In the largest settlement involving a pharmaceutical
company, the British drugmaker GlaxoSmithKline agreed to plead guilty to criminal charges and pay $3 billion in fines for
promoting its best-selling antidepressants for unapproved uses and failing to report safety data about a top diabetes drug,
federal prosecutors announced... The agreement also includes civil penalties for improper marketing of a half-dozen other
drugs...
In May, Abbott Laboratories settled for $1.6
billion over its marketing of the antipsychotic drug Depakote. And an agreement with Johnson & Johnson that could result
in a fine of as much as $2 billion is said to be imminent over its off-label promotion of another antipsychotic drug, Risperdal...
...critics argue that even large fines are not
enough to deter drug companies from unlawful behavior. Only when prosecutors single out individual executives for punishment,
they say, will practices begin to change.
The world’s
leading drug maker by sales, Pfizer was accused of bribing doctors, hospital administrators and regulators in several countries
in Europe and Asia to prescribe medicines. Authorities uncovered evidence that company units rewarded high-prescribing doctors
in China with cellphones and tea sets, while plying Croatian physicians who ordered Pfizer drugs with cash and international
trips, according to court filings. The investigators said Pfizer units also sought to hide the bribery by recording the payments
in accounting records as legitimate expenses, such as training, freight and entertainment.
Pfizer, founded in 1849, is the world's largest drug manufacturer, reporting revenue of USD $67.425 billion
in 2011. They are not above playing dirty, however, to achieve their number one position in the industry. They have a long
list of convictions in numerous countries forfraud, with themost recent this week. In the last ten years they have paid almost
$3 billion in fines entered into three corporate integrity agreements with the Department ofHealthand
Human Services aimed at preventing future fraud.
"Illegal conduct and fraud by
pharmaceutical companies puts the public health at risk, corrupts medical decisions by healthcare providers, and costs the
government billions of dollars," said Tony West, an assistant attorney general for the Civil Division.
Johnson & Johnson has agreed to pay as much
as $2.2 billion to resolve an investigation into its marketing of the anti-psychotic drug Risperdal, according to a published
report.
The Wall Street Journal, which reported the settlement,
said the settlement will include a $400 million criminal fine and that the final amount will depend on how many states accept
the settlement...
Read
more here: http://www.thenewstribune.com/2012/07/19/2220558/report-jj-will-pay-22b-in-risperdal.html#storylink=cpy
In 2010 the Justice Department joined a whistleblower
lawsuit alleging that a Johnson & Johnson division paid tens of millions of dollars in illegal kickbacks to a company
that provided prescription drugs to nursing home patients. The lawsuit said Johnson & Johnson made the payments to increase
sales of Risperdal, a drug that is used to treat conditions including symptoms of schizophrenia and bipolar disorder. It is
linked to increased risk of death for elderly people with dementia.
The drug dispensing company, Omnicare Inc. of Kentucky,
agreed to pay $90 million in 2009 to resolve an inquiry into its actions. The government said Johnson & Johnson made illegal
payments to Omnicare between 1999 and 2004, and Omnicare's annual sales of Risperdal nearly tripled to $280 million over that
period.
Read more here: http://www.thenewstribune.com/2012/07/19/2220558/report-jj-will-pay-22b-in-risperdal.html#storylink=cpy
The amount,
just in New York, is estimated by Issa’s committee to be in excess of $15 billion, equivalent to $1.9 million per patient
per year!
The daily rate for a Medicaid beneficiary to reside in a developmental
center grew from $195 per day in 1985 to $4,116 in 2009,vastly outgrowing
theMedicaid daily rate for private
developmental centers.
James Mehmet,
a former chief state investigator of Medicaid fraud and abuse in New York City, believes that at least 10% of Medicaid dollars
are lost on fraudulent claims, while another 20% to 30% consist of abuse, or services that were delivered but that were unnecessary.
Waste, fraud,
and abuse in New York’s Medicaid home-based health services [alone] are rampant. A Department of Health and Human Services
Inspector General’s (IG) audit, for example, estimates that between January 2004 and December 2006, New York City improperly
claimed over $275 million in Medicaid funds for personal care services. A second IG audit found that New York improperly claimed
$207 million for rehabilitative home care services provided between January 2004 and December 2007…
Ninety-one people including doctors,
nurses and other medical professionals were charged criminally after an investigation ofMedicarefraud
that involved $430 million in false billing in seven cities, officials said...It was the government’s second big raid in recent months after
a similar investigation in May involving $452 million in possible fraud in Medicare, the health program for the elderly and
disabled. The accusations include billing the government for unnecessary ambulance rides in California, writingprescriptionsfor
patients in Dallas who did not qualify for them and paying kickbacks like food andcigarettesto
patients in Houston if they attended programs for which a hospital could bill.
Pharmaceutical manufacturer Abbott Laboratories Inc. was sentenced by U.S. District
Court Judge Samuel G. Wilson of the Western District of Virginia in connection with its guilty plea related to its unlawful
promotion of the prescription drug Depakote for uses not approved as safe and effective by the Food and Drug Administration
(FDA) the Justice Department announced today.Abbott, which was ordered
to pay a criminal fine in the amount of $500 million, plus a forfeiture of $198.5 million, and $1.5 million to the Virginia
Medicaid Fraud Control Unit, will also be subject to a five-year term of probation.
Drug companies have long kept secret details of the payments
they make to doctors and other health professionals for promoting their drugs. But 12 companies have begun publicizing the
information, some because of legal settlements. ProPublica pulled their disclosures into a database so patients can search
for their doctor. Accepting payments isn’t necessarily wrong, but it can raise ethical issues
U.S. Health and Human Services Secretary Kathleen Sebelius and
Attorney General Eric Holder notified five medical groups of their intention to ramp up investigative oversight, including
possible criminal prosecutions, by letter on Monday.
The government action follows The Center for Public Integrity’s
“Cracking the Codes” series, published last week. The year-long investigation found that thousands
of medical professionals have steadily billed higher rates for treating seniors on Medicare over the last decade — adding
$11 billion or more to their fees.
The Center’s probe uncovered a broad range of costly billing
errors and abuses that have plagued Medicare for years—from confusion over how to pick proper payment codes to outright
overcharges. The findings indicated that Medicare billing problems are worsening as doctors and hospitals switch to electronic
health records.
A Detroit-area doctor was charged and arrested today in the Eastern District
of Michigan for his alleged leading role in a $40 million Medicare fraud scheme involving physician home visits and home health
services, announced the Department of Justice, the Department of Health and Human Services (HHS), the FBI and the HHS-Office
of Inspector General (OIG). In addition to the arrest, law enforcement agents executed search warrants at three locations
and seizure warrants for three bank accounts related to the scheme.
According to a criminal complaint unsealed today in U.S. District Court
in Detroit, Dr. Hicham Elhorr, 45, masterminded a $40 million scheme involving the submission of fraudulent claims submitted
to Medicare for services that were medically unnecessary and/or never provided through House Calls Physicians (HCP), a physician
home visiting service he owned and operated. Elhorr allegedly submitted claims through HCP for physician home visits
for patients who were never seen and for visits conducted by doctors who were not licensed. The complaint alleges Elhorr
submitted claims to Medicare for physician home visits purportedly rendered when he was out of the country, when beneficiaries
were hospitalized or when the beneficiary was dead.
A congressional
oversight committee on Thursday accused New York of overbilling Medicaid by billions of dollars by inflating reimbursement
payments to its state-run institutions for the mentally disabled. In a scathing report, the Republican-led House Oversight and Government Reform Committee said New
York overcharged taxpayers by $15 billion since 1990. In
2011, New York charged a per-diem rate of $5,118 for residents of the institutions, a network of 11 centers that now house
about 1,300 people with severe developmental disabilities. Over the course of a year, Medicaid spends $1.9 million for every
resident, or $2.5 billion in total—with half coming from the federal government. But the cost of running the institutions
is only a quarter of that amount. The
report said New York took advantage of a complex formula and kept federal officials in the dark for years. It also faulted
the federal agency that oversees Medicaid for waiting years before investigating after becoming aware of the high payments.
Center investigation suggests costs from upcoding
and other abuses likely top $11 billion
Thousands of doctors and other medical professionals
have steadily billed higher rates for treating elderly patients on Medicare over the last decade — adding $11 billion
or more to their fees and signaling a possible rise in medical billing abuse, an investigation by the Center for Public Integrity
has found.
...with pharmaceutical companies continuing to pay record civil
and criminal fines in the U.S. for illegal marketing practices, recent scrutiny of similar practices abroad raises questions
as to whether pharma has simply exported its fraudulent marketing playbook to Europe, Asia, the Middle East and elsewhere.
Those sales and marketing tactics are bad news for patients around
the world, as financial inducements and bribes should not be permitted to corrupt medical treatment decisions...
Pfizer, the world’s largest drugmaker, paid $60.2 million last month
to the U.S. to settle charges that the company bribed government officials – including hospital administrators, government
doctors and members of regulatory and purchasing committees — in China, Russia, Italy, Bulgaria, Croatia, Serbia and
Kazakhstan to approve and prescribe Pfizer..
Many of the bribery charges against Pfizer sound as if they were taken from pharma company sales plans in the
U.S. For instance:
Pfizer sales representatives in Bulgaria gave government doctors
“incentive trips” to Greece in exchange for commitments to prescribe specific quantities of Pfizer pharmaceuticals.
In China, Pfizer China offered to support travel to a conference
in Australia for two doctors if they promised to “use no less than 4,200 injections a year” and to prescribe a
Pfizer product to “more than 80%” of their patients, according to the SEC.
In Russia, Pfizer gave doctors a 5 percent kickback on certain
drugs they prescribed.
.
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