Pathology laboratory company Inform Diagnostics, formerly known as Miraca Life Sciences Inc., paid $63.5 million to resolve allegations that it paid kickbacks to referring physicians in the form of subsidies for electronic health records systems and free or discounted technology consulting services. In other healthcare settlements, Avanir Pharmaceuticals paid over $95 million to resolve allegations that it paid kickbacks and engaged in false and misleading marketing to induce healthcare providers in long term care facilities to prescribe the drug Neudexta for behaviors commonly associated with dementia patients, which is not an approved use of the drug. Reckitt Benckiser Group paid a total of $1.4 billion to resolve criminal and civil liability related to the marketing of the opioid addiction treatment drug Suboxone, which is a formulation of the opioid buprenorphine.Īs part of the resolution, RB Group paid $500 million to the United States to resolve civil allegations that it directly or through subsidiaries promoted Suboxone to physicians who were writing prescriptions for uses that were unsafe, ineffective, and medically unnecessary promoted Suboxone Film using false and misleading claims that it was less susceptible to diversion, abuse, and accidental pediatric exposure than other buprenorphine products and took steps to delay the entry of generic competition in order to improperly control pricing of Suboxone. The government also alleged that Insys improperly encouraged physicians to prescribe Subsys for patients who did not have cancer, and lied to insurers about patients' diagnoses to ensure payment by federal healthcare programs. The kickbacks allegedly took the form of sham speaker events, jobs for the prescribers' relatives and friends, and lavish meals and entertainment. Insys Therapeutics paid $195 million to settle civil allegations that it paid kickbacks to induce physicians and nurse practitioners to prescribe Subsys for their patients. Seven drug manufacturers – Actelion Pharmaceuticals US, Amgen, Astellas Pharma US, Alexion Pharmaceuticals, Jazz Pharmaceuticals, Lundbeck and US Worldmeds – paid a combined total of over $624 million to resolve claims that they illegally paid patient copays for their own drugs through purportedly independent foundations that the companies in fact treated as mere conduits.Įxcept where indicated, the government's claims in the matters described below are allegations only and there has been no determination of liability. Congress included copay requirements in the Medicare program, in part, to serve as a check on healthcare costs, including the prices that pharmaceutical manufacturers can demand for their drugs, the DOJ said. The department also investigated efforts by drug manufacturers to facilitate increases in drug prices by funding the co-payments of Medicare patients. Two of the largest recoveries involved opioid manufacturers. The government paid out $265 million to the individuals who exposed fraud and false claims by filing these actions. Of the $3 billion in settlements reported for the fiscal year ending September 30, over $2.1 billion arose from lawsuits filed by whistleblowers under the qui tam provisions of the False Claims Act. The amounts included in the $2.6 billion reflect only federal losses, but in many of these cases the department was instrumental in recovering additional millions of dollars for state Medicaid programs. The cases include drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians. Of the more than $3 billion in fraud settlements and judgments the government recovered from civil cases involving fraud and false claims, $2.6 billion involved healthcare, according to the Department of Justice.
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