Archive

February 28, 2020

Sanofi-Aventis U.S., LLC has agreed to pay $11.85 million to resolve allegations of paying kickbacks to Medicare patients in connection with a multiple sclerosis drug called Lemtrada.  According to the press release, Lemtrada costs nearly $100,000 per patient per year, and Medicare co-pays can be many thousands of dollars per year.  In order to break down barriers to access for Medicare patients, Sanofi allegedly provided kickbacks to them via payments to a purportedly independent charitable foundation, The Assistance Fund (TAF), which helps covers the co-pays in violation of the Anti-Kickback Statute.  The scheme was reported by a partnership formed by Sanofi's predecessor, Genzyme Corporation, which will receive about $2.7 million for their role in the case.  USAO MA

February 26, 2020

The two owners and operators of Royal Care Pharmacy in Los Angeles have been ordered to pay restitution of $11.8 million to Medicare and $17,000 to Cigna after being found guilty of healthcare fraud and money laundering.  Aleksandr Suri and Maxim Sverdlov were also sentenced to 12 years in prison.  From 2012 to 2015, the two had fraudulently billed Medicare and Cigna for prescription medications that were not purchased or dispensed to beneficiaries, hiding the conspiracy and laundering the proceeds through fake invoices.  DOJ

February 25, 2020

In a global settlement agreement with states and local entities, Mallinckrodt, the largest generic opioid manufacturer in the United States, has agreed to pay at least $1.6 billion in cash to a trust that would help fund treatment for opioid addiction.  Mallinckrodt also agreed to be subject to stringent injunctive terms, including prohibitions on the marketing of its opioid products and safeguards to prevent them from ending up in the wrong hands.  The pharmaceutical company had earlier paid $35 million to the DOJ for other opioid related charges.  CA AG; FL AG; GA AG; VA AG

February 14, 2020

Veterinary drug distribution company Animal Health International Inc. pled guilty to charges that it introduced misbranded drugs into interstate commerce, including by distributing wholesale veterinary drugs to end users and unlicensed individuals.  AHI's parent company, Patterson Companies, Inc., entered into a deferred prosecution agreement with specific compliance program guidelines.  AHI will forfeit $46.8 million, and pay fines totaling $6 million.  USAO WD VA

February 3, 2020

Senthil Kumar Ramamurthy of Texas has been sentenced to 10 years in prison for participating in two fraud schemes that amounted to $9.6 million in losses by Medicare and TRICARE.  In the first scheme, which ran for 10 months in 2014, Ramamurthy and his co-conspirators were paid millions of dollars by compounding pharmacies to get TRICARE beneficiaries to sign up for medically unnecessary compounded prescription drugs.  To get beneficiaries to sign up, defendants had falsely represented that the drugs would be free, when in fact co-payments were required.  In the second scheme, which ran from 2015 onward, Ramamurthy and his co-conspirators paid doctors to refer Medicare beneficiaries—without first examining them—for needless genetic cancer screening tests.  Many of Ramamurthy's co-conspirators have plead guilty and face sentencing later this month.  USAO SDFL

January 30, 2020

Johnson & Johnson has been ordered to pay $344 million to the State of California for misrepresenting the safety of its pelvic mesh implants, which were sold from 2008 to 2014 and have resulted in over 35,000 personal injury lawsuits nationwide.  The State of California brought suit in 2016 after finding the company failed to inform patients and their doctors of possible severe complications, including chronic pain and permanent dysfunctional elimination.  Johnson and Johnson previously settled similar allegations with some 40 other states, for $117 million, in October of last year.  CA AG

January 27, 2020

Practice Fusion, Inc., a provider of electronic health records systems, will pay $145 million to resolve criminal and civil charges that it accepted unlawful kickbacks from pharmaceutical companies and misrepresented the capabilities of its EHR software.  As part of the settlement, the defendant entered into a deferred prosecution agreement, paying $26 million in criminal fines and forfeitures, agreeing to compliance policies and monitoring, and admitting that it accepted payment from an unnamed opioid manufacturer in exchange for including "clinical decision support" alerts within its EHR system that were designed to increase prescriptions for the pharma company's drugs.  The civil settlement – $119 million for the federal government and up to an additional $5.2 million for states that choose to opt in – resolves the kickback allegations related to the opioid manufacturer and 13 other such arrangements, as well as allegations that Practice Fusion knowingly misrepresented the capabilities of its EHR system in order to secure federal certification for the software and secure eligibility for federal incentive payments for providers adopting its software.  DOJ; USAO VT

January 21, 2020

Patient Services, Inc., a foundation that operated pharmaceutical patient assistance programs, will pay $3 million to resolve claims that it unlawfully enabled pharmaceutical companies to pay kickbacks to Medicare patients in the form of co-payment assistance for patients who took the companies’ drugs.  PSI was alleged to have worked with the drugmakers to funnel their “contributions” to patients who took the company’s drugs, instead of using the contributions for purposes not tied to specific drugs and patients.  PSI was alleged to have worked with Insys on copayment assistance for Subsys patients; with Aegerion on copayment assistance for Juxtapid patients; and, with Alexion on copayment assistance for Soliris patients.  USAO Mass

December 20, 2019

Florida residents and married couple Rodolfo Pichardo and Marta Pichardo were sentenced to 15 years and 8 years, respectively, following earlier guilty pleas to healthcare fraud and wire fraud.  Defendants were also ordered to pay over $34 million in restitution. The Pichardos ran a network of home health agencies, pharmacies, and therapy staffing companies, that submitted more than $38 million in false claims to Medicare.  Defendants paid kickbacks to patient recruiters and medical clinics for patient referrals.  USAO SD FL

December 20, 2019

Andrew Hillman has been sentenced to 5.5 years in prison for his role in a kickback scheme designed to induce doctors to steer patients with good private insurance coverage to Dallas hospital the Forest Park Medical Center.  USAO ND Tex; USAO ND Tex (re: April, 2019 trial)