Medicare Compliance & Reimbursement

Pharmaceuticals:

PHARMA ENFORCEMENT REACHES A BOIL

Published on Thu Jun 12, 2003

Drug Giant Targeted In Criminal Probe

The aggressive health care fraud enforcement team at the U.S. attorney's office in Boston has chosen its next target.

U.S. Attorney Michael Sullivan's office on May 29 alerted Kenilworth, NJ-based Schering-Plough Corp. that it is the target of a criminal investigation focusing on some of the most high-profile pharmaceutical compliance hot buttons around. According to Schering-Plough, the target letter - a document that typically means the Department of Justice believes it has substantial evidence to support a criminal indictment - zeroes in on four key areas:

paying kickbacks, in the form of drug samples and grants among other things, as inducements to prescribe or purchase Schering-Plough products;

so-called off-label marketing, i.e., the promotion of products for non-Food and Drug Administration-approved indications;

violating Medicaid rebate requirements; and

destroying documents and obstructing the feds' investigation.

Lesson Learned: Deep-pocketed pharmaceutical companies appear to be the next big target for health care fraud fighters - and their business partners, including physicians, are likely to get caught in the crossfire.

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