Posts Tagged ‘Medicaid’

Kickbackers’ motto: ‘Do no harm’ (to profits)—How drug company used kickbacks to get patients on psych drugs

Tuesday, January 26th, 2010

Boston Globe
By Donald A. MacGillis
January 26, 2010

TALK ABOUT death panels. The US attorney in Boston recently filed suit against the world’s largest maker of health products, Johnson & Johnson, for using kickbacks to get more nursing home patients onto its drugs, including one that was later found to be so lethal to the elderly it had to carry a black-box warning. The government’s complaint leaves little doubt that the drug company acted in a predatory way to increase sales and market share for its products, especially Risperdal, an antipsychotic often used to keep Alzheimer’s and dementia patients under control.

Risperdal is used principally for the treatment of schizophrenia and bipolar disorder. Doping the elderly into placidity is an off-label use of the drug, one that the Food and Drug Administration finally cautioned against in 2005. The reason for the black box warning the FDA required? Too many of the elderly who got the drug were dying.

There is one other reason to thank the federal government for going after the suspect payments Johnson & Johnson made to the middleman to juice up sales of its drugs: Since Medicaid covers most of the nursing home patients, the taxpayer ends up paying much of the bill.

The middleman between Johnson & Johnson and the nursing homes is Omnicare, the country’s largest pharmacy for nursing homes. Last November, it agreed, without “any finding of wrongdoing’’ or “any admission of liability,’’ to a $98 million settlement with the government for its role in helping Johnson & Johnson boost sales to nursing homes. The government says that between 1999 and 2004 Omnicare received tens of millions of dollars in the form of escalating rebates based on greater market share for Johnson & Johnson drugs and in payments ostensibly made by Johnson & Johnson for “data’’ from Omnicare, much of which Omnicare never provided. Other kickbacks, the government says, came in the form of “grants’’ and “educational funding.’’

Read entire article:  http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2010/01/26/kickbackers_motto_do_no_harm_to_profits/

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Senator says Miami psychiatrist who wrote 284,908 drug prescriptions “should be a poster boy” for tougher laws

Monday, January 18th, 2010

Miami Herald
By John Dorschner
January 16, 2010

A Miami psychiatrist who wrote 284,908 prescriptions over the past six years has cost Florida taxpayers $43 million, and a state senator said Friday that “he should be a poster boy” for a legislative inquiry into whether “tougher enforcement provisions are needed.”

The practices of Fernando Mendez-Villamil, who has an office on Coral Way, came to light last month when Sen. Charles Grassley, R-Iowa, complained about him to federal authorities for writing prescriptions at a rate of 150 a day, seven days a week. Grassley, like many in Congress, is concerned about reducing America’s high healthcare costs to reform the system.

The Florida Agency for Health Care Administration has released data showing that those prescription-writing practices were expensive, too — since the patients had Medicaid, the state-federal insurance for the poor.

State Sen. Don Gaetz, R-Destin, chairman of the Senate healthcare committee, told The Miami Herald on Friday that the Legislature has “a tough law already on the books” that requires state regulators to investigate outliers like Mendez-Villamil, who writes twice as many anti-psychotic drugs as any other doctor in the state. But his case may mean the law needs to be tougher.

Read entire article:  http://www.miamiherald.com/business/v-fullstory/story/1428212.html

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Miami psychiatrist prescribed about 4,000 prescriptions per month for 5 years costing taxpayers $43 million

Friday, January 15th, 2010

Health News Florida
By Carol Gentry
January 15, 2010

Since 2004, a Miami psychiatrist has prescribed almost 14 million pills to Medicaid patients at a cost to taxpayers of $43 million, a state agency says.

Fernando Mendez-Villamil would have had to issue 4,000 prescriptions a month, or 1,000 a week, to keep up that pace, according to the report released this week by the Agency for Health Care Administration. Altogether in the six years from 2004-09, he issued nearly 285,000 prescriptions, the AHCA report showed.

However, AHCA noted that that total counts a refill as a prescription. The agency said its report does not conclude that Mendez-Villamil’s prescribing is improper; its investigation continues.

Mendez-Villamil’s status as the most prolific prescriber in the state was already known, based on a report released in December of a 21-month period in  2007-09. But that period was mild compared to the years before, the new data show, and a timeline suggests that the prescribing slowed down markedly after the state began implementing computer tracking and other controls.

His highest-prescribing year in the period studied was 2004, when he issued about 62,400 prescriptions that cost Medicaid $12.2 million, according to the chart. The number of patients: that year: 2,695. A quick calculation shows that he issued 23 prescriptions (or refills) per patient, for a total of more than 1,200 pills apiece.

Sen. Don Gaetz, chairman of the health regulation committee, said Mendez-Villamil “appears to be taking advantage of the taxpayers of Florida and draining money away from legitimate patients. He should be the poster boy for tougher enforcement actions.”

Read entire article:  http://www.healthnewsflorida.org/index.cfm/go/public.articleView/article/15742

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Advocates want new rules to protect abuse of nursing home patients with antipsychotic drugs

Wednesday, December 23rd, 2009

Tracy Staton
Fierce Pharma
December 22, 2009

Illinois advocacy groups are calling for an overhaul of antipsychotic drug use in nursing home residents. They want Gov. Pat Quinn’s nursing home task force to recommend tough new rules for the use of those drugs, including restrictions on doctors who prescribe them.

Apparently, that task force plans to take up the issue by targeting the misuse of psychotropic drugs in the homes. ”We want people to be safe and cared for in nursing homes, not threatened or unwillingly sedated,” task force chairman Michael Gelder told the Chicago Tribune. But some of the changes advocates want would require legislative action.

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Tighter rules sought against using anti-psychotic drugs to chemically restrain the frail & elderly

Sunday, December 20th, 2009

Sam Roe and Christina Jewett
Chicago Tribune
December 20, 2009

Health advocates are calling for tough new rules on the use of anti-psychotic drugs in Illinois nursing homes, including tighter controls on doctors who prescribe the powerful medications.

“Medical care should help you get better, not get worse,” said Wendy Meltzer of Illinois Citizens for Better Care, an advocacy group for nursing home residents.

A Tribune investigation recently showed how many frail and vulnerable Illinois nursing home residents have been unnecessarily dosed with anti-psychotics, leading to harm and an increased risk of death. One psychiatrist, the Tribune found in a joint investigation with ProPublica, provided assembly-line care to thousands of mentally ill patients.

The advocates want Gov. Pat Quinn’s Nursing Home Safety Task Force to address these problems. While the task force has focused on violent felons housed in nursing facilities, chairman Michael Gelder said the group will also target the misuse of psychotropic drugs.

Read entire article: http://www.chicagotribune.com/health/chi-psychotropics-reformdec20,0,3977364.story

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Breaking News: Florida Psychiatrist who wrote 153 psych drug prescriptions per day is now under federal investigation

Thursday, December 17th, 2009

Kelli Kennedy
Miami Herald
December 17, 2009

Medicare has stopped reimbursing a Miami doctor who prescribed about 96,685 mental health drugs to Medicaid patients in 18 months.

According to state records, Dr. Fernando Mendez Villamil wrote an average of 153 prescriptions to adults and children every day between 2007 and 2009. That figure is nearly twice the number of the second highest prescriber on the list, who wrote 53,018 prescriptions over the same time period.

Read entire article: http://www.miamiherald.com/news/florida/AP/story/1387071.html

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Psychiatrist comes under fire from Senator Grassley for writing 96,685 psych drug prescriptions – about 153 per day

Wednesday, December 16th, 2009

John Dorschner
Miami Herald
December 16, 2009

U.S. Sen. Charles Grassley, R-Iowa, has written a biting letter to top government officials using the example of a Miami psychiatrist who writes more than 100 prescriptions a day to raise questions about what federal officials are doing to monitor over-utilization of healthcare services.

The letter does not mention Fernando Mendez-Villamil by name, but it cites documents from the Florida Agency for Healthcare Administration about a prescriber who wrote 96,685 prescriptions from the last quarter of 2007 through the first quarter of 2009 for Medicaid patients.

AHCA records independently obtained by The Miami Herald indicate that is Mendez-Villamil, who wrote nearly twice as many prescriptions for mental health drugs as the No. 2 Medicaid prescriber in the state.

“ I note with alarm that the top Medicaid prescriber during that time wrote 96,685 prescriptions for mental health drugs,“ Grasley wrote. “That means that this physician wrote approximately 153 prescriptions each and every day, assuming he did not take vacations.”

Read entire article: http://www.miamiherald.com/business/breaking-news/story/1384786.html

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Eli Lilly to pay $24 million in Utah Attorney General’s Zyprexa lawsuit/AG says “we want their bad conduct to stop”

Thursday, November 12th, 2009

Geoff Leisik
Deseret News
November 11, 2009

Pharmaceutical giant Eli Lilly and Co. has agreed to pay $24 million to settle a lawsuit filed by the Utah Attorney General’s Office.

Attorney General Mark Shurtleff sued the company after a nearly four-year investigation revealed that Lilly concealed its knowledge of significant weight gain and obesity associated with the anti-psychotic medication Zyprexa. Investigators also showed that Lilly’s sales representatives illegally promoted the drug for uses not approved by the U.S. Food and Drug Administration.

“We’re not just asking them for money. We want their bad conduct to stop,” Shurtleff said Wednesday while announcing the settlement.

“As part of the settlement agreement, there are corporate integrity responsibilities and remedial provisions that will continue to be monitored by the court to stop (Lilly’s) harmful behavior.”

Zyprexa is approved for the treatment of schizophrenia and certain types of bipolar disorder in adults. But authorities say that in 1999, Lilly’s marketing arm that focuses on doctors who treat the elderly began encouraging physicians to prescribe the drug for dementia, Alzheimer’s disease, agitation, aggression, hostility, depression and generalized sleep disorder without prior FDA approval. Lilly also trained its sales teams to avoid discussions with health-care professionals about the weight gain side effect, investigators said.

Read entire article: http://www.deseretnews.com/article/705343716/Firm-to-pay-Utah-24M-in-settlement.html

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Eli Lilly’ s confidential settlement with seven states over its antipsychotic drug Zyprexa

Thursday, September 24th, 2009

Bob Van Voris, Margaret Cronin Fisk and Jef Feeley
Bloomberg.com
September 21, 2009

Eli Lilly & Co. agreed to settle, on confidential terms, lawsuits filed by seven states alleging the company improperly marketed its antipsychotic drug Zyprexa, a court-appointed official said.

“All of the states have essentially settled for the same” non-monetary arrangements, said Michael Rozen, special master appointed by the court to help settlement negotiations. The money terms, which weren’t disclosed, “have fallen roughly in line,” he said at a hearing today in federal court in Brooklyn, New York.

Lawyers told U.S. District Judge Jack B. Weinstein, who is overseeing the cases, that finishing the settlements may be delayed while the parties determine how much money the U.S. government plans to claim in compensation for federal dollars spent on Zyprexa through state Medicaid programs.

If completed and approved in court, the settlements would leave four suits filed by states pending against Lilly.

Read entire article: http://www.bloomberg.com/apps/news?pid=20601103&sid=aUgLzDmvzVK0

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Pfizer pays $300 million to resolve allegations of off-label marketing of its antipsychotic drug Geodon

Wednesday, September 2nd, 2009

PRNewswire
September 2, 2009

PHILADELPHIA — Pfizer, Inc. announced today it has agreed to plead guilty to criminal conduct and to pay more than $2 billion in criminal and civil fines, penalties and damages to settle allegations made in multiple whistleblower lawsuits that the pharmaceutical giant defrauded Medicare, Medicaid and other government-funded health care programs in connection with its market practices for four of its drugs. The settlement is the largest qui tam settlement in U.S. history.

Brian Kenney and Tavy Deming of Kenney Egan McCafferty & Young represented the Geodon whistleblowers and served as co-counsel to the Zyvox whistleblower.

As part of the record settlement, Pfizer agreed to pay $300 million to resolve allegations that it engaged in off-label marketing of its blockbuster atypical antipsychotic Geodon, which generated over $1 billion dollars in sales in 2008. The allegations were first made in a qui tam lawsuit filed by Kenney and Deming on behalf of Harrisburg psychiatrist, Dr. Stefan Kruszewski. Pfizer also agreed to pay $100 million to resolve allegations that it improperly marketed its antibiotic Zyvox. That case was filed by Ronald Rainero, a former Pfizer sales manager from New Jersey.

Read entire article: http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=104&STORY=/www/story/09-02-2009/0005087128&EDATE

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