Monday, September 21, 2009

NJ Pharma Company to Pay More Than $24 Million for Payment to Physicians to Research New Program

A New Jersey pharmaceutical company has pleaded guilty to kickback and conspiracy charges and will pay more than $24 million in criminal fines and civil payments.

The company, Biovail Pharmaceuticals, LLC., pleaded guilty to charges of paying thousands of physicians to engage in a program called “PLACE” (Proving Long Acting Through Experience) and to prescribe or recommend the drug Cardizem, L.A. The payments exceeded the reasonable fair market value of the medical prescribers’ time necessary to complete the different phases of the program.

And because the program resulted in prescriptions being paid for by Medicaid, the company has agreed to pay $2.4 million to resolve allegations of false claims submitted to the United States.

The case was investigated by the Federal Bureau of Investigation and the Department of Health and Human Services Office of Inspector General. The case is being handled by Assistant U.S. Attorney Sara Miron Bloom.

Click here to read about Biovail’s $24 million payment to the U.S. government

Thursday, September 17, 2009

North Iowa Hospital Pays $4.5 Million to Settle Improper Use of Medicare Claims

A Waterloo, Iowa, hospital paid $4.5 million to settle a claim that they improperly used Medicare to pay five physicians. They are among the highest paid doctors in the country.

The Covenant Medical Center allegedly paid the doctors above market value which disqualifies them from receiving Medicare dollars.

“It’s the combination of the referrals without being fair-market value and commercially responsible...when there’s improper financial incentives potentially at play there,” said U.S. Attorney Matt Dummermuth

The investigation by the Justice Department and the Department of Health and Human Services began in 2005.

Click here to read the full article “Iowa hospital pays $4.5 million in fraud case"

Wednesday, September 02, 2009

Largest Health Care Fraud Settlement in Justice Department History

The largest health care fraud settlement ever was announced by the U.S. Justice Department today. The settlement, totaling $2.3 billion, is with pharmaceutical company Pfizer and its subsidiary, Pharmacia & Upjohn.  According to the agreement, Pharmacia & Upjohn will plead guilty to charges of fraudulently marketing Bextra, an anti-inflammatory drug, which constitutes a felony violation of the Food, Drug and Cosmetic Act.  Pharmacia & Upjohn will pay a $105 million fine for the infraction, and Pfizer will pay $1.195 billion, the largest criminal fine in U.S. history.  The total criminal liability is $1.3 billion. 

Pfizer will also pay an additional $1 billion to settle allegations that it violated the federal False Claims Act by illegally promoting four drugs (Bextra, Geodon, Zyvox and Lyrica) and causing the submission of false claims to government healthcare programs.  The government also alleged that Pfizer had paid kickbacks to doctors in exchange for prescribing these medications.  The $1 billion represents the largest civil fraud settlement ever against a pharmaceutical company.  The settlement agreement also calls for Pfizer to establish business procedures aimed at preventing recurrence of the conduct alleged.

As part of the resolution, six whistleblowers will receive a total of $102 million from the federal share of the civil recovery.

Click here to read the full article “Justice Department Announces Largest Health Care Fraud Settlement in Its History"

Printer Friendly Page