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Drug and DME Pricing

This archive displays posts tagged as relevant to drug and durable medical equipment pricing. You may also be interested in our pages:

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August 3, 2015

Rouzbeh Javaherian, owner of Los Angeles-based Westaid Pharmacy and Medical Supply, was sentenced to 18 months in prison and to pay $644,060 in restitution for his role in a fraud scheme involving the Medicare Part D prescription drug program.  Specifically, Javaherian paid illegal cash kickbacks to Medicare beneficiaries to induce them to submit their prescriptions to Westaid.  Javaherian then filled some of those prescriptions, but also submitted false claims to Medicare Part D plan sponsors for prescriptions that he did not actually fill.  DOJ

December 3, 2014

Rite Aid Corporation agreed to pay $3M to resolve allegations it violated the False Claims Act by offering illegal inducements to Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies. The government alleged that from 2008 to 2010, Rite Aid had improperly influenced the decisions of Medicare and Medicaid beneficiaries to transfer their prescriptions to Rite Aid pharmacies by offering them gift cards in exchange for their business. The charges originated in a whistleblower complaint filed by Jack Chin under the qui tam provisions of the False Claims Act. Chin will receive a whistleblower award of approximately $500,000. DOJ

December 2, 2013

Caremark agreed to pay $4.25M to settle allegations that it knowingly failed to reimburse Medicaid for prescription drug costs paid on behalf of Medicaid beneficiaries, who also were eligible for drug benefits under Caremark-administered private health plans. The allegations were first raised in a qui tam lawsuit filed under the whistleblower provisions of the False Claims Act. DOJ

DOJ Catch Of The Week -- Nashville Pharmacy Services

Posted  01/8/16
By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Nashville Pharmacy Services, LLC, and its majority owner Kevin Hartman.  On Tuesday, Mr. Hartman and his Nashville-based pharmacy that specializes in dispensing HIV and AIDS-related medications agreed to pay up to $7.8 million to settle charges they overbilled Medicare and TennCare for pharmacy services.  Click here...

State Fraud Enforcement Spotlight -- Astrazeneca and Cephalon

Posted  11/6/15
By the C|C Whistleblower Lawyer Team On Wednesday, New York State Attorney General Eric T. Schneiderman announced that AstraZeneca LP and Cephalon, Inc. agreed to pay $54 million to settle government charges they overcharged state Medicaid programs for their pharmaceutical products.  AstraZeneca will pay $46.5 million and Cephalon, the wholly-owned subsidiary of Teva Pharmaceutical Industries. Ltd., will pay $7.5...

November 4, 2015

The federal government, District of Columbia, and 48 states, settled claims against AstraZeneca LP and Cephalon, Inc., for a total of $54 million. The settlement resolves allegations that AstraZeneca and Cephalon under-paid drug rebates owed to the states. Under the federal law known as the Medicaid Drug Rebate Program, drug manufacturers must periodically return a portion of the amount paid by state Medicaid programs for the manufacturers’ drugs. The rebate program is designed to ensure that states pay competitive prices for drugs, and is calculated based on a percentage of the average price drug wholesalers pay for the manufacturers’ drugs. This average price, which the manufacturer reports to the federal government, is known as the Average Manufacturer’s Price or “AMP.” The greater the AMP reported by the manufacturer, the greater the rebate the manufacturer must pay. NY; MA; NH

Can Data Bring Reason to Drug Pricing?

Posted  07/24/15
As far as purveyors of all things pharmaceutical go, Walter White isn’t looking so bad these days.  Well, at least his prices were competitive.  With major pharmaceutical companies putting astronomical and ever-increasing price tags on frequently life-saving medications, patients and insurers, including state and federal government payers, are finding themselves looking for new options and opportunities to...

October 16, 2014

Texas Attorney General Greg Abbott entered into a settlement with generic drug maker Ranbaxy Pharmaceuticals, Inc., Ranbaxy Laboratories, Inc., Ranbaxy USA, Inc. and Ranbaxy, Inc. to resolve allegations they violated the Texas Medicaid Fraud Prevention Act by fraudulently reporting inflated drug prices to the Medicaid program. Under the settlement, Ranbaxy must pay the State of Texas about $18M. TXAG

July 28, 2014

Vascular Solutions Inc (VSI), a Minneapolis-based medical device maker, agreed to pay $520,000 to resolve allegations that it violated the False Claims Act by marketing a product for sealing veins without FDA approval.  Specifically, the government charged that VSI marketed and sold its "Vari-Lase Short Kit" for treating perforator veins (which run deep in the leg muscle) even though the FDA approved the device only for treating surface (or superficial) veins.  DeSalle Bui, a former sales representative of VSI, will receive a whistleblower award in an undisclosed amount.  DOJ
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