover, the Supreme Court of Louisiana emphasized consideration of the legislative intent of statutes. Considering the legislative intent here, the trial court interpreted the statute to mean that not only private citizens, but also the Attorney General, should be able to protect the integrity of medical assistance programs, and the deceptive, misleading materials constituted damage.
Statutory Interpretation is rarely simple. Considering not just the words of the statute and its requirements but also the legislative intent behind it can be crucial. It’s important to make sure you have the best lawyers to present arguments that courts can use when the case may be a bit more simple but impacts you rather than a major company.