Pharmaceutical giant Novartis recently reached a settlement with the Department of Justice, Securities Exchange Commission and U.S. Attorney for the Southern District of New York regarding various claims of criminal wrongdoing. The allegations include claims the group violated the False Claims Act (FCA) and Anti-Kickback Statute (AKS). Essentially, the government claimed the group gave health care providers various incentives in exchange for using and prescribing their products.
New York officials recently charged a local pharmacy owner of Anti-Kickback Statute (AKS) violations and tax crimes. Prosecutors claim the man, along with others associated with the pharmacy, began illegally bribing doctors to use their pharmacy for services in 2010. In addition to cash payments, the government claimed the accused offered expensive meals and lavish gifts to entice doctors and doctors' employees in New Jersey and New York to send prescriptions to their facility.
The giant, nationwide pharmacy Walgreens went through many changes in 2019. The year began with a new partnership with Microsoft to help better ensure the pharmacy was up to date on technological innovations for health care delivery as well as retail innovations. The company also made additional investments in digital health throughout the year.
The government continues to crackdown on allegations of health care fraud. One recent example involves a pharmacist accused of various crimes. According to the complaint, the prosecution has charged the pharmacy owner with two crimes. The first is conspiracy to commit health care fraud and the second conspiracy to pay illegal kickbacks to a physician.
The government has been very clear on its take on the current opioid crisis. It is coming down on medical professionals that do not follow regulations when prescribing these medications and pushing for serious penalties.
Several pharmaceutical companies intentionally misrepresented the degree to which certain drugs and other items were reimbursable under Medicaid, according to the attorney general of another state. The drugs and medical devices were marketed to the state and health care providers as covered outpatient drugs despite being unapproved by the U.S. Food and Drug Administration, the AG alleges, and these fraudulent marketing practices resulted in big gains in market share for the companies.