Kickback deals involving physicians and drugmakers usually involve millions of dollars in fraud. However, a recent federal indictment involved one doctor and only $23,500 in money paid. Still, Feds hope the case will send a message to companies and doctors who are committing False Claims Act violations.
Actonel and Atelvia are osteoporosis treatment drugs made by Warner-Chilcott (now Allergan). According the federal indictment, sales representatives from the drugmaker approached a gynecologist in Massachusetts after determining she was a “high volume prescriber” of the two drugs. They offered her money, lunches and other kickbacks equaling $23,500 in exchange for her agreeing to continue to write a high number of those prescriptions.
Additionally,however, and potentially more egregiously, she agreed to give those sales reps access to patient files when insurance companies refused to approve payment for those drugs. According to court paperwork, Warner-Chilcott was attempting to collect confidential patient data so information could be submitted on prior authorization forms, potentially making the approval process easier.
Dr. Margaret Luthra, the gynecologist in Springfield, Mass., denies all wrongdoing and, according to her lawyer, looks forward to clearing her name at trial.
However, federal officials are confident about the case that came out of a 2011 whistleblower lawsuit filed by two former sales representatives from Warner-Chilcott. In their lawsuit, they claimed the drug company did pay kickbacks to doctors to increase sales figures of those drugs and also illegally marketed the medications. The whistleblower case is still pending.
In a related case that was concluded in mid-2015, a former sales manager from Warner-Chilcott plead guilty to directing his reps to review patient medical charts to obtain information needed to fill out prior authorizations forms. As a result of that fraudulent behavior, the Feds contend insurance companies and Medicare paid out at least $200,000 for prescriptions that were not medically necessary and should never have been approved for payment through regular channels.
When whistleblowers are brave enough to come forward and expose important information that can lead to uncovering fraudulent activity against the government, everyone wins — except the wrongdoers. If you or someone you know has information that may lead to uncovering a crime under the False Claims Act, contact qui tam attorney Ross Begelman for a free consultation today.