Daily Archives: July 18, 2008

OREGON receives $3M from Bristol-Meyers Squibb settlement


Portland Business Journal

The Oregon Department of Justice Medicaid Fraud Control Unit has finalized a settlement with Bristol-Meyers Squibb and its former wholly owned subsidiary, Apothecon Inc., resolving allegations of illegal pharmaceutical marketing and pricing.

Oregon was joined by 43 states, the District of Columbia and the federal government.

As a result of the settlement, New York-based Bristol-Meyers Squibb paid $389 million in Medicaid restitution, penalties and interest, which was allocated based on states’ payments for the products at issue. Oregon received more than $3 million for its Medicaid program.

“This case is part of a continuing effort by DOJ to pursue fraud in the pricing of pharmaceutical products purchased by the Oregon Medicaid Program,” Oregon Attorney General Hardy Myers said. “Over the last five years, our Medicaid Fraud unit has returned more than $12 million in damages, penalties and interest to Oregon’s Medicaid program.”

The settlement addresses allegations that Bristol-Meyers Squibb engaged in a number of improper marketing and pricing practices for pharmaceutical products that impacted the Oregon Medicaid Program, including:

Reporting inflated prices for various prescription drugs knowing that Medicaid and various federal health care programs would use those numbers to pay for Bristol-Meyers Squibb and Apothecon products used by their recipients;

Illegally compensating physicians, health care providers and pharmacies to induce them to purchase Bristol-Meyers Squibb and Apothecon products for Medicaid patients;
Promoting the sale of Abilify, an antipsychotic drug, for pediatric use and for treatment of dementia-related psychosis, uses for the product that are not approved by the Food and Drug Administration; and

Misreporting sales prices for Serzone, an antidepressant, resulting in the underpayment of rebates owed under the Federal Medicaid Drug Rebate Program.

The settlement reimburses the federal government and participating states for excessive amounts their Medicaid programs paid for Bristol-Meyers Squibb products as a result of the alleged illegal conduct.

As part of the settlement, Bristol-Meyers Squibb entered into a Corporate Integrity Agreement with the Office of the Inspector General of the U.S. Department of Health and Human Services, which requires Bristol-Meyers Squibb to accurately report its average sales prices and average manufacturer prices, governing Medicaid and Medicare reimbursement for its products in the future.

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INDIANA receives $2.2M for overcharges to Medicaid

WANE

Indiana Attorney General Steve Carter says Indiana has received $2.2 million as part of a $500 million national settlement with drug maker Bristol-Myers Squibb (BMS).

The settlement announced last September resolved allegations that the company and its wholly-owned subsidiary, Apothecon, Inc. provided false pricing information for more than 20 drugs leading to excessive reimbursement. It also resolved a number of other claims including off-label marketing and kick-back violations.

Indiana’s total recovery amount was $5.8 million in the settlement. The $2.2 million represents the state’s share of the Medicaid loss with the remainder going to the federal government for its share.

“Taxpayers are ultimately harmed when companies take advantage of governmental services to help the underprivileged,” said Carter. “The recovery of $5 million for Indiana is significant and is one of several such recoveries over the past several years.”

BMS and its subsidiary Apothecon, Inc. were alleged to have engaged in various activities between 1994 and 2004 resulting in overpayments by Medicare and Medicaid Programs.

Some of the claims included:

Payments to physicians in the form of extravagant travel expenses and fees for advisory board service, preceptorships and consulting, all to induce them to purchase drugs;

Payments to retail pharmacies and wholesaler customers in the form of stocking allowances, prebates, and free goods, all to induce them to purchase drugs;

Off-label promotion of Abilify, an atypical antipsychotic drug, to treat pediatric patients and to treat geriatric patients for dementia-related psychosis;

Reporting falsely inflated average wholesale prices, thereby creating a “spread” between the reimbursement rates for federal health care providers and the actual prices for drugs; and

Misreporting its best price for the anti-depression drug, Serzone.

The settlement includes a Corporate Integrity Agreement with the federal government, which requires BMS to report accurate average sales prices and average manufacturer prices for its drugs covered by Medicare and other health care programs.

Carter’s Medicaid Fraud Control Unit (MFCU) handled the settlement agreement. The Unit has recovered more than $17 million for the state in the first seven months of 2008 – exceeding the record $14 million it recovered for the Medicaid program last year.

The agreement includes 43 states, the District of Columbia and the federal government.

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SOUTH DAKOTA wins $700,000 from pharmaceutical company

ARGUS LEADER

The state of South Dakota will receive more than $700,000 in a settlement to be paid by a pharmaceutical company.

South Dakota is one of 43 states and the federal government who will receive part of the settlement from Bristol-Myers Squibb Co. to resolve allegations of illegal drug marketing and pricing of prescription medications by the states’ Medicaid programs.

The settlement addresses allegations that Bristol-Myers Squibb engaged in a number of improper marketing and pricing practices, including reporting inflated prices for prescription drugs and illegally paying health care providers to induce them to purchase their products, among other allegations.

The settlement reimburses the federal government and the participating states for excessive amounts paid by Medicaid programs as a result of this conduct.

The South Dakota Medicaid Fraud Control Unit and the South Dakota Department of Social Services assisted in recovering the settlement money.

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Maryland Attorney General: Maryland and 42 Other States Reach Multi-Million Dollar Settlement with Bristol Myers Squibb to Resolve Medicaid Pharmaceutical Pricing and Marketing Allegations


Insurancenewsnet.com

Maryland Attorney General: Maryland and 42 Other States Reach Multi-Million Dollar Settlement with Bristol Myers Squibb to Resolve Medicaid Pharmaceutical Pricing and Marketing Allegations

BALTIMORE, MD — Attorney General Douglas F. Gansler today announced that 43 states, the District of Columbia and the federal government have settled with Bristol-Meyers Squibb Company (BMS) and its former wholly owned subsidiary Apothecon, Inc., to resolve allegations of illegal drug marketing and pricing of prescription medications. The total amount of the settlement that is to be distributed to the participating states is $389 million plus interest. The federal portion of the settlement was concluded last fall. Maryland’s Medicaid program will receive $2,358,532 of the settlement amount.

The settlement addresses allegations that BMS engaged in a number of improper marketing and pricing practices, including:

* Reporting inflated prices for various prescription drugs knowing that Medicaid and various federal health care programs would use these reported prices to pay for BMS and Apothecon products used by their recipients;

* Illegally paying physicians, health care providers, and pharmacies to induce them to purchase BMS and Apothecon products;

* Promoting the sale and use of Abilify, an antipsychotic drug, for pediatric use and for treatment of dementia-related psychosis, uses which the federal Food and Drug Administration has not approved; and,

* Misreporting sales prices for Serzone, an antidepressant, resulting in the improper reduction of the amount of rebates paid to the state Medicaid programs.

The settlement reimburses the federal government and the participating states for excessive amounts paid by Medicaid programs as a result of this conduct. As part of the settlement, BMS has also entered into a Corporate Integrity Agreement with the Office of the Inspector General of the US Department of Health and Human Services, under which BMS will be required to report accurately its average sales prices and average manufacturers prices in the future.

A team from the National Association of Medicaid Fraud Control Units participated in the investigation and represented the states’ interests in the settlement negotiations.

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Drug company paying NEW HAMPSHIRE $1.2 million

Associated Press

CONCORD, N.H. (AP) – A national drug company is paying New Hampshire $1.2 million as part of a settlement resolving allegations that the company scammed state Medicaid programs.

Attorney General Kelly Ayotte says Bristol-Myers Squibb Company and a former subsidiary, Apothecon, Inc., agreed to the settlement.

The company was accused of overpricing prescription medicine to Medicaid programs, illegally paying health care providers to get them to buy its drugs, promoting a drug for illnesses for which it had not been approved and misreporting sales prices for another medicine so Medicaid programs got smaller rebates.

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