The U.S. Attorney’s Office for the Middle District of Pennsylvania recently announced it initiated a lawsuit against family medical doctor Peter J. Baddick, III over allegations of medically unnecessary prescriptions for Subsys, a fentanyl-based spray used for cancer pain.
In the complaint, the federal government alleges Dr. Baddick violated the False Claims Act by routinely prescribing Subsys to patients for whom the drug was either inappropriate or not medically necessary. This resulted in excessive payments from Medicare and TRICARE.
The lawsuit contains detailed allegations that state from April through December 2015 Dr. Baddick prescribed Subsys to two patients, neither of whom had cancer. He continued to write prescriptions for the drug to both patients even after they noted their concerns about its effects. For these prescriptions, the federal healthcare programs paid out a total of $308,701,94.
The spray is manufactured by Insys Therapeutics, Inc., which was already prosecuted under a criminal information suit in Massachusetts and agreed to a global resolution of the civil and criminal investigations against the company. The civil resolution included a $195 settlement with INsys related to False Claims Act violations. It also paid a $2 million fine and $28 million in forfeiture after a subsidiary pleaded guilty to five counts of mail fraud.
There is still a significant way to go in this case before any sort of settlement is reached, and the press release from the government noted that at this point these are allegations only.
For more information about the steps you should take if you become aware of healthcare fraud occurring within your organization, contact an experienced whistleblower lawyer at Kardell Law Group.