ALUMNI Q&A: Justice Dept Lawyer Andy Mao '98 on Prosecuting Health Fraud, Major Pharma Settlement

Justice Department attorney Andy Mao '98 was part of the team that led the federal government's health care fraud case against GlaxoSmithKline, in which the pharmaceutical firm agreed to plead guilty and pay $3 billion to resolve its criminal and civil liabilities related to the illegal promotion of certain drugs, its failure to report certain safety data, and for alleged false price-reporting practices.

Mao, who serves as senior counsel for health care fraud and elder justice at the Justice Department, recently discussed the case, his career and his advice for law students hoping to work at the DOJ.

What are your responsibilities as the Justice Department?

I am fortunate to have a position with a diverse range of responsibilities. I advise the Civil Division on health care fraud matters, which often entails working with our federal and state partners to develop new strategies and means to identify or combat health care fraud more effectively. I also help to coordinate the department's elder justice activities, which span from our investigative and prosecutorial efforts to helping to fund research and training for those law enforcement personnel and prosecutors who combat elder abuse, neglect, and exploitation locally. Lastly, I continue to work on actual health care fraud cases, mostly involving the pharmaceutical and nursing home industries.

What does your typical day involve?

An upside of having different responsibilities is that my daily activities vary pretty widely. For example, last week I participated in a mediation in a False Claims Act matter, worked on a complaint against a health care provider for providing medically unnecessary services, reviewed several briefs, held teleconferences with my team on two nationwide investigations, and coordinated with other DOJ components on an upcoming elder justice–related event. [The False Claims Act holds individuals or companies liable for defrauding government programs.] Then, because I also supervise certain types of cases, I also meet regularly with attorneys in my office or speak with assistant U.S. attorneys to discuss investigative strategy or legal issues. Finally, I am often called upon to review draft legislation that has been submitted by Congress to the [Justice Department] in order to obtain our views.

What can you tell us about the GlaxoSmithKline case, and your involvement?  

There is a fair amount of publicly available information about the GlaxoSmithKline matter, including the conduct we investigated, the contours of the resolution, and the scope of the government's release. The [Justice Department] has invested a tremendous amount of resources in these types of cases not only because of the financial impact that the alleged conduct has on the Medicare and Medicaid programs, but because of the potentially corrosive effect that the illegal marketing of drugs, the payment of kickbacks, and the withholding of safety data has on the integrity of a physician's decision-making process.

I was part of a phenomenal team that investigated allegations that GlaxoSmithKline had marketed certain of its drugs for uses unapproved by the Food and Drug Administration and thereby caused the government to pay for drugs for non-covered uses.  I also assisted with the settlement process, which requires a surprising amount of effort and coordination among all the interested parties, including the Department of Justice, the Department of Health and Human Services and its Office of Inspector General, the defendant, the states, all victim agencies, and the whistleblowers.   

Often overlooked when a resolution like this is announced is how much raw time, effort, and manpower are consumed by an investigation into nationwide corporate conduct. Given that every attorney, agent, and auditor has dozens of other cases he or she is juggling, it requires a tremendous amount of leadership, coordination, and vision to push an investigation to completion.  Fortunately, we had a number of great leaders on the GlaxoSmithKline case, which contributed significantly to the ultimate outcome.

Did you always want to work as a lawyer for the Justice Department? What was your career path?

I think so. Before law school, I worked as a paralegal at DOJ for two years.  During that time, I was impressed by the caliber and commitment of the attorneys and sold on the idea of public service.  Following law school and my clerkship (with Judge John W. Bissell '65), I was hired through the Attorney General's Honors Program in 2000 and have worked here ever since.

It's been reported that both health care fraud and elder abuse have been on the rise in recent years.  Do you see these trends from your vantage point at the Justice Department? What more, if anything, do you think is needed to address the problems? 

To the extent False Claims Act complaints are a reliable barometer of health care fraud trends more broadly, there has been a steady and significant increase in the number of complaints filed alleging health care fraud in recent years. While there were approximately 200 False Claims Act health care fraud complaints filed in 2007, there were over 400 such complaints filed in 2011. As far as elder abuse cases, the [Justice Department] does not track those numbers, but a New York study conducted last year found that 7.6 percent of older Americans experienced some form of elder mistreatment in the year prior, and over half of those cases involved some form of financial exploitation.

I think a lot more can and should be done to stem these two problems. One step would be to increase public awareness and to educate citizens more about what they can do to help. For example, in a case that the department resolved last year, a Medicaid beneficiary noticed on his billing statement that his home healthcare provider was billing for services it never performed and so he reported it to the government. That tip eventually led to a nationwide investigation and the provider ultimately paying a $20 million criminal penalty and $130 million to resolve civil False Claims Act allegations arising from its conduct. While not every tip will turn into a resolution like this, this example does demonstrate the difference that an individual can make. For similar reasons, I think providing greater education to law enforcement personnel, ombudsmen, and the public at large on the potential signs of elder abuse, neglect, and exploitation can make a significant difference in both preventing these crimes and bringing perpetrators to justice.  

(These are my personal views and not necessarily the views of the Department of Justice.)

What advice would you give current UVA Law students who want to one day work for the Justice Department?

Because the department hires most of its attorneys laterally, familiarity with the relevant subject matter and the ability to hit the ground running could be deciding factors, especially if there is a competitive pool of applicants. Along those lines, your work ethic — regardless of your place of employment — is extremely important. How you are viewed by current employers is a critical element in our hiring process. Moreover, because the department does not hire in regular intervals, it requires a fair amount of persistence (and patience) to monitor for opportunities as they arise. Lastly, I would tell students that the Department of Justice is a great place to work and if this is where they want to be, it is worth hanging in there!