Case Title: State v. Abbott Labs.

Citation: 2012 WI 62

Docket Number: 2010AP000232-AC

State: wisconsin

Court: Wisconsin Supreme Court

Date: 2012-06-22T00:00:00Z

Document:
2012 WI 62 

SUPREME COURT OF WISCONSIN 
 
 
 
 
 
CASE NO.: 
2010AP232-AC 
COMPLETE TITLE: 
 
State of Wisconsin, 
          Plaintiff-Respondent-Cross-Appellant, 
     v. 
Abbott Laboratories, AstraZeneca LP, AstraZeneca  
Pharmaceuticals LP, Aventis Behring, LLC f/k/a 
ZLB Behring, LLC, Aventis Pharmaceuticals, Inc., 
Ben Venue  Laboratories, Inc., Boehringer 
Ingelheim Pharmaceuticals, Inc., Boehringer 
Ingelheim Roxane, Inc., Bristol-Myers Squibb 
Co., Dey, Inc., Ivax Corporation, Ivax 
Pharmaceuticals, Inc., Janssen LP f/k/a Janssen 
Pharmaceutica Products, LP, Johnson & Johnson, 
Inc., McNeil-PPC, Inc., Merck & Co. f/k/a 
Schering-Plough Corporation, Merck Sharp & Dohme 
Corp. f/k/a Merck & Company, Inc., Mylan 
Pharmaceuticals, Inc., Mylan, Inc. f/k/a Mylan 
Laboratories, Inc., Novartis Pharmaceuticals 
Corp., Ortho Biotech Products, LP, Ortho-McNeil  
Pharmaceutical, Inc., Pfizer Inc., Roxane 
Laboratories, Inc., Sandoz, Inc. f/k/a Geneva 
Pharmaceuticals, Inc., Sicor, Inc. f/k/a Gensia 
Sicor Pharmaceuticals, Inc., SmithKline Beecham 
Corp. d/b/a GlaxoSmithKline, Inc., TAP 
Pharmaceutical Products, Inc., Teva 
Pharmaceuticals USA, Inc., Warrick 
Pharmaceuticals Corporation, Watson Pharma, Inc. 
f/k/a Schein Pharmaceuticals, Inc. and Watson  
Pharmaceuticals, Inc., 
          Defendants, 
Pharmacia Corporation, 
          Defendant-Appellant-Cross-Respondent. 
 

 
 
ON CERTIFICATION FROM THE COURT OF APPEALS 
 
 
OPINION FILED: 
June 22, 2012   
SUBMITTED ON BRIEFS: 
        
ORAL ARGUMENT: 
December 6, 2011 
 
 
SOURCE OF APPEAL: 
 
 
COURT: 
Circuit   
 
COUNTY: 
Dane 
 
JUDGE: 
Richard G. Niess 
 
 
 
JUSTICES: 
 
 
CONCURRED: 
        



 
DISSENTED: 
        
 
NOT PARTICIPATING: BRADLEY, CROOKS, and PROSSER, J.J., did not 
participate.    
 
 
 
ATTORNEYS: 
 
 
For the defendant-appellant-cross-respondent, there were 
briefs filed by O. Thomas Armstrong, Beth J. Kushner, Douglas M. 
Raines, and von Briesen & Roper S.C., Milwaukee, John C. Dodds, 
Erica Smith-Klocek, Máire E. Donovan, and Morgan, Lewis, & 
Bockius, LLP, Philadelphia, and John Clayton Everett, Jr. and 
Morgan, Lewis, & Bockius, LLP, Washington D.C., and oral 
argument by John C. Dodds. 
For the plaintiff-respondent-cross-appellant, there were 
briefs filed by Frank D. Remington, assistant attorney general, 
with whom on the brief was J.B. Van Hollen, attorney general, 
and George F. Galland, Jr., Charles Barnhill, Jr., Betty Eberle, 
Barry J. Blonien, and Miner, Barnhill & Galland, P.C., Madison, 
and oral argument by George F. Galland. 
An amicus brief was filed by Donald K. Schott, Elyce Wos, 
Matthew J. Splitek, and Quarles & Brady, LLP, Madison; William 
F. Cavanaugh, Adeel A. Mangi, and Patterson, Belknap, Webb & 
Tyler, LLP, of counsel, New York; and Andrew D. Schau and 
Covington & Burling, LLP, of counsel, New York, for the Non-
Pharmacia Brand Defendants. 
An amicus brief was filed by Robert H. Friebert, Shannon A. 
Allen, and Friebert, Finerty, & St. John, S.C., Milwaukee; and 
Joseph Angland, Michael J. Gallagher, Heather K. McDevitt, and 
White & Case, LLP, New York, for the Non-Pharmacia Generic 
Defendants. 


2012 WI 62
NOTICE 
This opinion is subject to further 
editing and modification.  The final 
version will appear in the bound 
volume of the official reports.   
No.   2010AP232-AC 
(L.C. No. 
2004CV1709) 
STATE OF WISCONSIN  
 
 
   : 
IN SUPREME COURT 
 
 
State of Wisconsin, 
 
          Plaintiff-Respondent-Cross-Appellant, 
 
     v. 
 
Abbott Laboratories, AstraZeneca LP, 
AstraZeneca Pharmaceuticals LP, Aventis 
Behring, LLC f/k/a ZLB Behring, LLC, Aventis 
Pharmaceuticals, Inc., Ben Venue Laboratories, 
Inc., Boehringer Ingelheim Pharmaceuticals, 
Inc., Boehringer Ingelheim Roxane, Inc., 
Bristol-Myers Squibb Co., Dey, Inc., Ivax 
Corporation, Ivax Pharmaceuticals, Inc., 
Janssen LP f/k/a Janssen Pharmaceutica 
Products, LP, Johnson & Johnson, Inc.,  
McNeil-PPC, Inc., Merck & Co. f/k/a Schering-
Plough Corporation, Merck Sharp & Dohme Corp. 
f/k/a Merck & Company, Inc., Mylan 
Pharmaceuticals, Inc., Mylan, Inc. f/k/a Mylan 
Laboratories, Inc., Novartis Pharmaceuticals  
Corp., Ortho Biotech Products, LP, Ortho-McNeil  
Pharmaceutical, Inc., Pfizer Inc., Roxane 
Laboratories, Inc., Sandoz, Inc. f/k/a Geneva 
Pharmaceuticals, Inc., Sicor, Inc. f/k/a Gensia 
Sicor Pharmaceuticals, Inc., SmithKline Beecham 
Corp. d/b/a GlaxoSmithKline, Inc., TAP 
Pharmaceutical Products, Inc., Teva 
Pharmaceuticals USA, Inc., Warrick 
Pharmaceuticals Corporation, Watson Pharma, 
Inc. f/k/a Schein Pharmaceuticals, Inc. and 
Watson Pharmaceuticals, Inc., 
 
          Defendants, 
 
Pharmacia Corporation, 
FILED 
 
JUN 22, 2012 
 
Diane M. Fremgen 
Clerk of Supreme Court 
 
 


 
          Defendant-Appellant-Cross-Respondent. 
 
 
 
 
APPEAL from orders of the Circuit Court for Dane County, 
Richard G. Niess, Judge.  Affirmed and remanded. 
 
¶1 
MICHAEL J. GABLEMAN, J.   This case comes before us on 
certification from the court of appeals.  The State brought a 
civil 
action 
against 
Pharmacia 
Corporation 
("Pharmacia"), 
alleging that the company reported inflated drug prices to 
Wisconsin Medicaid.  A jury found Pharmacia liable for violating 
Wisconsin Statutes sections 100.18(1) (1992)1——the Deceptive 
Trade Practices Act ("DTPA")——and 49.49(4m)(a)2. ("Medicaid 
fraud statute").  The jury awarded the State $2 million for the 
DTPA claim and $7 million for the Medicaid fraud claim, totaling 
$9 million in damages.  Answering a special verdict question, 
the jury also determined that Pharmacia committed 1,440,000 
separate violations of the Medicaid fraud statute.  In post-
trial proceedings, the circuit court vacated that answer and 
reduced the number of violations to 4,578.  See Reyes v. 
Greatway Ins. Co., 220 Wis. 2d 285, 301, 582 N.W.2d 480 (Ct. 
App. 1998) (holding that a circuit court may change a jury 
answer where it is not supported by credible evidence).  Both 


1 The complaint alleged violations dating back to 1992.  All 
subsequent references to any statutes or regulations, state or 
federal, are to the versions in effect in 1992 unless otherwise 
indicated. 
No. 
 2010AP232-AC 

3 
 
parties appealed, raising numerous issues.2  The court of appeals 
certified three to this court: 1) whether the State was entitled 
to a jury trial; 2) whether the damages were based on 
impermissible speculation by the jury; and 3) whether the 
circuit court properly reduced the number of violations.  
Because each of these issues was correctly resolved in the 
circuit court, we affirm and remand to the court of appeals. 
I. 
FACTUAL BACKGROUND 
¶2 
As with most aspects of this case, many of the facts 
are sharply disputed by the parties.  Here we present only the 
undisputed facts.  In the procedural history below we present in 
greater detail the parties' differing characterizations of the 
facts at trial.  Because of the volume of facts relevant to the 
certified issues, we also present additional facts during the 
course of our analysis. 
¶3 
Medicaid is a program jointly funded and managed by 
the states and the federal government.  Harris v. McRae, 448 
U.S. 297, 301 (1980).  Its purpose is to facilitate the 
provision of health care services to those without the means to 
pay for them.  42 U.S.C. § 1396.  At the federal level, Medicaid 


2 The issues raised by Pharmacia on appeal but not certified 
to this court include, inter alia, a separation of powers issue, 
an issue regarding the duty to mitigate damages, various 
evidentiary issues, and an issue regarding attorney fees and 
costs.  The issues raised by the State on appeal but not 
certified to this court include, inter alia, the correctness of 
the circuit court's determination of the forfeiture amount 
imposed per violation and the breadth of the injunction.  In our 
order accepting the certification from the court of appeals we 
limited our review to the certified issues. 
No. 
 2010AP232-AC 

4 
 
is administered by the Centers for Medicare and Medicaid 
Services ("CMS"), an agency within the aegis of the U.S. 
Department of Health and Human Services.  Douglas v. Indep. 
Living Ctr. of S. Cal., Inc., 565 U.S. __, 132 S. Ct. 1204, 1208 
(2012).  In Wisconsin, the program is run by the Department of 
Health Services ("DHS").  See generally Wis. Stat. ch. 46. 
¶4 
Pursuant to federal law, states participating in the 
Medicaid program must submit "state plans" to CMS to receive 
federal funding.  42 U.S.C. §§ 1396a and 1396b(a).  Such plans 
are required to "assure that payments are . . . sufficient to 
enlist enough providers so that care and services are available 
under the plan at least to the extent that such care and 
services are available to the general population in the 
geographic area."  42 U.S.C. § 1396a(a)(30)(A); 42 C.F.R. 
§ 447.204.  Federal regulations compel state Medicaid agencies 
to devise procedures for reimbursing pharmacists who dispense 
drugs to Medicaid recipients.  42 C.F.R. § 447.518.  Under the 
federal guidelines, the reimbursements may not exceed the lesser 
of 1) the estimated acquisition cost ("EAC") of the drug, plus a 
reasonable dispensing fee, or 2) the "usual and customary" price 
the pharmacy charges to consumers paying for the drug without 
government assistance.  42 C.F.R. § 447.512(b).  The regulations 
define EAC as the "best estimate of the price generally and 
currently paid by providers for a drug."  42 C.F.R. § 447.502.  
Whenever states change their reimbursement policies, they must 
seek CMS approval to institute the new plan.  See Douglas, 132 
S. Ct. at 1208. 
No. 
 2010AP232-AC 

5 
 
¶5 
In Wisconsin, reimbursement formulae are drawn up by 
the legislature as part of the biennial budget process and 
signed into law by the governor.  During that process, the 
legislature and governor receive extensive input from various 
lobbying interests, as well as from DHS and other state 
officials.  The litigation leading to the case at bar was 
principally over one part of the reimbursement formula, a figure 
known in the industry as an "average wholesale price" ("AWP").3 
¶6 
During the period of time implicated by the complaint, 
AWP 
played 
a 
different 
role 
in 
Wisconsin 
Medicaid's4 
reimbursement process depending on whether the drug was a 
generic or a brand.5  For brand drugs, Medicaid paid pharmacies 
AWP 
minus 
a 
specific 
percentage. 
 
Cf. 
In 
re 
McKesson 
Governmental Entities AWP Litig., 767 F. Supp. 2d 263, 267 


3 There is considerable disagreement here and in other 
jurisdictions, see generally, e.g., Phuong D. Nguyen, A Review 
of Average Wholesale Price Litigation and Comments on the 
Medicare Modernization Act, 9 Quinnipiac Health L.J. 249 (2006) 
(surveying AWP litigation), as to the precise meaning of AWP, 
and that subject will be discussed below at length.  There is 
also disagreement concerning the formulation and transmittal of 
AWPs, and that too will be elaborated on in the following 
section. 
4 Henceforth we will refer to Wisconsin Medicaid simply as 
"Medicaid." 
5 A brand name drug is a product under patent protection and 
thus marketed by a single company.  A generic drug, by contrast, 
is a product that has been released from patent protection and 
is thus available from multiple pharmaceutical manufacturers in 
the 
same 
form. 
 
See 
generally 
Caraco 
Pharmaceutical 
Laboratories, Ltd. v. Novo Nordisk, 566 U.S. __, 132 S. Ct. 1670 
(2012). 
No. 
 2010AP232-AC 

6 
 
(D. Mass. 2011) 
("Public 
payors 
generally 
reimburse 
retail 
pharmacies for brand name drugs based on a percentage off of 
AWP.").  The percentage remained constant for all brand drugs 
until the next legislative revision in the biennial budget 
process.  Thus, for example, if the formula had been set at AWP 
minus 10% for a given period, and a pharmacy dispensed to a 
Medicaid recipient a brand drug with an AWP of $10, Medicaid 
would pay the pharmacy $9 ($10 AWP minus 10%).  Over the years 
covered by the lawsuit, the percentage deducted from AWP in 
Wisconsin increased incrementally during various biennial budget 
sessions. 
¶7 
The reimbursement process is different with respect to 
generic drugs.  For such drugs, Medicaid sets a maximum 
allowable cost, a number determined by state officials or 
consultants through independent research in the market.  We will 
elaborate further on that process below where it is relevant to 
our analysis. 
II. 
PROCEDURAL HISTORY 
¶8 
In 2004, the State filed a civil action against 
several dozen large pharmaceutical manufacturers, alleging that 
each reported inflated AWPs, thereby causing Medicaid to overpay 
for drugs and violating the DTPA6 and the Medicaid fraud 


6 The relevant provision of the DTPA provides: 
No . . . corporation . . . or 
agent 
or 
employee 
thereof, with intent to sell, distribute, increase the 
consumption 
of 
or 
in 
any 
wise 
dispose 
of 
any . . . merchandise . . ., directly or indirectly, 
to the public for sale . . ., shall make, publish, 
No. 
 2010AP232-AC 

7 
 
statute.7 
 
After 
several 
years 
of 
extensive 
discovery, 
Pharmacia,8 which manufactures both brand and generic drugs, was 
the first defendant to go to trial.9 
¶9 
The State sought a jury trial at circuit court, and 
Pharmacia a bench trial.  Applying our case law on the subject, 
the circuit court concluded that the State was entitled to a 
jury trial on both statutory claims. 

disseminate, circulate, or place before the public, or 
cause, directly or indirectly, to be made, published, 
disseminated, circulated or placed before the public, 
in this state, in a newspaper, magazine or other 
publication, or in the form of a . . . notice, 
 . . . bill, circular, pamphlet, letter, . . .  or 
over any radio or television station, or in any other 
way similar or dissimilar to the foregoing, an 
advertisement, 
announcement, 
statement 
or 
representation of any kind to the public relating to 
such purchase [or] sale, . . . which advertisement, 
announcement, statement or representation contains any 
assertion, representation or statement of fact which 
is untrue, deceptive or misleading. 
 
Wisconsin Statutes section 100.18(1). 
7 The relevant provision of the Medicaid fraud statute 
states that "[n]o person, in connection with medical assistance, 
may . . . knowingly make or cause to be made any false statement 
or representation of a material fact for use in determining 
rights to a benefit or payment."  Wis. Stat. § 49.49(4m)(a)2. 
8 Pharmacia is a wholly-owned subsidiary of Pfizer.  At 
trial, evidence was introduced relating to various branches of 
Pharmacia and predecessor companies.  The parties have never 
suggested that these distinctions are significant to the case.  
In 
the interest of clarity, we therefore use the term 
"Pharmacia" even where other corporate names were employed at 
trial. 
9 Proceedings involving the other defendants are stayed 
pending the resolution of this case. 
No. 
 2010AP232-AC 

8 
 
A. 
The State's Case at Trial 
¶10 Over the course of a nine-day trial, the two sides 
presented 
radically 
different 
versions 
of 
the 
Medicaid 
reimbursement system, and of Pharmacia's role in that system.  
The State's account is summarized in this section.   
¶11 Because 
of 
the 
complexity 
and 
dynamism 
of 
the 
pharmaceutical industry, Medicaid required a consistent and 
broadly applicable formula for determining the appropriate 
reimbursements for pharmacies that dispensed drugs to Medicaid 
patients.  The agency did not have sufficient staff or resources 
to collect the information necessary to calculate proper 
reimbursement rates, so it was dependent upon assistance from 
companies in the industry.   
¶12 As with other states throughout the country, the 
solution that emerged was for pharmaceutical manufacturers like 
Pharmacia to report certain figures relating to the sales of 
their products, and for Medicaid to use those figures to 
calculate reimbursements.  The most important of those figures 
was AWP.  Pharmacia provided AWPs for its drugs to First 
DataBank ("FDB"), an independent company that organized and 
disseminated information regarding the pharmaceutical industry 
No. 
 2010AP232-AC 

9 
 
to Medicaid,10 which then plugged them into its reimbursement 
formula. 
¶13 Pharmacia, as with all manufacturers, reported AWPs in 
agreement with Medicaid that the AWPs were supposed to reflect 
what the name suggested: the average price for which the drug 
was sold by the wholesaler to the pharmacy.  During the early 
days of Medicaid, this assumption was largely accurate.  AWPs 
did reflect the average price paid by the pharmacies, and 
Medicaid was able to simply reimburse the pharmacies in those 
amounts.   
¶14 Over time, however, the manufacturers began reporting 
inflated AWPs.  They did so to engage in a practice known as 
"marketing the spread."  When a manufacturer "marketed the 
spread," it reported an inflated AWP to Medicaid and Medicaid 
then paid the pharmacy more for the drug than the pharmacist 
paid the wholesaler for the same product.  As a consequence, 
pharmacies 
had 
an 
incentive 
to 
buy 
products 
from 
the 
manufacturer (via a wholesaler) who reported the most inflated 
AWP, because pharmacies then made a higher profit margin than 
they would have on drugs made by other manufacturers.  In turn, 
the manufacturer obtained a larger and larger share of the 


10 There was actually yet another intermediary involved in 
the process, Electronic Data Systems, but it served for all 
intents and purposes as an arm of the state and neither party 
suggests its role is relevant to the issues before us.  For the 
sake of simplicity, we therefore discuss the transfers of 
information from Pharmacia as though they were conveyed directly 
to FDB. 
No. 
 2010AP232-AC 

10 
 
market, as pharmacies became increasingly aware of wider profit-
margins on the manufacturer's product.  Pharmacia "marketed the 
spread" along with its competitors, and it reported more and 
more dramatically inflated AWPs over time. 
¶15 Medicaid and other officials in Wisconsin knew, to 
varying degrees and at varying times, that AWP no longer 
represented an accurate barometer of what pharmacies were paying 
wholesalers for drugs.  Nevertheless, it was confronted with 
inconsistent 
and 
often 
contradictory 
information, 
with 
considerable disagreement as to how far AWPs were from actual 
wholesale prices.  Consequently, the state was forced to guess 
as to just how unrealistic AWPs were.  After formulating such a 
guess, the state would then determine a percentage to subtract 
from AWP in order to derive the reimbursement amounts.  That 
percentage grew over time, as the state acquired more and better 
information on the magnitude of the inflations.  Although the 
formulae by which AWPs were reduced represented the state's best 
guess as to the amount of the inflation, it erred on the side of 
generosity to ensure that no supplier was shortchanged, and its 
payments were therefore almost universally too high.  Thus, the 
manufacturers, along with everyone else in the supply chain, 
continued to profit from the false AWPs. 
¶16 Pharmacia was aware of the benefits accruing by virtue 
of its misrepresentations, and it took measures to perpetuate 
the scheme and avoid detection.  One such measure was the so-
called 
"charge 
back," 
whereby 
the 
company 
would 
provide 
wholesalers various secret discounts designed to compensate them 
No. 
 2010AP232-AC 

11 
 
for the difference between the amount the pharmacy paid for the 
products and the amount the wholesaler paid Pharmacia.  In this 
way, the true prices of the drugs were obscured from public 
view.  
¶17 If the state had known true AWPs, it would have simply 
reimbursed pharmacies at those prices.  Thus, the damage 
suffered by the state is the difference between the amount it 
did pay Pharmacia and the actual wholesale prices11 for its 
products, i.e., the true average price at which it sold its 
drugs to wholesalers.  Finally, the number of violations 
committed by Pharmacia is the number of times the state overpaid 
for a product as the result of an inflated AWP, for that is the 
truest measure of the company's wrongful conduct. 


11 We use "actual wholesale prices" as a shorthand to mean 
prices that did in fact reflect the average prices that 
pharmacies were paying wholesalers for the drugs at issue.  We 
do not thereby imply any conclusion as to whether the AWPs at 
issue in the present case were required by law to reflect actual 
wholesale prices in the sense that Pharmacia had a legal 
obligation to report different numbers, as that question is not 
before us.  It has not been certified and so remains at the 
court of appeals.  For the same reasons, we will refer to 
Pharmacia's 
reported 
AWPs 
as 
"inflated" 
to 
reflect 
the 
undisputed fact that they did not track actual wholesale prices 
without implying anything about the "truth" or "falsity" of the 
AWPs. 
 
We 
recognize 
that 
this 
terminology 
may 
engender 
confusion, but it is unavoidable given the complexity and 
interrelationship of the certified and uncertified issues.  We 
caution the parties and the court of appeals not to take this 
opinion as bearing on the proper resolution of the uncertified 
issues upon remand, as those are not before us. 
No. 
 2010AP232-AC 

12 
 
B. 
Pharmacia's Case at Trial 
¶18 Unsurprisingly, Pharmacia related a very different 
narrative to the jury, which is summarized in this section.  By 
its account, AWPs are and always were a "benchmark," designed to 
allow for consistency and stability in reimbursement rates, but 
never intended to reflect actual prices or their averages.  The 
state was well aware of that fact, and well aware that 
pharmacists were profiting from Medicaid reimbursements.  Such 
profits do not demonstrate the existence of any fraud; rather, 
they were necessary and required by federal law to ensure that 
pharmacies participated in Medicaid.  If the profits did not 
exist, pharmacies would withdraw from the program and indigent 
patients would lose access to the subsidized medications to 
which they are entitled.   
¶19 True wholesale prices were no more accessible to 
Pharmacia than they were to the state.  Such prices are known 
only to the wholesalers and their pharmacy customers; Pharmacia 
is not privy to their confidential arrangements.  In the absence 
of 
that 
information, 
Pharmacia 
calculated 
AWPs 
not 
with 
reference to transactions between wholesalers and pharmacies, 
but with reference to wholesale acquisition cost——that is, the 
amount the wholesalers paid for its products. 
¶20 In any event, the AWPs upon which the state relied 
were not Pharmacia's, they were FDB's.  FDB committed itself to 
independently verifying the AWPs it provided to the state by 
conducting 
surveys 
of 
wholesalers. 
 
Pharmacia 
was 
not 
responsible for the AWPs published by FDB, nor should it be held 
No. 
 2010AP232-AC 

13 
 
accountable for any characterization of the AWPs put forth by 
FDB. 
¶21 Had the state desired other pricing information, it 
could easily have acquired it.  FDB offered a variety of data 
encompassing a wide range of transactions in the pharmaceutical 
industry.  The state opted for AWP, knowing full well what it 
signified, and what it did not.  Alternatively, the state could 
have declined FDB's services altogether and gathered the 
necessary information itself.  It already had access to 
pharmaceutical pricing data through the extensive drug purchases 
Wisconsin makes outside of the Medicaid program, for example 
those obtained for use in correctional facilities.  More simply, 
it could just have asked Pharmacia for the data it wanted, a 
straightforward approach it never took. 
¶22 Medicaid's reimbursement formulae were a function of 
the political process.  As each budget was being prepared, 
various government officials would recommend that the rates be 
lowered by substantial amounts to generate taxpayer savings. At 
the same time, a vigorous pharmacy lobby would counter that the 
reimbursements were more accurate than alleged, and that 
significant reductions would eliminate their profit margins and 
force them to withdraw from Medicaid, thereby depriving eligible 
individuals of access to necessary medication.  The legislature 
and governor took both perspectives into consideration and came 
up with a reimbursement rate that balanced the interest in 
fiscal responsibility with the interest in ensuring access to 
No. 
 2010AP232-AC 

14 
 
subsidized medicine.  Pharmacia should not be punished for a 
political decision made by Wisconsin. 
C. 
Verdict and Post-Trial Proceedings 
¶23 The jury found Pharmacia liable for violating both the 
DTPA and the Medicaid fraud statute.  It awarded $2 million in 
damages for the DTPA claim and $7 million for the Medicaid fraud 
claim, for a total of $9 million in damages.  Answering a 
special verdict question, the jury concluded that Pharmacia 
violated the Medicaid fraud statute 1,440,000 times, the number 
of times the State alleged that Medicaid had overpaid for the 
company's products as a result of the inflated AWPs.  Pharmacia 
then successfully moved the circuit court to vacate the number 
of violations found by the jury.  During post-trial proceedings 
regarding the issue, the circuit court determined that the 
record supported a finding of 4,578 violations.  It imposed a 
$1,000 forfeiture on each violation, totaling $4,578,000.   
¶24 Both parties appealed, raising numerous issues.  The 
court of appeals certified three: 1) whether the State was 
entitled to a jury trial; 2) whether the damages were based on 
impermissible speculation by the jury; and 3) whether the 
circuit court properly reduced the number of violations.  To 
expedite the resolution of this important case, we accepted the 
certification and limited our review to the certified issues.  
We now affirm the circuit court on each of those issues. 
III. 
STANDARD OF REVIEW 
¶25 The 
first 
issue——whether 
the 
State 
had 
a 
constitutional right to a jury trial——hinges on our reading of 
No. 
 2010AP232-AC 

15 
 
the Wisconsin Constitution, and is therefore subject to our 
independent review.  Harvot v. Solo Cup Co., 2009 WI 85, ¶32, 
320 Wis. 2d 1, 768 N.W.2d 176 (citations omitted). 
¶26 On the second issue——whether the jury's damage award 
was impermissibly speculative——we will not reverse the award if 
it was "within the realm of reason in view of the evidence."  
Rupp v. Travelers Indem. Co., 17 Wis. 2d 16, 26, 115 N.W.2d 612 
(1962).  Under this standard, we search the record for credible 
evidence to support the award, and view that evidence in the 
light most favorable to the jury's determination.  Springen v. 
Ager Plumbing & Heating, Inc., 19 Wis. 2d 487, 489, 120 
N.W.2d 692 (1963). 
¶27 With respect to the third issue——the question of 
whether the circuit court properly reduced the number of 
Medicaid fraud violations——the standard of review depends on 
whether the jury's alleged error is properly characterized as an 
error of law or of fact.  Because the circuit court sufficiently 
instructed the jury on what constituted a violation, the jury's 
error is best understood as one of fact.  We therefore apply a 
sufficiency of the evidence standard of review to the third 
issue.  Morden v. Cont'l AG, 2000 WI 51, ¶38, 235 Wis. 2d 325, 
611 N.W.2d 659.  That standard requires us to overturn a circuit 
court's decision to change the jury's answer if there is "any 
credible 
evidence" 
to 
support 
the 
verdict, 
direct 
or 
inferential.  Hanson v. Am. Family Mut. Ins. Co., 2006 WI 97, 
¶18, 294 Wis. 2d 149, 716 N.W.2d 866 (internal quotation marks 
and citation omitted).  As with the speculativeness issue, we 
No. 
 2010AP232-AC 

16 
 
answer this question while viewing the record in the light most 
favorable to the jury's determination.  Morden, 235 Wis. 2d 325, 
¶41.  Because the circuit court was better situated to assess 
the evidence than we are, we also accord its weighing of the 
evidence "substantial deference."  D.L. Anderson's Lakeside 
Leisure Co. v. Anderson, 2008 WI 126, ¶59, 314 Wis. 2d 560, 757 
N.W.2d 803 (internal quotation marks and citations omitted).  
Therefore, we will accept the circuit court's reduction of the 
number of violations unless the record reveals that the number 
it found was "clearly wrong."  Richards v. Mendivil, 200 
Wis. 2d 665, 671-72, 548 N.W.2d 85 (Ct. App. 1996) (internal 
quotation marks and citation omitted). 
IV. 
DISCUSSION 
¶28 We 
first 
consider 
whether 
the 
State 
had 
a 
constitutional right to a jury trial and conclude that it did.  
We 
then 
consider 
whether 
the 
jury's 
damage 
award 
was 
impermissibly speculative and determine that it was not.  
Finally, we consider whether the circuit court properly reduced 
the number of violations and hold that it did. 
A. 
The State Had a Constitutional Right to a Jury Trial 
¶29 The Wisconsin Constitution provides that "[t]he right 
of trial by jury shall remain inviolate, and shall extend to all 
cases at law."  Wis. Const. art. I, § 5.  It is well-settled 
that  the provision guarantees the right to a civil jury trial 
as the right existed at the time our state's constitution was 
adopted in 1848.  Town of Burke v. City of Madison, 17 
Wis. 2d 623, 635, 117 N.W.2d 580 (1962).  When the right to a 
No. 
 2010AP232-AC 

17 
 
civil jury trial for a particular cause of action is in dispute, 
we pose a two-pronged test to resolve the dispute.  Vill. Food & 
Liquor Mart v. H&S Petroleum, Inc., 2002 WI 92, ¶11, 254 
Wis. 2d 478, 647 N.W.2d 177 ("the Village Food test").  First, 
we ask whether the "cause of action created by statute existed, 
was known, or was recognized at common law at the time of the 
adoption of the Wisconsin Constitution in 1848."  Id.  Next we 
consider whether the cause of action was viewed as "at law" in 
1848.  Id. 
¶30 The question of whether the State had a constitutional 
right to a jury trial reduces to two separate inquiries: 1) 
whether the State was entitled to a jury trial on the DTPA claim 
and 2) whether it was entitled to one on the Medicaid fraud 
claim.  The circuit court answered both questions in the 
affirmative.  Because both prongs of the test are satisfied by 
both causes of action, we agree with the circuit court that the 
State was entitled to a jury trial and therefore affirm its 
ruling. 
1. 
The State Had a Constitutional Right to a Jury Trial on its 
DTPA Claim 
¶31 The State's DTPA claim meets both prongs of the test: 
it was recognized at common law in 1848 and it was regarded as 
"at law" at that time.  Accordingly, we conclude that the State 
had a constitutional right to a jury trial on its DTPA claim. 
¶32 We first analyze whether the DTPA claim "existed, was 
known, or was recognized at common law at the time of the 
adoption of the Wisconsin Constitution in 1848."  Id.  The State 
No. 
 2010AP232-AC 

18 
 
submits that the DTPA claim is an essential counterpart to the 
common law claim of "cheating."  The circuit court agreed, and 
so too do we. 
¶33 A common law claim can be regarded as the essential 
counterpart to a statutory cause of action in a civil jury trial 
analysis where the two share a similar purpose.  Harvot, 320 
Wis. 2d 1, ¶72.  The DTPA and common law cheating share such a 
purpose: combatting deceptive commercial conduct. 
¶34 When ascertaining whether a statutory cause of action 
had an essential common law counterpart in 1848, we often resort 
to Sir William Blackstone's Commentaries on the Laws of England 
(1778) (hereinafter "Blackstone").  See Harvot, 320 Wis. 2d 1, 
¶84; State v. Schweda, 2007 WI 100, ¶23, 303 Wis. 2d 353, 736 
N.W.2d 49; Dane Cnty. v. McGrew, 2005 WI 130, ¶23 n.18, 285 
Wis. 2d 519, 699 N.W.2d 890 (collecting cases).  Blackstone 
categorizes cheating as an "offence . . . against public trade."  
4 Blackstone at *157.  The DTPA announces, by its very name, 
that it targets a similar category of wrongful conduct, namely, 
deceptive trade practices.   
¶35 Similarly, Blackstone's description of cheating tracks 
the 
DTPA's characterization of deceptive trade practices.  
Blackstone notes that the object of the common law rule is to 
"prevent deceits in particular trades."  Id.  As examples of 
such deceits, Blackstone cites, amongst other conduct, "the 
offence of selling by false weights and measures," the offense 
of "playing with false dice," and the offense of defrauding 
"another of any valuable chattels by colour of any false token, 
No. 
 2010AP232-AC 

19 
 
counterfeit letter, or false pretence."  Id. at *157-58 
(formatting altered).  Although the DTPA speaks in less 
antiquated terms, it displays a similar emphasis on attempts to 
profit through deception.  Tietsworth v. Harley-Davidson, Inc., 
2003 WI App 75, ¶24, 261 Wis. 2d 755, 661 N.W.2d 450 ("[T]he 
DTPA is a broad remedial statute designed to protect the public 
from all untrue, deceptive or misleading representations made in 
sales promotions.") (internal quotation marks and citation 
omitted), reversed on other grounds by 2007 WI 97, 303 
Wis. 2d 94, 735 N.W.2d 418.  We conclude, therefore, that both 
the common law cause of action of cheating and the DTPA combat 
analogous practices. 
¶36 In Pharmacia's view, the Wisconsin courts have already 
settled that there is no right to a jury trial for an action 
brought pursuant to the DTPA.  For that proposition, it relies 
upon State v. Ameritech Corp., 185 Wis. 2d 686, 517 N.W.2d 705 
(Ct. App. 1994).  Ameritech did indeed hold as much, but the 
holding is no longer good law.  The court of appeals there 
employed the "codification" test, whereby a statutory cause of 
action carries with it a right to a jury trial if "the statute 
codifies an action known to the common law in 1848."  Id. at 
690.  In Village Food we expressly renounced that test because 
it construed our precedent "too narrowly."  254 Wis. 2d 478, 
¶11.  Instead, we reaffirmed the two-prong test set forth above.  
Id.  Consequently, Pharmacia may not rely upon Ameritech's 
holding, as its holding resulted from the application of an 
No. 
 2010AP232-AC 

20 
 
erroneous and defunct test.12  Our ascertainment of a jury trial 
right under the DTPA must be performed according to the 
appropriate test, i.e., the one enumerated in Village Food. 
¶37 Pharmacia also seeks to apply that test, but it does 
so unconvincingly.  It submits that the elements of common law 
cheating and those of the DTPA do not match each other 
identically.  A party accusing another of cheating at common law 
was required to prove that the individual: 1) performed an act 
calculated to deceive; 2) the act was aimed at, or affected, the 
public or the individual; and 3) "ordinary prudence" would not 
have protected the victim against the fraud.  See, e.g., People 
v. Cummings, 46 P. 284, 284 (Cal. 1896); Hammer v. State, 89 
N.E. 850, 852 (Ind. 1909).  In comparison, a plaintiff alleging 
violations of the DTPA must prove: 1) that the defendant made a 
representation to the public with the intent to induce an 
obligation; 2) that the representation was untrue, deceptive or 
misleading; and 3) that the representation caused the plaintiff 
a pecuniary loss.  K&S Tool & Die Corp. v. Perfection Mach. 
Sales, Inc., 2007 WI 70, ¶19, 301 Wis. 2d 109, 732 N.W.2d 792 
(internal quotation marks and citations omitted).  Pharmacia 


12 Ameritech is no longer good law only with respect to its 
discussion and application of the test for determining whether 
there is a right to a civil jury trial, not with respect to any 
of its other holdings, which we explicitly and specifically 
preserve for their precedential value.  See Blum v. 1st Auto & 
Ca. Ins. Co., 2010 WI 78, ¶42, 326 Wis. 2d 729, 786 N.W.2d 78 
(holding "that when the supreme court overrules a court of 
appeals decision, the court of appeals decision no longer 
possesses any precedential value, unless this court expressly 
states otherwise"). 
No. 
 2010AP232-AC 

21 
 
focuses on the "ordinary prudence" element of common law 
cheating, arguing that it has no essential counterpart in the 
elements of the DTPA and that no right to a jury trial therefore 
exists. 
¶38 As 
a 
preliminary 
matter, 
we 
reject 
Pharmacia's 
insinuation that a statutory cause of action carries no 
constitutional right to a jury trial merely because the elements 
of that cause of action and those of the purported common law 
claim are not identical.  Such an approach would restore by 
another name the "codification" test articulated in Ameritech 
and unequivocally abandoned in Village Food.   
¶39 The real question is whether the divergence between 
the elements of the DTPA and those of common law cheating is 
sufficiently significant to demonstrate that the State had no 
right to a jury trial.  We conclude that it is not, and 
therefore affirm the circuit court's decision to grant the jury 
trial. 
¶40 To support its view that the elements of common law 
cheating are too distinct from those of the DTPA to give rise to 
a jury trial right, Pharmacia relies principally upon Schweda.  
There, we determined that no jury trial right attached to 
various environmental statutory causes of action.  Schweda, 303 
Wis. 2d 353, ¶14.  We rejected the proffered analogy between 
those statutes and common law nuisance because the latter was a 
"sprawling concept" that "could encompass a vast array of causes 
of action," whereas the former applied to a much narrower realm 
of conduct.  Id., ¶32.  In drawing that distinction, we 
No. 
 2010AP232-AC 

22 
 
emphasized that "[t]he breadth of nuisance is so great that we 
must narrowly construe the actions that we analogize to" it.  
Id., ¶40.   
¶41 Common law cheating does not capture nearly so wide a 
swath of activity as does nuisance.  On the contrary, it is 
cabined to a similar field as that covered by the DTPA itself.  
Compare Tietsworth, 261 Wis. 2d 755, ¶24 (characterizing the 
DTPA) with Cummings, 46 P. at 284 (describing common law 
cheating).  As a result, Schweda's analysis did not compel a 
bench trial in the instant case.    
¶42 We acknowledge that Schweda called attention to the 
elements of nuisance and those of the environmental statutes in 
play in that case.  In particular, the opinion observed that a 
claim sounding in common law nuisance was required to prove 
"substantial and unreasonable harm to interests in the use and 
enjoyment of land."  Schweda, 303 Wis. 2d 353, ¶35.  It 
contrasted that requirement with modern environmental laws, 
which "regulate more subtle and attenuated harms than the common 
law of nuisance does."  Id. (quoting Solid Waste Agency of N. 
Cook Cnty. v. U.S. Army Corps Of Eng'rs, 101 F.3d 503, 505 (7th 
Cir. 1996)).   It is clear from this quote that the problem with 
the analogy between the elements of common law nuisance and 
those of the environmental laws was not simply that they were 
not identical.  Rather, the problem was that all of the 
similarities between the two flowed from the fact that nuisance 
was so broad as to encompass all environmental laws.   
No. 
 2010AP232-AC 

23 
 
¶43 Given the context of these comments in Schweda, one 
cannot escape the conclusion that no such deficiency plagues the 
analogy between common law cheating and the DTPA.  Unlike 
nuisance, the reasonable reliance requirement does not highlight 
any substantial difference in the breadth of the two laws being 
compared.  Common law cheating covers the same substantive area 
of conduct as does the DTPA, and the difference in elements 
between the two is insufficient to outweigh the similarities.  
Accordingly, we conclude that the cause of action created by the 
DTPA "was recognized at common law at the time of the adoption 
of the Wisconsin Constitution in 1848" and the first prong of 
the Village Food test is therefore satisfied with respect to 
that cause of action.  Vill. Food, 254 Wis. 2d 478, ¶11.   
¶44 Pharmacia does not deny that common law cheating was 
regarded as "at law" in 1848, and there is no reason to believe 
it was not.  See 3 Blackstone at *165 (noting that a plaintiff 
can seek damages in a common law cheating action); see also 
Josma v. W. Steel Car & Foundry Co., 94 N.E. 945, 946 (Ill. 
1911) (same); Vill. Food, 254 Wis. 2d 478, ¶33 ("An action 
seeking money damages is one at law.").  Consequently, common 
law cheating was considered "at law" in 1848, both prongs of the 
Village Food test are satisfied with respect to the DTPA claim, 
and the State was entitled to a jury trial on that claim. 
2. 
The State was Entitled to a Jury Trial on its Medicaid 
Fraud Claim 
¶45 Applying the Village Food test to the State's Medicaid 
fraud claim, we conclude that Medicaid fraud is an essential 
No. 
 2010AP232-AC 

24 
 
counterpart to common law fraud and that common law fraud was 
considered "at law" in 1848.  Thus, we affirm the circuit 
court's decision to grant the State a jury trial on its Medicaid 
fraud claim. 
a. 
Common Law Fraud is an Essential Counterpart to Medicaid 
Fraud 
¶46 The State offers common law fraud as the "essential 
counterpart" to Medicaid fraud for purposes of the first prong 
of the Village Food test. 
¶47 The Medicaid fraud statute and common law fraud target 
similar conduct.  See Schweda, 303 Wis. 2d 353, ¶35 (examining 
the conduct targeted by causes of action as part of the jury 
trial right inquiry).  The Medicaid fraud statute is centrally 
concerned 
with 
"false 
statement[s] 
or 
representation[s] 
of . . . material fact for use in determining rights to a 
benefit or payment."  Wis. Stat. § 49.49(4m)(a)2.  Setting to 
one side for the moment the fact that the statute is limited to 
a narrow species of fraud (that which takes place in medical 
assistance programs), it is apparent what sort of practices it 
seeks to prohibit: deceptive conduct designed to enrich one 
party at the expense of another.  Common law fraud historically 
targeted a similar range of conduct, combatting deceptive 
behavior in a variety of business relationships and thereby 
protecting the integrity of the market.  See Pasley v. Freeman, 
(1789) 100 Eng. Rep. 450 (K.B.) 457, 3 T.R. 51, 64 (holding that 
an action for "deceit lies when a man does any deceit to the 
damage of another"). 
No. 
 2010AP232-AC 

25 
 
¶48 Pharmacia submits that the Medicaid fraud statute 
carries no jury trial right because the medical assistance 
programs it governs did not exist in 1848.  We decline to 
address Pharmacia's historical premise because we disagree with 
its method of analysis.  A statute that creates a cause of 
action with an essential counterpart at common law becomes no 
less an essential counterpart simply because it addresses a 
narrower range of practices.  In other words, if the legislature 
focuses and directs the principles of common law fraud to a 
specific realm——Medicaid——it does not strip a litigant of his 
right to a jury trial where it would otherwise exist.  Were we 
to adopt Pharmacia's reasoning, a legislative enactment clearly 
modeled on a common law cause of action but applied to a 
specific context would carry no right to a jury trial.  See, 
e.g., Dura Pharmaceuticals, Inc. v. Broudo, 544 U.S. 336, 344 
(2005) (emphasizing the "common-law roots of . . . securities 
fraud action[s]").  In such circumstances, to deprive plaintiffs 
of a jury right based not on the substance of the law at issue, 
but upon historical happenstance, would be an absurd result, and 
we therefore reject Pharmacia's argument. 
¶49 To 
substantiate 
its 
contention 
regarding 
the 
relatively 
recent 
advent 
of 
medical 
assistance 
programs, 
Pharmacia cites Harvot.  It finds in that decision a holding 
that where "modern social legislation" was "unheard of" in 1848, 
there can be no essential common law counterpart to the 
legislation for purposes of a jury trial right.  We read Harvot 
differently.  In that decision, we upheld a circuit court ruling 
No. 
 2010AP232-AC 

26 
 
denying a jury demand in an action brought under the Wisconsin 
Family and Medical Leave Act (WFMLA).  It is true, as Pharmacia 
says, that we noted in Harvot that the WFMLA represents "modern 
social legislation" of a type that "was quite unheard of in 
1848."  320 Wis. 2d 1, ¶80.  Contrary to Pharmacia's intimation, 
however, that sentence represents only one component of the 
decision's reasoning, not its overall holding. 
¶50 In Harvot, we ultimately rejected the plaintiff's 
claim to a jury trial right because "the most analogous common 
law cause of action" that the plaintiff offered to the court was 
essentially a claim for the breach of an employment contract.  
320 Wis. 2d 1, ¶85.  The purpose of such a claim, we reasoned, 
was "to ensure that the . . . employee . . . was cared for and 
compensated as he was promised."  Id., ¶86.  It was not, like 
the WFMLA, motivated by an intent to help employees "balance 
work and family demands."  Id. 
¶51 Seen in its context, the "modern social legislation" 
language from Harvot does not avail Pharmacia.  Medicaid fraud, 
unlike the WFMLA, is in fact motivated by a purpose closely 
similar to the purpose of its suggested common law forebear: 
protecting the integrity of business relationships and market 
transactions.  See generally Jason Chimon, George C. Chipev, & 
Timothy Feulner, Health Care Fraud, 48 Am. Crim. L. Rev. 783 
(2011) (conducting general review of health care fraud law).  
The fact that the Medicaid fraud statute projected those 
concerns on a more contemporary screen does not render the 
fundamental purpose substantively different.  Indeed, the common 
No. 
 2010AP232-AC 

27 
 
law as a whole adjusts to historical circumstance, see O. 
Holmes, 1 The Common Law (1881) ("The law embodies the story of 
a nation's development through many centuries . . . ."), and 
this is particularly true of common law fraud.  See, e.g., 
Samuel W. Buell, What is Securities Fraud?, 61 Duke L.J. 511, 
522 (2011) ("[F]raud is a legal concept designed to adapt 
alongside the evolving behaviors that it targets.") (citing, in 
part, Stonemets v. Head, 154 S.W. 108, 114 (Mo. 1913) ("Fraud is 
kaleidoscopic, infinite.  Fraud being infinite and taking on 
protean form at will, were courts to cramp themselves by 
defining it with a hard and fast definition, their jurisdiction 
would be cunningly circumvented at once by new schemes beyond 
the definition.")).  It would therefore be especially illogical 
for us to confine a jury trial right to only those fraud 
statutes which mimic the common law as it was in 1848, when the 
common law in 1848 could not imagine many of the contexts in 
which fraud operates today.  We decline to rest an important 
constitutional right on historical vicissitude.   
¶52 Pharmacia also compares the elements of Medicaid fraud 
with those of common law fraud, insisting that they differ in 
crucial respects.  While we agree that this line of inquiry is 
relevant, see Schweda, 303 Wis. 2d 353, ¶35 (comparing elements 
of causes of action as part of a jury trial right analysis), we 
disagree with Pharmacia's conclusion.  At common law, a 
plaintiff alleging fraud must prove: 1) a representation of 
material fact; 2) the representation's falsity; 3) the intent to 
deceive (or reckless disregard for truth or falsity); 4) intent 
No. 
 2010AP232-AC 

28 
 
to defraud or to induce action; 5) justifiable reliance by the 
deceived party.  See Krause v. Busacker, 105 Wis. 350, 350, 81 
N.W. 406 (1900); Kaloti Enters., Inc. v. Kellogg Sales Co., 2005 
WI 111, ¶12, 283 Wis. 2d 555, 699 N.W.2d 205.  Although no 
published decision from the Wisconsin courts has set forth the 
elements of the Medicaid fraud statute, they are easily deduced 
from the statute: 1) knowingly making or causing to be made; 2) 
a false statement or representation of material fact; 3) for use 
in determining rights to a benefit or payment in connection with 
medical assistance.  Wis. Stat. § 49.49(4m)(a)2.; see also 
United States v. Laughlin, 26 F.3d 1523, 1526-29 (10th Cir. 
1994) (discussing the elements of federal Medicaid fraud 
statute).  Aside from the medical assistance requirement 
addressed above, the only divergence between the elements 
advanced by Pharmacia is the presence of reasonable reliance in 
common law fraud and its absence from Medicaid fraud. 
¶53 We do not believe that this discrepancy, such as it 
is, outweighs the closely similar purposes of the two laws.  
First, although the Medicaid fraud statute does not include the 
term "reasonable reliance," it does require a showing that the 
deceptive statement was made "for use in determining rights to a 
benefit or payment in connection with medical assistance."  Wis. 
Stat. § 49.49(4m)(a)2.  By inserting such language into the 
statute, the legislature indicated that Medicaid fraud could be 
substantiated only by proof that the false statement played some 
role in the state's calculation of payments.  Though that 
requirement is not identical to reasonable reliance, it is also 
No. 
 2010AP232-AC 

29 
 
not wholly dissimilar, as both require evidence that the 
culpable conduct influenced the decision-making process of the 
relevant actor.  In any event, the difference between the two is 
insufficient to override the substantial overlap in purpose 
between Medicaid fraud and common law fraud.  Accordingly, we 
conclude that the cause of action created by the Medicaid fraud 
statute "was recognized at common law at the time of the 
adoption of the Wisconsin Constitution in 1848" and the first 
prong of the Village Food test is therefore satisfied with 
respect to that cause of action.  Vill. Food, 254 Wis. 2d 478, 
¶11. 
b. 
Common Law Fraud was "At Law" in 1848 for Purposes of the 
State's Right to a Jury Trial 
¶54 In their discussions regarding the State's right to a 
jury trial on its Medicaid fraud claim, the parties quarrel over 
the nature of the forfeitures and damages sought by the State.  
Pharmacia 
contends 
that 
the 
State 
pursued 
in 
personam 
forfeitures, which were unrecognized at common law in 1848, and 
that its damage claim was in actuality an equitable one, and 
thus properly resolved in a bench trial.  The State takes the 
opposite position on both points.  Although they do not frame 
this debate in terms of whether common law fraud was "at law" 
for purposes of the State's claims, that is the only conceivable 
relevance it has for the certified questions.13 


13 Otherwise, the argument reduces to a dispute over which 
particular matters should have been submitted to the jury, and 
which to the trial judge, and that question lies outside the 
scope of our present review. 
No. 
 2010AP232-AC 

30 
 
¶55 At common law, an action for fraud could sound either 
at law or in equity.  Strom v. Goldman, Sachs & Co., 
202 F.3d 138, 143-44 (2d Cir. 1999), abrogated on other grounds 
by Great-West Life & Annuity Ins. Co. v. Knudson, 534 U.S. 204 
(2002).  When heard in a court of equity, fraud was defined in a 
looser, more flexible fashion than it was in a legal proceeding.  
See Aaron v. SEC, 446 U.S. 680, 693 (1980) ("[F]raud has a 
broader meaning in equity than at law.") (internal brackets, 
quotation marks, and citations omitted).  We need not delve 
deeper into the distinction, however, because common law fraud, 
as it was at law in 1848, is sufficiently analogous to Medicaid 
fraud to satisfy the second prong of the test.  Compare Pasley 
v. Freeman, (1789) 100 Eng. Rep. 450 (K.B.) 457, 3 T.R. 51, 64 
(describing 
common 
law 
fraud 
at 
law) 
with 
Wis. 
Stat. 
§ 49.49(4m)(a)2. (setting forth the elements of Medicaid fraud).  
Pharmacia's focus on the equitable remedies purportedly sought 
by the State is misplaced.  Regardless of whether or not the 
State pursued some equitable relief, the question before us now 
is whether the cause of action as a whole is an essential 
counterpart to a cause of action considered "at law" in 1848.  
We 
have 
answered 
that 
question 
in 
the 
affirmative.  
Consequently, the second prong of the Village Food test is met, 
and the State was entitled to a jury trial on its Medicaid fraud 
claim. 
No. 
 2010AP232-AC 

31 
 
B. 
The Jury's Damage Award of $9 Million for Pharmacia's 
Inflated AWPs in Connection with Brand and Generic Drugs Was not 
Impermissibly Speculative  
¶56 The next issue before us is whether the jury engaged in 
impermissible speculation in determining the damage award.  
Because the damages were based on reasonable inferences drawn by 
the jury from credible evidence, we hold that it did not 
speculate and accordingly uphold the award.  
¶57 The jury's damage award of $9 million reflected the 
State's request for an award in approximately that amount.14  The 
request in turn reflected the State's position, communicated 
through expert testimony and reiterated at closing argument, 
that approximately $9 million represented the amount of money 
Medicaid would have saved had it received, and used, actual 
wholesale prices.  Specifically, Lawrence DeBrock, Professor of 
Economics and Dean of the College of Business at the University 
of Illinois ("Professor DeBrock"), explained to the jury how he 
calculated Wisconsin's damages for both brand name and generic 
drugs.  Comparing Medicaid records to subpoenaed documents 
detailing wholesale drug transactions in the private market, he 
found the difference between what Medicaid reimbursed pharmacies 


14 The State's damages expert suggested that the most 
appropriate calculation of damages was $9,527,180.  At closing 
argument, the State requested a reduced damage award of 
$9,146,180 because of an issue regarding the statute of 
limitations.  The jury awarded $9 million.  Pharmacia does not 
argue that the discrepancy between the two amounts has any 
significance to our analysis. 
No. 
 2010AP232-AC 

32 
 
and the prices actually paid by the pharmacies to their 
wholesalers.  His estimate of that difference was advanced by 
the State at closing argument and presumably adopted by the 
jury. 
¶58 Pharmacia attacks the damage award because Medicaid 
reimbursement was set through the political process and, in 
Pharmacia's view, there was no way the jury could sufficiently 
predict what the legislature and governor would have done with 
different AWPs.15 
¶59 The damage award was calculated with reference to the 
AWPs reported by Pharmacia.  Because brand drugs are reimbursed 
by a different process than are generic drugs, we discuss them 
in turn. 


15 Pharmacia further contends that the evidence at trial 
indicated that Wisconsin political officials knowingly used 
higher AWPs to pay pharmacies more than their acquisition costs 
in order to ensure that they participated in Medicaid.  As 
Pharmacia sees it, such evidence disproved the assumption upon 
which the jury grounded its damage award: that the legislature 
desired actual wholesale prices and would have reimbursed 
pharmacies in accordance with such prices.  This argument 
essentially goes to liability, not damages.  That is, if there 
was insufficient evidence to sustain the State's claim that it 
would have paid lower AWPs if they had been published, then the 
damage award would not be lower, it would be zero.  For in that 
event, there would have been no injury and thus no fraud.  It is 
well-settled that "the uncertainty which prevents recovery is 
uncertainty as to the fact of the damage and not to its amount."  
Eden Stone Co. v. Oakfield Stone Co., 166 Wis. 2d 105, 125, 479 
N.W.2d 557 
(Ct. 
App. 
1991)(emphasis 
altered)(citing 
Cutler 
Cranberry Co. v. Oakdale Elec. Co-op., 78 Wis. 2d 222, 233, 254 
N.W.2d 234 (1977)).  The court of appeals did not certify the 
question of Pharmacia's liability, so we do not address this 
argument. 
No. 
 2010AP232-AC 

33 
 
1. 
The Jury Did Not Impermissibly Speculate as to the Damage 
Award with Respect to Brand Name Drugs 
¶60 The jury did not impermissibly speculate as to the 
damage award with respect to brand name drugs because the jury 
received credible evidence supporting a reasonable inference 
that, had actual wholesale prices been provided, the legislature 
would have used them to reimburse pharmacies for brand name 
drugs.    
¶61 Many of the facts regarding the reimbursement process 
are sharply disputed by the parties.  Since we are bound to 
uphold a damage award where it is based on credible evidence 
viewed in the light most favorable to the jury's determination, 
Springen, 19 Wis. 2d at 489, we focus on the reimbursement 
process as it was characterized to the jury at trial. 
¶62 The evidence at trial unequivocally revealed that, at 
all times relevant to the case, Medicaid paid pharmacies AWP 
minus a specific percentage for brand name drugs.  The parties 
and their witnesses likewise agreed that Pharmacia reported AWPs 
that did not track the actual prices pharmacies were paying 
wholesalers for drugs.16  The dispute is over how reimbursement 
rates would have changed, if at all, had accurate prices been 
conveyed to Medicaid.  As the following discussion demonstrates, 


16 At trial, Pharmacia presented evidence and argument to 
convince the jury that the company was not in fact responsible 
for the published AWPs because FDB alone determined some of them 
and confirmed and vouched for all of them.  That issue, again, 
relates to liability and not to whether the damage award was 
speculative, and we consequently do not address it. 
No. 
 2010AP232-AC 

34 
 
the jury was presented with sufficient credible evidence to 
support a reasonable inference that reimbursement rates would 
have been reduced to reflect actual wholesale prices, had they 
been provided.  Accordingly, we conclude that the jury did not 
impermissibly speculate in reaching its damage award with 
respect to brand name drugs. 
¶63 First, the jury considered evidence that the federal 
Office of Inspector General for CMS ("OIG") provided to 
Wisconsin Medicaid officials the results of a national audit of 
pharmacy acquisition costs for drugs reimbursed under Medicaid.  
The report indicated that Wisconsin pharmacies were purchasing 
brand name drugs at an average of 20.25% below the published 
AWPs, during a period when the Wisconsin Medicaid reimbursement 
rate was AWP minus 11.25%.  The OIG advised DHS to consider the 
report in making changes to pharmacy reimbursement policy.  Most 
important, the State submitted evidence that the legislature 
ultimately reduced the reimbursement rates just as the OIG 
recommended.  Such evidence strongly supports the jury's 
determination that Wisconsin would have paid Pharmacia prices in 
line with actual wholesale prices if such prices had been 
faithfully reported, and it therefore strongly supports the 
damage award. 
¶64 Second, the jury heard from Amie Goldman ("Goldman"), 
a 
former 
analyst 
with 
the 
Legislative 
Fiscal 
Bureau, 
a 
nonpartisan agency tasked with providing fiscal analyses to the 
Wisconsin legislature for use in formulating the state's 
biennial budget.  While on the stand, Goldman recounted several 
No. 
 2010AP232-AC 

35 
 
meetings she had with agents representing various lobbying 
interests, as well as DHS and other officials, as part of her 
effort 
to 
compile 
a 
comprehensive 
report 
advising 
the 
legislature 
on 
the 
ramifications 
of 
adopting 
alternative 
Medicaid reimbursement formulae.  Goldman explained that her 
agency, as well as legislators themselves, were unsure how 
closely AWPs tracked actual wholesale prices in light of 
conflicting input from different actors.  Ultimately, she and 
her colleagues both "wanted" and "needed accurate information" 
regarding AWPs.  Had such information been provided, Goldman 
testified, there would have been no need for her to prepare the 
report, 
as 
the 
legislature 
would 
have 
simply 
reimbursed 
according to actual wholesale prices.  Thus, Goldman's testimony 
substantially bolstered the State's position that inflated AWPs 
caused Wisconsin to overpay for Medicaid drugs, and provided a 
credible foundation for the jury to calculate damages.   
¶65 Other witnesses called by the State confirmed the 
picture drawn by the OIG report and Goldman's testimony, and 
provided yet further evidence that Pharmacia damaged the state 
by providing inflated AWPs when actual wholesale prices would 
have resulted in lower reimbursements.  For instance, Mark W. 
Moody, a former director of Medicaid who served on the 
governor's commission on pharmacy reimbursement, testified that 
it would have assisted the commission in reaching a consensus on 
adjusting Medicaid reimbursement rates if they had been provided 
information 
that 
reflected 
actual 
wholesale 
prices. 
Additionally, Dr. Gerard Anderson, the Director of the Center 
No. 
 2010AP232-AC 

36 
 
for Hospital Finance and Management at the Johns Hopkins 
Bloomberg School of Public Health, opined that his survey of 
Pharmacia and government documents revealed that "all of 
Pharmacia's AWPs . . . were false, and because they were false, 
the Wisconsin Medicaid program overpaid providers, resulting in 
excess payments by the Wisconsin Medicaid programs."   
¶66 Lastly, Professor DeBrock provided a well-informed, 
detailed basis for the jury to calculate Wisconsin's damages.  
He compared Medicaid records with subpoenaed documents detailing 
wholesale drug transactions in the private market and found the 
difference between what Medicaid reimbursed pharmacies and the 
prices actually paid by the pharmacies to their wholesalers.  
His estimate of that difference——$9,527,180——was advanced by the 
State at closing argument (reduced to $9,146,180 as a result of 
statute of limitations considerations) and presumably formed the 
basis for the jury's damage award. 
¶67 In summary, there was plentiful evidence from a wide 
range of credible witnesses with extensive experience in the 
field to substantiate the State's argument that the legislature 
would have reduced brand drug reimbursements to reflect actual 
wholesale prices had Pharmacia offered them.     
¶68 Challenging the credibility of the evidence summarized 
above, Pharmacia emphasizes the testimony it proffered to rebut 
the State's account.  In particular, Pharmacia asserts that 
sounder evidence supported a conclusion that the legislature 
knew that the reported AWPs did not track accurate wholesale 
prices.  Indeed, Pharmacia argues, the greater weight of the 
No. 
 2010AP232-AC 

37 
 
evidence demonstrated that the state did in fact have access to 
actual pricing information and made the deliberate choice not to 
rely upon it.  In support of that contention, Pharmacia 
presented evidence suggesting that various state officials 
received actual pricing information, as well as reports that the 
reimbursement rates were substantially higher than pharmacies' 
actual acquisition costs.  Other evidence was advanced to 
substantiate 
Pharmacia's 
argument 
that 
the 
legislature 
repeatedly declined to follow various recommendations to lower 
reimbursement rates in order to bring them closer to actual 
prices.17  Several witnesses informed the jury that various 
branches of the Wisconsin government, most prominently the 
prison and hospital systems, paid wholesalers directly for 
medication and thus knew the prices such drugs commanded on the 
open market. 
¶69 It is true, as Pharmacia submits, that the jury heard 
accounts that clashed with the State's characterization of the 
legislature's knowledge and intentions.  But there are factual 
disputes in every jury trial; indeed, there would be no need for 


17 For example, James Vavra ("Vavra"), Director of the 
Benefits Management Bureau in the Division of Health Care Access 
and Accountability for Wisconsin Medicaid, testified that his 
office provided information to DHS in formulating budget issue 
papers, which were used by the governor and legislature to make 
changes to DHS's budget.  Vavra further testified that his 
office recommended lower reimbursement rates in accordance with 
the OIG report, in order to bring Wisconsin in line with actual 
acquisition costs for pharmacies.  Finally, he testified that 
the legislature repeatedly rejected such proposals.  Pharmacia 
admitted several exhibits to support Vavra's testimony. 
No. 
 2010AP232-AC 

38 
 
a jury trial at all if there were not.  See, e.g., Tri City Nat. 
Bank v. Fed. Ins. Co., 2004 WI App 12, ¶34, 268 Wis. 2d 785, 674 
N.W.2d 617 ("Juries resolve factual disputes.").  It would be 
especially surprising if the evidence had been consistent and 
clear in the trial here, given that it involved an enormously 
complex process with numerous moving parts.  Nevertheless, our 
inquiry asks only whether the record contains credible evidence, 
viewed in the light most favorable to the jury's determination, 
to support the damages awarded.  Springen, 19 Wis. 2d at 489.   
¶70 Applying that standard, it cannot be said that the 
damages here were speculative simply because some officials in 
state government received some information indicating that some 
AWPs were inflated above actual prices by some amount.  The 
State has never alleged, in any court, at any stage of the 
proceedings, that no one in the Wisconsin government knew that 
AWPs did not reflect actual wholesale prices.  What it alleged 
at trial, and what it continues to allege, is that no one in 
Wisconsin state government knew the exact degree of inflation, 
and that that uncertainty caused it to overpay for Medicaid 
drugs.  The jury was given a compelling account of that 
uncertainty, as it heard testimony describing a chaotic, 
confusing process in which decision-makers received dramatically 
different reports from different sources.  Indeed, Pharmacia's 
evidence only strengthened that account, because it described 
even more disagreements among the actors feeding information to 
the state.  Cf. Commonwealth v. TAP Pharm. Prods., 36 A.3d 1112, 
1152 (Pa. Commw. Ct. 2011) ("[G]iven the trial judge's findings 
No. 
 2010AP232-AC 

39 
 
regarding the significant confusion over AWP, we reject [the] 
argument that it is clear that the Commonwealth knowingly 
asserted 
in 
earlier 
litigation 
that 
it 
intended 
its 
reimbursement rates to be more generous than other entities in 
order to provide pharmacists a reasonable profit on ingredient 
costs.") (emphasis altered); but see AstraZeneca LP v. State, 41 
So. 
3d 
15, 
29-30 
(Ala. 
2009)(reversing 
judgment 
in 
AWP 
litigation 
against 
pharmaceutical 
company 
for 
fraudulent 
misrepresentation 
because 
the 
state 
"had 
actual 
knowledge . . . that published AWPs were not net prices" in the 
form 
of 
information 
known 
to 
certain 
Alabama 
Medicaid 
officials).   
¶71 In light of these conflicts, we have concluded that 
the jury's damage award as to brand name drugs was based on a 
reasonable inference flowing from credible evidence.  When, as 
here, "facts are in dispute or the evidence is such that fair-
minded [jurors] may draw different inferences," it is for the 
jurors, not for us, to determine "what seems to them to be the 
most reasonable inference."  Weber v. Chicago & Nw. Transp. Co., 
191 Wis. 2d 626, 636, 530 N.W.2d 25 (Ct. App. 1995) (quoting 
Lavender v. Kurn, 327 U.S. 645, 653 (1946)).  The jury had ample 
evidence to credit suggesting that Wisconsin officials did not 
know with certainty actual wholesale prices, that Pharmacia's 
published prices provided the basis for its reimbursement rates, 
and that Medicaid paid more than it intended to and rightfully 
owed as a consequence.  That evidence was offered by several 
witnesses with extensive experience in different areas of the 
No. 
 2010AP232-AC 

40 
 
Wisconsin Medicaid process, and by numerous documents from 
official bodies and others involved in the formulation and 
payment of the reimbursements.  The jury chose who among the 
witnesses to believe and we are not at liberty to disturb its 
damage award merely because Pharmacia would rather they had 
believed others.  See Fischer v. Cleveland Punch & Shear Works 
Co., 91 Wis. 2d 85, 92, 280 N.W.2d 280 (1979) ("The credibility 
of witnesses and the weight given to their testimony are matters 
left to the jury's judgment, and where more than one inference 
can be drawn from the evidence, this court must accept the 
inference drawn by the jury.") (citations omitted).   
¶72 In essence, Pharmacia asks us to search the record for 
evidence to sustain an award that the jury could have, but did 
not reach, and this we cannot do.  K&S Tool & Die Corp., 301 
Wis. 2d 109, ¶38.  The jury was free to rely on the evidence it 
found most credible and equally free to discount evidence it did 
not.  Both parties presented supporting material, and the jury 
made its decision.  For the reasons set forth above, we conclude 
that the jury did not impermissibly speculate in arriving at its 
damage award with respect to brand name drugs.18  


18 The parties debate the significance and relevance of 
various federal regulations, particularly requirements regarding 
the relationship between estimated and actual acquisition costs.  
Because it is not necessary to resolve this dispute in order to 
answer the speculativeness question, we do not address them. 
No. 
 2010AP232-AC 

41 
 
2. 
The Jury did not Impermissibly Speculate as to the Damage 
Award with Respect to Generic Drugs 
¶73 As with brand drugs, the jury's award of damages with 
respect to generic drugs was based on credible evidence 
supporting 
the 
inference 
that 
the 
publication 
of 
actual 
wholesale prices would have resulted in corresponding reductions 
to reimbursements.  Specifically, Ted Collins ("Collins"), the 
consultant to DHS who established the reimbursement rates for 
generic drugs, testified that he was forced to rely on his own 
research in the market because he knew AWPs were substantially 
inflated.  He further testified that he would have used actual 
wholesale prices to set reimbursement rates for generic drugs 
had he been given them.  Thus, Collins' testimony provided a 
solid foundation from which the jury could have reasonably 
inferred that Medicaid would have used actual wholesale prices 
to reimburse generic drugs had Pharmacia supplied them.  The 
same foundation therefore supported the reasonable inference 
that Medicaid was damaged by the inflated AWPs in the generic 
context in the same manner as it was damaged in the brand 
context: namely, that the difference between the inflated AWPs 
and actual average wholesale prices constituted the amount of 
the damage.19  Accordingly, we conclude that the jury did not 
impermissibly speculate and therefore uphold the damage award. 


19 For 
this 
reason, 
Professor 
DeBrock's 
method 
of 
calculating damages, summarized above, was reasonably applied by 
the jury to both brand and generic drugs. 
No. 
 2010AP232-AC 

42 
 
¶74 Unlike brand name drugs, generic drugs are generally 
not reimbursed by Medicaid based on AWP.20  Instead, they are 
reimbursed based on maximum allowable cost ("MAC"), an amount 
calculated to provide a uniform ceiling for generic drugs, given 
that they are often made available on the market at a wide range 
of prices.  The purpose of a MAC is to reflect the price paid by 
a pharmacy to a wholesaler for a given drug.     
¶75 One witness in particular spoke to the damages issue 
with respect to generic drugs, and his unique insight and 
credible testimony provided a solid foundation for the jury's 
damage award.   
¶76 Collins, a consultant to DHS, was responsible for 
setting the MACs for Wisconsin during the time relevant to this 
case.  At trial, Collins recounted at length how he had 
struggled to obtain accurate pricing information for calculating 


20 According to Collins' testimony, generic drugs were 
occasionally reimbursed on the basis of AWP.  For instance, 
there was sometimes a "lag" period for a generic drug while it 
was on the market but before Collins was able to set a MAC.  
During such a period, Collins would set the reimbursement at the 
same rate as applied to brand drugs, e.g., the AWP of the drug 
minus 10%.  However, because Collins' uncontroverted testimony 
established (and because the parties agree) that MACs were more 
central to the reimbursement process for generics than were 
AWPs, we focus our analysis in this section on the role MACs 
played in providing the basis for generic reimbursements, and 
the role AWPs would have played in that process had they 
reflected actual wholesale prices.  To the extent that some 
generic drugs were at some times reimbursed on the basis of 
AWPs, damages assessed for those drugs at those times were not 
speculative for the same reasons set forth in the section 
discussing the damages imposed for Pharmacia's brand drugs, 
which were also reimbursed on the basis of AWP.     
No. 
 2010AP232-AC 

43 
 
MACs to set on generic drugs because he could not use the 
reported AWPs, which he knew to be substantially inflated and 
thus unreliable.  In order to determine the MACs, Collins 
conducted independent research,21 which often resulted in spotty 
and conflicting information.  He compensated by adding money to 
the reimbursement rates to avoid erring on the side of excessive 
conservatism.  As a result, he testified, "[t]he poorer I was at 
guessing what the price should be, the more money" the state 
paid.  He further stated under oath that if he had known the 
actual prices pharmacies paid wholesalers for generics, and if 
those prices had been lower than his MACs, he would have set the 
MACs consistent with such prices.  Collins went so far as to 
claim that his job would have been rendered superfluous if 
companies like Pharmacia reported actual wholesale prices, 
remarking, "[i]f it was accurate information, [the state would] 
just apply it." 
¶77 As 
with 
brand 
name 
drugs, 
Pharmacia 
sought 
to 
undermine the State's damages claim concerning generic drugs by 
offering evidence that various governmental officials had access 
to true pricing information and elected not to rely on it.22  


21 For example, Collins testified that he researched the 
prices charged to veterinary hospitals for generic drugs 
purchased 
from 
wholesalers. 
 
He 
also 
consulted 
online 
information made available by a co-operative of pharmacists and 
records relating to drug purchases made by Wisconsin's prison 
system. 
22 For example, the jury received evidence that wholesalers 
themselves provided accurate pricing information and that the 
state had access to such information through FDB and other 
sources. 
No. 
 2010AP232-AC 

44 
 
Their continuing reliance on that evidence fails for the same 
reason as it does with respect to brand name drugs.  In a word, 
the jury reasonably rejected it.  Indeed, its rejection is even 
more difficult to question in this context given the force of 
Collins' testimony.  Regardless of what various other officials 
said to the jury, and regardless of what various governmental 
and industry documents contained, the jury heard a first-hand 
account of how the reporting of actual wholesale prices would 
have influenced Medicaid's reimbursement of generic drugs.  
Whatever other reasonable inferences the evidence might have 
occasioned, it surely must be said, at the very least, that 
"fair-minded" jurors could have drawn the "reasonable inference" 
that actual wholesale prices reported by Pharmacia would have 
reduced the amount paid by Medicaid for generic drugs.  Weber, 
191 Wis. 2d at 636.   The jury selected "what seem[ed] to them 
to be the most reasonable inference," id., and we may not 
disturb that decision. 
¶78 Finally, Pharmacia submits, as it has throughout these 
proceedings, that because generics were not reimbursed on the 
basis of AWPs, any damage award based on the inflation of AWPs 
with respect to generics must be speculative.  Such an argument 
mischaracterizes the State's theory and the jury's verdict.  The 
State did not argue at trial that Medicaid paid too much for 
generic drugs because it was incorporating inflated AWPs into 
its reimbursement process; rather, it argued that it paid too 
much for generic drugs because it did not have actual wholesale 
prices to use.  Indeed, the State's theory regarding damages in 
No. 
 2010AP232-AC 

45 
 
the generic context was not substantively different in this 
respect than its theory in the brand name context.  With brand 
drugs as well as generics, the State never contended that 
Medicaid paid Pharmacia the amounts Pharmacia supplied in its 
AWPs; it contended that Medicaid estimated what pharmacies paid 
to wholesalers because it knew the AWPs were inflated, but did 
not know by how much.  Thus, in both contexts, the reporting of 
inflated AWPs harmed Medicaid, and in both the reporting of 
accurate AWPs would have saved Medicaid money.  See In re Pharm. 
Indus. AWP Litig., 582 F.3d 156, 190 (1st Cir. 2009) (affirming 
damages in AWP litigation as non-speculative where expert 
testimony established "that had the AWPs not been inflated, the 
plaintiffs would not have paid as much as they did"), petition 
for cert. dismissed, 561 U.S. __, 131 S. Ct. 60 (2010).23   
¶79 Simply put, the proper calculation of damages focuses 
primarily on what would have happened absent the liable conduct, 
not what did happen with the liable conduct.  See, e.g., Schulz 
v. St. Mary's Hosp., 81 Wis. 2d 638, 657, 260 N.W.2d 783 (1978) 
(holding that a damage calculation is sound where the jury can 
"estimate with reasonable probability what would have happened 
had the injury not occurred").  Here, absent the liable conduct, 
Pharmacia would have reported actual wholesale prices, and the 
jury had credible evidence to support the inference that 


23 In re Pharmaceutical Industry AWP Litigation dealt with a 
single brand name drug, but the simple proposition for which it 
is cited here——that damages are not speculative if accurate 
wholesale prices would have resulted in lower reimbursements——
applies to generics as well.   
No. 
 2010AP232-AC 

46 
 
Medicaid 
would 
have 
reimbursed 
Pharmacia's 
generic 
drugs 
consistently with such accurate prices.    
¶80 Lastly, and most importantly, the State supported its 
damage theory regarding generic drugs with credible evidence, 
most powerfully in the form of Collins' testimony that Medicaid 
would have used actual wholesale prices as the basis for its 
generic reimbursements if it had them.  Far from constituting 
impermissible speculation, the jury's decision to rely on such 
testimony represented an exercise of the jury's traditional role 
in calculating damages.  See, e.g., Weber, 191 Wis. 2d at 634-37 
(collecting cases concerning the role of expert witnesses in 
helping to guide the jury in the calculation of damages based on 
likely future events).  The jury chose to credit Collins' 
credible testimony, and we are not at liberty to unsettle that 
determination.  See Fischer, 91 Wis. 2d at 92 ("The credibility 
of witnesses and the weight given to their testimony are matters 
left to the jury's judgment, and where more than one inference 
can be drawn from the evidence, this court must accept the 
inference drawn by the jury."); Mgmt. Computer Services, Inc. v. 
Hawkins, Ash, Baptie & Co., 206 Wis. 2d 158, 189, 557 N.W.2d 67 
(1996) (reiterating that a plaintiff need not "prove damages 
with mathematical precision; rather, evidence of damages is 
sufficient if it enables the jury to make a fair and reasonable 
approximation.") (citations omitted).  
¶81 In sum, with respect to both generic and brand name 
drugs, Pharmacia sought to convince the jury that Medicaid knew 
it 
was 
paying 
pharmacies 
more 
than 
the 
pharmacies 
were 
No. 
 2010AP232-AC 

47 
 
themselves paying.  It ably made that case at trial, placing its 
evidence in the most convincing light possible.  Nevertheless, 
it lost the battle and the jury credited contrary evidence 
suggesting that the inflated AWPs injured the state by causing 
it to overpay for the drugs.  That evidence also supported the 
reasonable inference that Wisconsin, if it had been equipped 
with actual wholesale prices for both brand name and generic 
drugs, would have paid Pharmacia in those amounts.24  In such 
circumstances, we are not permitted to substitute our judgment 
for that of the jury, and we therefore uphold its damage award. 
C. 
The Circuit Court Properly Reduced the Number of Violations 
Found by the Jury 
¶82 The final question presented for our consideration is 
whether the circuit court properly reduced the number of 
Medicaid fraud statute violations found by the jury.  We hold 
that it did, and therefore affirm. 
1. 
Factual Background 
¶83 At closing argument, the State argued to the jury that 
it should calculate the number of Medicaid fraud statute 


24 As it did at trial, Pharmacia stresses the political 
nature of the reimbursement process.  Some of its language 
appears to suggest that it believes the politicization of the 
process, in and of itself, renders the damage award speculative.  
Pharmacia's claim that the proceedings below constituted an 
inappropriate invasion by the judicial branch into the exclusive 
province of the legislative and executive branches is pending in 
the court of appeals.  It has not been certified, so we do not 
address it here.  We answer only the certified question, which 
is whether or not the damages were impermissibly speculative.  
That 
inquiry 
does 
not 
require 
us 
to 
delve 
into 
the 
politicization of the process as a free-standing issue. 
No. 
 2010AP232-AC 

48 
 
violations with reference to the number of times Medicaid 
overpaid as the result of an inflated AWP for a discrete drug 
product (brand or generic) purchased by a consumer.  It 
submitted that 1,440,000 was the best estimate of that number.  
Pharmacia argued, consistent with its theory of the case, that 
Pharmacia never acted unlawfully, and sought to convince the 
jury that there were no violations and that the jury should 
answer this question "zero." 
¶84 Question Four of the special verdict form completed by 
the jurors asked them whether Pharmacia "knowingly [made], or 
knowingly 
cause[d] 
to 
be 
made, 
any 
false 
statement 
or 
representation of material fact for use in determining rights to 
a Wisconsin Medicaid payment."  Question Five asked, "[h]ow many 
such false statements or representations of material fact for 
use in determining rights to a Wisconsin Medicaid payment did 
Pharmacia Corporation knowingly make or cause to be made?"  The 
jury instructions recited the elements of an offense of the 
Medicaid fraud statute,25 but gave no further guidance on how to 
determine the precise number of violations.  After deliberating, 
the jury adopted the State's position and in a verdict rendered 
on February 16, 2009 found 1,440,000 violations. 


25 The instructions informed the jury that a violation 
occurs where: 1) the defendant makes or causes to be made a 
representation of material fact for use in determining the 
rights to a payment requested by a Medicaid provider, i.e., a 
fact affecting the amount of payment; 2) the representation was 
false when made; 3) the defendant made the representation 
knowingly; and 4) the false statement was used in determining a 
provider's right to the payment requested by a Medicaid 
provider. 
No. 
 2010AP232-AC 

49 
 
¶85 In a post-trial brief, Pharmacia moved the circuit 
court to vacate the jury's calculation of violations and reduce 
the number to zero.  The circuit court agreed with Pharmacia 
that the jury's finding was erroneous, because, as it stated in 
its order, it was based on a misleading argument by the State 
that shifted the "focus" from "the culpable conduct of the 
defendant" to the "consequences of the culpable conduct." 
(emphasis in original).  In a decision dated May 15, 2009, the 
circuit court determined that "Pharmacia [was] subject to 
forfeiture for each false material statement or representation 
it made or caused to be made, not each time someone looked at 
[the statement or representation], or even relied on it."  
Finding that the jury's determination was based on an erroneous 
legal premise, the circuit court vacated its answer.  However, 
the circuit court rejected Pharmacia's contention that the 
proper number of violations was zero, finding instead that there 
was "clearly evidence in [the] record that would support the 
imposition of forfeitures."  Accordingly, the circuit court 
ordered further briefing and argument on the issue. 
¶86 After that briefing and argument took place, the 
circuit court issued an order on September 30, 2009.  In that 
order, the circuit court concluded that the jury had "completely 
missed the boat" as a result of the plaintiff's decision to 
"adopt[] an unsustainable theory of recovery" and go "all in" by 
"equating claims paid with misrepresentations made."  The court 
then reduced the number of violations to 4,578.  It derived that 
number by searching the record for the number of times that FDB 
No. 
 2010AP232-AC 

50 
 
conveyed to Medicaid (in its quarterly reports) a false AWP for 
a Pharmacia product that Medicaid then used, at least once, in 
the reimbursement of a pharmacy.  In other words, the circuit 
court found a violation "each time . . . updates were purchased 
by Wisconsin for each drug" and then used at least once by 
Medicaid in the reimbursement process.  Weighing various factors 
related to the appropriate forfeiture amount per violation,26 the 
circuit court imposed $1,000 for each violation, leading to a 
total forfeiture amount of $4,578,000. 
2. 
The Circuit Court Resolved the Post-verdict Motion within 
90 Days, as Required by Wis. Stat. § 805.16(3) 
¶87 As a threshold matter, Pharmacia argues that the 
circuit court had no authority to reduce the number of 
violations because it did so more than 90 days after the jury 
rendered the verdict.  In Pharmacia's opinion, the circuit 
court's order vacating the jury's determination concerning the 
number of violations was timely, but the ruling reducing the 
number of violations from 1,440,000 to 4,578 was in violation of 
Wis. Stat. § 805.16(3) and thus void.  Because that ruling was 
void, Pharmacia reasons, the timely order vacating the jury's 
calculation of violations remains valid, and the number of 
violations is therefore frozen at zero.  We disagree, and 


26 For example, the circuit court mentioned as aggravating 
factors that Pharmacia knowingly defrauded the state and that 
virtually all of the inflated AWPs resulted in multiple 
overpayments.  It categorized as a mitigating factor the absence 
of evidence to suggest that the overpayments went "directly into 
Pharmacia's pockets."   
No. 
 2010AP232-AC 

51 
 
conclude that the circuit court acted within the timeline set by 
the statute. 
¶88 Wisconsin Stat. § 805.16(3) states: "If within 90 days 
after the verdict is rendered the court does not decide a motion 
after verdict on the record or the judge . . . does not sign an 
order deciding the motion, the motion is considered denied and 
judgment shall be entered on the verdict."  Pharmacia would have 
us apply that provision to the facts at hand to mean that "the 
trial court correctly vacated the answer to Question No. 5 
within 90 days of verdict [but] then lost competence to provide 
a new answer."  However, § 805.16(3) cannot sustain such a 
construction. 
¶89 The circuit court did resolve the motion implicated by 
Wis. Stat. § 805.16(3) within 90 days; it did so by vacating the 
jury's calculation of violations.  The further proceedings were 
not held to dispose of the motion; rather, those proceedings 
were required to answer the question left unresolved after the 
motion's disposition: how many violations of the Medicaid fraud 
statute did Pharmacia commit?  That fact is sufficient to 
distinguish this case from Brandner v. Allstate Ins. Co., 181 
Wis. 2d 1058, 512 N.W.2d 753 (1994), one of the principal 
authorities relied upon by Pharmacia in the trial court.  There, 
we deemed a "supplemental decision" a "nullity" because the 
circuit court issued it more than 90 days after the verdict.  
Id. at 1071.  Crucially, however, there were no disputed issues 
in Brandner left unresolved by the earlier proceedings.  Thus it 
presented a very different circumstance from this case, where 
No. 
 2010AP232-AC 

52 
 
the circuit court's original post-trial order itself indicated 
that 
further 
proceedings 
were 
necessary 
to 
determine 
an 
unresolved matter of great importance.27  Consequently, a plain 
language reading of the statute leads us to conclude that it was 
not violated by the circuit court reducing the number of 
violations. 
¶90 Furthermore, as we have previously observed, the 
purpose of the timeline established by Wis. Stat. § 805.16(3) is 
"to prevent unnecessary protraction of litigation." Jos. P. 
Jansen Co. v. Milwaukee Area Dist. Bd. of Vocational, Technical 
& Adult Ed., 105 Wis. 2d 1, 9, 312 N.W.2d 813 (1981) (emphasis 
added) (internal quotation marks and citation omitted).  Here, a 
thorough consideration of the issue can hardly be called 
unnecessary.  On the contrary, the question of how many 
violations Pharmacia committed for forfeiture purposes was an 
enormously consequential one for both parties, as well as for 
the citizens of the state, the remaining defendants, and the 
pharmaceutical industry as a whole.  Indeed, the difference 
between the jury's tally of violations and the circuit court's 
was well over one million, an amount that would be amplified 
considerably by the circuit court's award of a monetary amount 
for each violation.  The circuit court acted properly and within 


27 It is also worth noting that even though we regarded the 
supplemental decision in Brandner as void, we nevertheless 
upheld it under our discretionary powers because, among other 
things, the earlier ruling "reflect[ed] [an] incorrect legal 
analysis."  Brandner v. Allstate Ins. Co., 181 Wis. 2d 1058, 
1072, 512 N.W.2d 753 (1994). 
No. 
 2010AP232-AC 

53 
 
the permitted timeframe in ensuring that such an important issue 
received the extensive briefing, argument, and deliberation that 
it deserved. 
¶91 Finally, it would be absurd to leave the violation 
calculation at zero, where it would be if Pharmacia were right 
that the order vacating the jury's answer concerning the number 
of violations was timely but the subsequent order setting the 
number of violations at 4,578 was not.  The circuit court 
vacated the jury's verdict with the express intention of 
reducing the number of violations to an amount supported by the 
record.28  It would make no sense to read the statute as 
preserving the number of forfeitures at zero when the only 
reason they were vacated at all was to supply a reduced number.  
State ex rel. Kalal v. Circuit Court for Dane Cnty., 2004 WI 58, 
¶46, 271 Wis. 2d 633, 681 N.W.2d 110 ("[S]tatutory language is 
interpreted . . . to avoid absurd or unreasonable results.").  
As a result, we conclude that the court's ruling was not in 
violation of Wis. Stat. § 805.16(3). 


28 The circuit court noted that "[b]y striking the jury's 
answer . . . the court is not holding that the answer should be 
changed to '0.'"  It added, "there is clearly evidence in this 
record that would support the imposition of forfeitures . . . .  
However, their number cannot be determined without . . . further 
argument from counsel." 
No. 
 2010AP232-AC 

54 
 
3. 
There was Insufficient Evidence to Support the Number of 
Violations Found by the Jury and the Circuit Court Was Therefore 
Required to Vacate that Number 
¶92 We now turn to the question of whether the circuit 
court properly vacated the number of violations found by the 
jury.  To evaluate that decision, we must determine whether 
there was any credible evidence to support the jury's finding.  
Hanson, 294 Wis. 2d 149, ¶18.  Because the number of violations 
found by the jury was unsupported by any evidence, we conclude 
that the circuit court acted properly. 
¶93 The jury’s calculation of violations was based on the 
State's theory that Pharmacia violated the Medicaid fraud 
statute every time the state overpaid for a drug on the basis of 
an inflated AWP.  However, there is no authority to support that 
theory, which flies in the face of the statute's plain language, 
as well as every judicial decision on the issue.  See, e.g., 
State v. Menard, Inc., 121 Wis. 2d 199, 358 N.W.2d 813 (Ct. App. 
1984); United States v. Bornstein, 423 U.S. 303 (1976); United 
States v. Ehrlich, 643 F.2d 634 (9th Cir. 1981).  Furthermore, 
there has never been any dispute that the jury's finding of 
1,440,000 violations was based solely on the State's legal 
theory, which the jury adopted despite the fact that the court's 
instructions contradicted that theory.  Because the jury's 
finding was based on an improper legal definition, there is no 
evidence to support it and the circuit court was required to 
vacate the number of violations. 
No. 
 2010AP232-AC 

55 
 
¶94 As an initial matter, it is important to clarify 
whether the jury's error was one of law or fact. The circuit 
court 
was 
itself 
understandably 
confused 
on 
the 
issue, 
expressing uncertainty as to the proper source of authority for 
vacating the jury's answer.29  The line here is a blurry one, for 
the jury's error falls near the gray area between law and fact.  
That is, the jury's finding of 1,440,000 violations flowed from 
a legal error but, as a result, it was unsupported by the 
evidence.  Stated differently, the jury's finding can only be 
fairly understood as supported by the evidence if one adopts an 
erroneous legal theory. 
¶95 Such 
complications 
might 
pose 
a 
more 
difficult 
question in another case, but they are resolved by a simple fact 
here: the jury was sufficiently instructed by the circuit court 
to have rejected the State's flawed legal theory.  Ultimately, 


29 The circuit court was unsure whether the proceedings were 
properly governed by Wis. Stat. § 805.14(1)(error of fact) or by 
§ 805.15(1)(error of law).  Although it is somewhat ambiguous, 
the circuit court's June 18, 2009 ruling appears to fall more on 
the side of § 805.14(1).  For instance, the circuit court stated 
that "the court here must enter judgment only based upon the 
number of statutory violations that the credible evidence, 
viewed in the light most favorable to the plaintiff within the 
context of the applicable law, can support."  Such language 
suggests a § 805.14(1) inquiry into whether the jury committed 
an error of fact.  Morden v. Cont'l AG, 2000 WI 51, ¶38, 235 
Wis. 2d 325, 611 N.W.2d 659.  For the reasons set forth below, 
we agree that the mistake is best characterized as one of fact, 
not law, and we therefore bring to bear the § 805.14(1) standard 
of review.  Under that standard we will reverse the circuit 
court's ruling if there is any credible evidence, direct or 
inferential, to support the jury's finding.  Hanson v. Am. 
Family Mut. Ins. Co., 2006 WI 97, ¶18, 294 Wis. 2d 149, 716 
N.W.2d 866. 
No. 
 2010AP232-AC 

56 
 
that fact resolves the standard of review.  For there can be no 
error of law by the jury in the legal sense, in the context of a 
post-verdict motion, where a jury makes a challenged factual 
finding after accurate instructions from the court.  Reduced to 
its essence, our system of law entrusts a trial court with 
instructing the jury on the law, and it entrusts the jury with 
applying the law to the facts.  See, e.g., Roehl Transp., Inc. 
v. Liberty Mut. Ins. Co., 2010 WI 49, ¶¶121-29, 325 Wis. 2d 56, 
784 N.W.2d 542. 
¶96 In this case, the jury was sufficiently instructed on 
the relevant law to understand that the State's theory of what 
constituted a violation was mistaken.  They were told, in an 
instruction that tracked the language of the statute, that 
Pharmacia committed a violation whenever it made or caused to be 
made a misrepresentation.  There is no logically defensible 
reading of that instruction that does not clearly contradict the 
State's theory.  This is so because whatever legal significance 
one chooses to place upon the number of times Medicaid overpaid 
for Pharmacia drugs, that number cannot represent the number of 
times Pharmacia "made or caused to be made" any representations.  
By the time of overpayment, Pharmacia had already reported its 
AWP, and FDB had already published it to Medicaid.  Any 
fraudulent "statements" had already been communicated and the 
alleged fraud was complete.  The number of times pharmacies were 
overpaid is merely a consequence of the alleged fraud, not the 
fraudulent conduct itself.  Cf. People v. Pharmacia Corp., 27 
Misc. 3d 368, 
374 
(N.Y. 
Sup. 
Ct. 
2010) 
(holding 
that 
No. 
 2010AP232-AC 

57 
 
"each . . . inflated price report constitutes the accrual of a 
separate wrong" in AWP litigation) (emphasis added).  Indeed, as 
a number that reflects the ramifications of the fraud to the 
injured party, the 1,440,000 violations goes to damages, if it 
goes to anything, not to forfeitures.  See, e.g., White v. 
Benkowski, 37 Wis. 2d 285, 290, 155 N.W.2d 74 (1967)(noting that 
compensatory damages are awarded to make the injured party whole 
for the damage suffered while punitive damages, such as 
forfeitures, are given to punish the wrongdoer for malice and to 
deter others from similar conduct). 
¶97 Case law confirms our plain language reading of the 
statute.  Three decisions have shaped the debate in this case 
over what constitutes a violation.  None of them supports the 
State's theory. 
¶98 The only Wisconsin case among the three is Menard.  
There, the court of appeals held that a violation of a 
regulation prohibiting price-comparison advertising occurred 
each time an improper advertisement was published, and that each 
newspaper edition (as opposed to each newspaper containing the 
advertisement) constituted a separate publication.  Menard, 121 
Wis. 2d at 814.  The court reasoned that this approach best 
reflected the defendant's culpable conduct, given that each 
publication of the same advertisement in a different newspaper 
required an independent act.  Id. at 815. 
¶99 The United States Supreme Court dealt with a similar 
issue in Bornstein, a case involving shipments of falsely 
branded tubes for use in Army radios in violation of the False 
No. 
 2010AP232-AC 

58 
 
Claims Act.  In that decision, the court held that a 
subcontractor was subject to three statutory forfeitures based 
on three separate shipments of the falsely branded tubes to the 
contractor.  Bornstein, 423 U.S. at 313.  Rejecting the argument 
that the number of forfeitures should reflect the number of 
false invoices the defendant "caused to be submitted," the 
Bornstein court concluded that a forfeiture analysis should be 
geared to "the specific conduct of the person from whom the 
Government seeks to collect the forfeiture."  Id.  Applying this 
reasoning, 
the 
court 
noted 
that 
the 
defendant 
did 
not 
deliberately cause the contractor to submit any particular 
number of false claims.  Id. at 322. Instead, the number of 
false 
claims 
was 
"completely 
fortuitous 
and 
beyond 
[the 
defendant's] knowledge or control."  Id. 
¶100 The third and final decision that has shaped the 
forfeiture debate in this case is that of the Ninth Circuit 
Court of Appeals in Ehrlich, another case concerning the False 
Claims Act.  In Ehrlich, the Ninth Circuit held that a builder 
was subject to 76 forfeitures relating to each false monthly 
statement he made to the government.  643 F.2d at 638.  Applying 
the reasoning of Bornstein while distinguishing its fact 
pattern, the Ehrlich court held that "if a person knowingly 
causes a specific number of false claims to be filed, he is 
liable for an equal number of forfeitures."  Id. 
¶101 There is no colorable argument, under either the 
statute or the cases, that Pharmacia committed a violation every 
time Medicaid overpaid for a drug.  As noted, that event is not 
No. 
 2010AP232-AC 

59 
 
a statement——by Pharmacia, by FDB, or by anyone else——and it 
therefore fails to satisfy the plain language of the statute.  
Moreover, the payment occurs after the completion of the alleged 
fraud, and so it does not reflect "the specific conduct of the" 
defendant, Bornstein, 423 U.S. at 313, and it consequently does 
not form the basis for a forfeiture award. 
¶102 The jury did not require this exposition of case law 
in order to be able to discount the legal theory presented by 
the State.  Equipped with instructions from the circuit court 
that a violation occurred every time Pharmacia made or caused to 
be made a misrepresentation, the jury was in a position to 
understand that the number of times Medicaid overpaid for 
Pharmacia drugs was not the number of times Pharmacia violated 
the Medicaid fraud statute.  For whatever reason, the jury 
failed to apply that instruction.  Nonetheless, the fact that 
its misunderstanding stemmed from the State's flawed legal 
theory does not operate to transform the appropriate legal 
analysis performed by either the circuit court or this court 
from a mistake of fact inquiry to a mistake of law inquiry.  As 
the jury was accurately informed, it is the court's role to 
instruct the jury on the law, not the attorneys'.  Mullen v. 
Reinig, 72 Wis. 388, 392-93, 39 N.W. 861 (1888).  The circuit 
court was required, and so too are we, to presume that the jury 
followed this instruction and all others.  State v. LaCount, 
2008 WI 59, ¶23, 310 Wis. 2d 85, 750 N.W.2d 780; cf. Ex parte 
Par Pharm., Inc., 58 So. 3d 767, 781 (Ala. 2010) (holding that 
there is "no reason why [a] trial court through careful 
No. 
 2010AP232-AC 

60 
 
management will not be able to avoid or minimize any prejudice 
or confusion that might result" from a jury's attempt to 
understand complex AWP litigation). 
¶103 Thus, once the circuit court properly instructed the 
jury on the law and the jury applied that law to find 1,440,000 
violations, the circuit court had no choice but to review the 
record for evidence supporting that finding.  In so doing, it 
was not required to look at the evidence through the lens of a 
legal theory that it knew was incorrect.  On the contrary, it——
and we——are required to presume the jury obeyed the instructions 
as given, LaCount, 310 Wis. 2d 85, ¶23, and the circuit court 
therefore properly reviewed the evidence in the context of those 
instructions.  Kovalic v. DEC Int'l, Inc., 161 Wis. 2d 863, 873 
n.7, 469 N.W.2d 224 (Ct. App. 1991).  Ultimately, it is of no 
legal consequence that the jury's erroneous factual finding was 
based on an erroneous legal theory, because that theory was 
submitted by a party and thus did not bind the jury.  Mullen, 72 
Wis. at 392-93.  For purposes of ascertaining whether the error 
was factual or legal, the dispositive fact is that the jury was 
properly instructed. 
¶104 Applying the standard for factually erroneous jury 
verdicts, we have no doubt that the circuit court correctly 
vacated the number of violations.  This is so because there was 
simply no evidence to directly or inferentially support the 
proposition that the number of times Medicaid overpaid for drugs 
represented the number of times Pharmacia violated the Medicaid 
fraud statute.  For the reasons set forth above, there is 
No. 
 2010AP232-AC 

61 
 
evidence to support the finding of 1,440,000 violations only if 
one assumes the veracity of the State's legal theory.  Because 
that legal theory is mistaken, there is no evidence to support 
the jury's finding and the circuit court was empowered to vacate 
the finding.   
4. 
The Circuit Court Properly Reduced the Number of Violations 
to 4,578 
¶105 Having determined that the circuit court was required 
to reduce the number of violations, the question remains as to 
whether it reduced the number in the correct amount.  To answer 
that question, we must consider whether the record reveals that 
the number of violations found by the circuit court was "clearly 
wrong."30  Richards, 200 Wis. 2d at 671-72.  We hold that it was 
not, and therefore affirm the circuit court's ruling. 
¶106 Four approaches have been suggested for calculating 
the number of violations.  We have already rejected one——the 


30 The "clearly wrong" language cited in this section, and 
the "any credible evidence" language cited in the section above 
regarding whether the circuit court properly vacated the jury's 
answer are actually different iterations of the same standard.  
That is, "[a] circuit court's decision to change the jury's 
answer is 'clearly wrong' if the jury verdict is supported by 
'any credible evidence.'"  Best Price Plumbing, Inc. v. Erie 
Ins. Exch., 2012 WI 44, ¶30, 340 Wis. 2d 307, __ N.W.2d __ 
(emphasis added) (citation omitted).  Here, because the jury 
determined the original number of violations, while the circuit 
court determined the final number, it makes most sense in the 
context of this case to employ the "any credible evidence" 
language in our analysis of the circuit court's decision to 
vacate the jury's answer, and the "clearly wrong" language in 
our analysis of the circuit court's determination of the actual 
number of violations. 
No. 
 2010AP232-AC 

62 
 
State's theory that Pharmacia committed a violation every time 
Medicaid overpaid for a drug——and declined to address another.31  
The remaining alternatives are: 1) a violation occurred every 
time Pharmacia reported an inflated AWP (i.e., every time it 
transmitted an inflated AWP to FDB which was then conveyed to 
Medicaid), or 2) a violation occurred every time FDB transmitted 
an inflated AWP to Medicaid and Medicaid then relied on it at 
least once in the reimbursement of a pharmacy.  The circuit 
court chose the latter approach, and we agree that it was the 
appropriate one. 
¶107 Beginning with the plain language of the statute, 
Kalal, 271 Wis. 2d 633, ¶49, the circuit court's calculation of 
violations 
is 
consistent 
with 
the 
words 
chosen 
by 
the 
legislature.  Wisconsin Stat. § 49.49(4m)(a)2. provides that 
"[n]o 
person, 
in 
connection 
with 
medical 
assistance, 
may . . . [k]nowingly make or cause to be made any false 
statement or representation of material fact for use in 
determining rights to a benefit or payment."  By including the 
phrase, "cause to be made," the legislature made clear that a 
defendant commits a violation when a third party transgresses 
the statute in a manner that was caused by the defendant.  That 
is precisely what occurred in this case.  Pharmacia reported its 
AWPs to FDB so that FDB would in turn convey them to Medicaid.  


31 The question of whether Pharmacia committed no violations 
is a question that goes to the question of liability; that 
question has not been certified and we therefore do not address 
it. 
No. 
 2010AP232-AC 

63 
 
It therefore knowingly caused those statements to be made, and 
the circuit court properly followed the language of the statute. 
¶108 Case 
law 
bolsters 
our 
statutory 
interpretation.  
Viewing the cases in this area of law as a whole, we draw the 
following lesson.  Where a defendant perpetrates a fraud, the 
completion of which requires a third party to act in furtherance 
of that fraud in a manner reasonably foreseeable to the 
defendant, the calculation of violations should include such 
actions by the third party.  See Menard, 121 Wis. 2d 199; 
Bornstein, 423 U.S. 303; Ehrlich, 643 F.2d 634.  Indeed, it 
would be irrational for a forfeiture award to be based on a 
small number of fraudulent actions by a defendant, when the 
defendant acts with the knowledge and purpose that a third party 
will complete the fraud and hugely amplify the consequences of 
those actions, and when the defendant then benefits greatly from 
the third party's conduct. 
¶109 Applying 
these principles, we conclude that the 
circuit court's calculation of violations properly included the 
number of times FDB transmitted an inflated AWP for a Pharmacia 
product to Medicaid, and Medicaid then relied upon it at least 
once in the reimbursement process.  This is so because 
Pharmacia's purpose in reporting AWPs to FDB was for the 
ultimate use of state Medicaid agencies.  While Pharmacia may 
not have known the precise number of times Medicaid would then 
access the information (because that number was a function of 
Medicaid's arrangement with FDB), it knew that its AWPs would 
only reach Medicaid via FDB.  Furthermore, the fraud that the 
No. 
 2010AP232-AC 

64 
 
jury found Pharmacia liable for committing could not have been 
realized until the inflated AWPs reached Medicaid through FDB; 
for until that happened, the inflated AWPs could not have played 
any role in the calculation of reimbursements, where the injury 
occurred.  Unlike the number of times Medicaid overpaid for 
drugs, which took place after the fraud occurred, FDB's 
transmittal of the inflated AWPs was an integral component of 
the fraud.  We therefore conclude that the number of times FDB 
transmitted to Medicaid an inflated AWP provided by Pharmacia 
and 
used 
at 
least 
once 
by 
the 
state 
in 
the 
Medicaid 
reimbursement process constituted the best measure of how many 
violations occurred.  Accordingly, the circuit court properly 
reduced the jury's calculation of violations to 4,578, and we 
affirm its order. 
V. 
CONCLUSION 
¶110 The court of appeals certified three questions to this 
court: 1) whether the State was entitled to a jury trial; 2) 
whether the damages were based on impermissible speculation by 
the jury; and 3) whether the circuit court properly reduced the 
number of violations.  Because each of these issues was 
correctly resolved in the circuit court, we affirm.  We remand 
the cause to the court of appeals to resolve the remaining 
issues.  See DeChant v. Monarch Life Ins. Co., 200 Wis. 2d 559, 
595 n.2, 547 N.W.2d 592 (1996) (remanding a case to the court of 
appeals to resolve remaining issues after limiting review to 
certified questions). 
No. 
 2010AP232-AC 

65 
 
By the Court.—The orders of the circuit court are affirmed 
and the cause is remanded to the court of appeals. 
¶111 ANN WALSH BRADLEY, N. PATRICK CROOKS, and DAVID T. 
PROSSER, J.J., did not participate.  
 
No. 
 2010AP232-AC 

 
 
