Physician blows whistle on Dignity Health hospital system and neurosurgical group in surgeries by inexperienced medical students

An anesthesiologist and member of the medical staff at Dignity Health, d/b/a St. Joseph’s Hospital, brought a False Claims Act qui tam lawsuit against the hospital and Neurosurgical Associates, LTD, in which he alleged a bait-and-switch scheme whereby patients thought they were undergoing invasive and high-risk surgeries performed by highly regarded and experienced neurosurgeons. However, […]

Continue reading…

Marketing firm Publicis sued by Massachusetts AG for fueling opioid epidemic and getting docs to prescribe more OxyContin

 Massachusetts Attorney General Maura Health sued a global marketing company  Publicis for engaging in unfair and deceptive marketing schemes to help Purdue Pharma sell OxyContinm an addictive painkiller. The work included creating sales training materials and emails and other information distributed to prescribers to “humanize” the OxyContin brand, Healey said. The suit says that the […]

Continue reading…

Under Armour pays $9 million to end charges is misled investors about sales growth to meet analysts’ revenue targets

Under Armour will pay $9 million to settle federal regulators’ charges that it misled investors about its sales growth in 2015 and 2016 to meet analysts’ revenue targets. For six consecutive quarters beginning in the third quarter of 2015, the sports apparel company “pulled forward” a total of $408 million in existing product orders that […]

Continue reading…

Pharmaceutical Manufacturer Incyte Becomes Latest To Settle Co-Pay Foundation Kickback Allegations

On May 4, 2021, the Department of Justice announced that Incyte Corporation, a Delaware-based pharmaceutical company, agreed to pay $12.6 million to resolve allegations that it used a foundation, Chronic Disease Fund dba Good Days (“CDF”), to funnel kickbacks to Medicare patients taking its own drug. Incyte sells Jakafi, a drug that, through 2014, was […]

Continue reading…

Bristol-Myers Squibb Pays $75 Million to settle False Claims Act case on underpayment of drug rebates owed through medicaid

Bristol-Myers Squibb (“BMS”) will pay the United States and participating states $75 Million, plus interest, to settle a case alleging it knowingly underpaid rebates owed under the Medicaid Drug Rebate Program. Of that amount, BMS will pay approximately $41 million, plus interest, to the United States, and the remainder to states participating in the settlement. […]

Continue reading…

Court Sentences Pharmacy Owner And Others On Charges That They Paid Kickbacks To Pharmaceutical Sales Rep In Exchange For Prescription Referrals

On April 16, 2021, the Department of Justice announced that a court sentenced six individuals, including a Virginia pharmacy owner and a former sales representative for Kaléo Pharmaceuticals, after they pled guilty to a variety of criminal charges. Mohamed Abdallah, the owner of Medex Health Pharmacy and Royal Care Pharmacy, was sentenced to four years […]

Continue reading…

Compliance Issues with Overcoming “Friction” in the Sale of Expensive Pharmaceutical Products

By Gregg Shapiro The pharmaceutical distribution and reimbursement system in the United States has many inherent “friction points” that discourage unnecessary use of expensive pharmaceutical products. Because having a robust compliance program makes good business sense,[1] compliance professionals in the pharmaceutical industry should understand the dynamics of these friction points and be aware of the […]

Continue reading…

Large visa fraud scheme results in two companies and nine individuals being indicted including charges for harboring or transporting aliens

An indictment was returned by a federal grand jury in the Southern District of Georgia charging two businesses and nine of their officers and managers located across the country for their roles in an alleged conspiracy to defraud the U.S. government and commit various visa fraud and criminal immigration offenses for profit. According to court […]

Continue reading…

Massachusetts Hospital Pays $2.6 Million To Resolve Allegations That It Abused “Modifier 25” Billing Code

On April 20, 2021, the Department of Justice announced that Massachusetts Eye and Ear, a Boston hospital, agreed to pay over $2.6 million to resolve allegations that it improperly used the “Modifier 25” billing code to obtain higher reimbursements from Medicare and Medicaid. Typically, when a Medicare or Medicaid beneficiary visits a physician to have […]

Continue reading…