Latest Department of Justice Settlement with Specialty Pharmacies Reflects Ongoing Crackdown on Prior Authorization Fraud and Waiver of Medicare Co-Pays

In its recent settlement with pharmaceutical company kaléo, Inc., the Department of Justice foreshadowed that it also would be pursuing cases against specialty pharmacies that sold and dispensed Evzio, a kaléo drug. Evzio, a naloxone anti-overdose auto-injector, cost over $4000, while Narcan, which was approved for the same purpose, cost only about...
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Appeals Court Affirms All Convictions of Insys Executives

Today, the First Circuit affirmed all of the convictions of the executives of Insys, the manufacturer of a highly-addictive sublingual fentanyl spray that the FDA had approved only to treat breakthrough cancer pain. Congratulations to Assistant United States Attorneys Nat Yeager and David Lazarus for successfully leading perhaps the most important pharma...
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Info tech company Practice Fusion pays $145 million to settle charges it set up electronic records system getting docs to prescribe opioids

 A San Francisco-based health information technology company will pay $145 million to resolve criminal and civil charges that it helped set up an electronic health records system that encouraged physicians to prescribe opioids to patients who might not need them, federal prosecutors in Vermont said Monday. Vermont U.S....
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Framingham Massachusetts Lab pays $26.67 Million to resolve allegations of payment kickbacks for patient referrals and improper billing

Laboratory Boston Heart Diagnostics Corporation (Boston Heart), of Framingham, Massachusetts, has agreed to pay $26.67 million to resolve False Claims Act allegations involving payments for patient referrals in violation of the Anti-Kickback Statute and the Stark Law, as well as claims otherwise improperly billed to federal healthcare programs for laboratory testing, the Department of...
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