Qui Tam

FOLLOW THE MONEY: New Database Details Pharma Payments to Doctors

By Nolan and Auerbach

According to a new database compiled and published by ProPublica, a non-profit investigative journalism group, drug companies shelled out more than $250 million to some 17,000 doctors and nurses across the country in 2009 and 2010. While some of these payments may be legitimate, the aggregate amount certainly raises eyebrows, especially since several drug companies have recently admitted to sidestepping the Anti-Kickback Act by disguising bribes as ?consulting fees? or ?speakers? honoraria.?

Applied to the pharmaceutical world, the Anti-Kickback Act, 42 U.S.C. § 1320a-7b(b), makes it illegal for a drug company to bride a doctor to prescribe its drugs. The Anti-Kickback Act is designed to, inter alia, ensure that patient care is not improperly influenced by inappropriate compensation from the pharmaceutical industry.

There are a variety of rules and exceptions that come into play when assessing whether a drug company?s payments to a doctor violates the Anti-Kickback Act. However, at the end of the day, the question boils down to whether the drug company was looking to improperly influence the doctor?s prescribing habits. If the company was looking to bribe its way into the medicine cabinets of Medicare and Medicaid patients, the payments were likely illegal kickbacks, under the federal Anti-Kickback Act.

To encourage insiders to step forward and report these shadowy payments, the US Congress recently clarified, in the federal health care reform legislation, that violations of the federal Ant-Kickback Act are per se violations of the federal False Claims Act. In turn, if a person has detailed information about a drug company bribing doctors to prescribe its drugs, that person might receive a substantial whistleblower reward.

For more information about qui tam law and pharmaceutical fraud, contact Nolan and Auerbach, PA.

Full post as published by Pharma 101 - Pharmaceutical Fraud on December 23, 2010 (boomark / email).