Patient Services, Inc. or PSI was pressed to take responsibility for influencing Medicare beneficiaries to use their medical products through corruption. The company has suffered a blow after it agreed to settle a 3-million dollar allegation of corruption involving pharmaceutical companies and special purpose vehicles created to operate the scheme. The office of the U. The attorney general announced a milestone making PSI the fourth firm in the conspiracy scheme to be fined. Previously, PSI’s alleged partners were charged and fine. The total amount the state has received now amounts to 850 million dollars regarding this matter. PSI was fines according to its current ability to pay the fine.
What does this case have in common with others that have come before it involving similar claims? The conspiracy to entice healthcare beneficiaries to buy the medications that put the companies at an advantage individually has been identified as the common denominator, although the companies used different tactics. More so, payment of kickbacks is an offense they both committed alongside fraud. The other implicated companies include Alexion that was charged for paying bribes to patients. It was accused of approaching PSI to broker a deal by creating a special fund that would benefit Medicare patient beneficiaries using Soliris, a drug sold by Alexion in co-pay arrangements to patients as a prescription drug. The foundation was aided by PSI to conduct corrupt deals.
It was further revealed that PSI was responsible for creating another fund in partnership with a pharmaceutical firm, Insys Therapeutics, in 2013. The fund created by PSI was targeting co-payments made by medicare for patients prescribed to use Subsys opioids. The drug was manufactured and sold by Insys to cancer patients. However, Insys was the sole donor of the foundation, and PSI oversaw the money illegally used to give incentives to patients to acquire the drug exclusively. They were not given alternative treatment, although they were available. More disturbing details revealed the drug was given even to patients who were not suffering from cancer. The idea was to market the medicine and fraudulently obtain payment from healthcare program beneficiaries.
Another compelling evidence was from a firm that was earlier fined in connection to this case by Aegerion. They requested a fund created by PSI, also targeting Medicare beneficiaries in co-payments. They sold the drug at excessively high prices and required the patients to use it as the only drug. Since the insurance program made the payments, the patients had no option even when the prices were high but to purchase them. Further, it was claimed the company alleged the donations onto the fund would help patients to access a drug it sold exclusively at subsidized prices. It was, therefore, an incentive to the patients. The foundation was used to pay inducements and unauthorized co-payments for the Medicare beneficiaries with PSI facilitating these transactions. It was clear, PSI played a crucial role in planning and running the purported charitable organizations to promote crime. During the period this scheme was operating, many patients were subjected to medications they were not medically required to take.
All these plans were executed purporting to channel the drug co-payments to the right beneficiaries but were a fraudulent scheme. Receiving and paying bribes and kickbacks is a serious offense. More so, the department of justice condemned the kickback tendency by foundations in the healthcare sector that are used by companies as a conduit of bribes while defrauding federal healthcare programs. The department offered a commitment to end this criminal behavior in conjunction with the FBI by ensuring patients do not receive unjustified medical treatment or induced to use fraudulent schemes.
There was a prohibition to third parties participating in co-payments programs either directly or directly. More so, any material gains or monetary incentive to the patients to purchase drugs or seeks services of a specific firm are burned. Kickbacks or bribery acts are a serious crime, according to the law. However, these provisions were not observed, exposing PSI’s role in aiding the purportedly charitable organizations to integrity failure. Consequently, the settlement agreed upon could leave a permanent dent on the image and operations of the giant drug maker.
Commenting on the same issue, an FBI representative noted the schemes of this nature erode public confidence. The companies involved in fraudulent schemes could see a significant reduction in their bottom-line as a result of such public opinion on their operations. He also warned the pharmaceutical companies and nonprofit organizations’ failure to observe the law, and involving themselves in criminal activities is a disgrace to the healthcare system. The settlement announcement has served as a demonstration of commitment to delivering justice to not only the patients but also the healthcare programs and the system as a whole. The team insisted that the foundations working to assist patients must be operated with integrity and follow the rule of law. As such, operating independently from the donor would be a viable way of ensuring the donor interests are not put first, but those of the beneficiaries precedes everything else.
PSI contravened the anti-kickback statute by allowing its operations to act as corruption conduits. This matter involves qui tam prosecution where a whistleblower aided the government in stopping this type of crime. As a civil matter, PSI consented to the allegations, and although the actual liability was not established, the company will pay at least 3 million dollars. Individuals can also be prosecuted for criminal liability for corruption allegations. The legal consequences include expulsion form service delivery, jail term, fines, and forfeiture of property. However, corporations and individuals may be sued under this provision when they are not guilty. If such an event occurs, the accused must get together a reliable defense team to fight for their justice in courts. Healthcare Fraud Group is an excellent team of defense lawyers that have been working with clients wrongly accused of healthcare fraud charges. Anyone looking to maintain their innocence in court and are facing similar charges should take a step of contacting our criminal defense attorneys at 888-402-4054 to speak to a legal expert in healthcare fraud.