Compliance News Roundup: A $2.5 Million Fine Here, a $225 Million Fine There

1. Telemarketer Agrees To Pay $2.5 Million for Illegal Kickback And Unnecessary Prescription Scheme - United States Attorneys announced that Scott Roix and his telemarketing businesses have agreed to pay $2.5 million to resolve allegations of violating the False Claims Act. The government alleged that Roix and his companies fraudulently obtained insurance information from individuals nationwide and arranged for them to receive prescription pain creams and other similar products that were not medically necessary. “The United States Attorney’s Office is committed to protecting TRICARE and other federal healthcare programs from improper practices that harm our nation’s healthcare programs,” said U.S. Attorney Chapa Lopez. Get the full scoop here >>

2. NY Doctor Pleads Guilty To Accepting Bribes In Exchange For Prescribing Fentanyl - Dialecti Voudouris, a Manhattan-area doctor, pled guilty to conspiring to violate the Anti-Kickback Statute. This violation was in connection of a scheme to prescribe Subsys, a fentanyl-based spray, in exchange for bribes and kickbacks from Subsys’s manufacturer, Insys Therapeutics. Voudouris, a prominent Manhattan oncologist, prescribed her patients Subsys in exchange for over $100,000 in bribes and kickbacks from Insys. Voudouris is scheduled to be sentenced in January, 2020. Her conspiracy violation carries a maximum sentence of 5 years. For it’s part, Insys has already admitted to bribing doctors and has agreed to pay a $225 Million settlement. Read the full story here >>

3. Deeper Than the Headlines: The OIG Uncovered Deficiencies in Ambulatory Surgery Centers - Medicare beneficiaries are increasingly using Ambulatory Surgery Centers (ASCs) for outpatient surgical procedures. In fact, Medicare payments to ASCs increased from $3.4 billion in 2011 to $4.6 billion in 2017.

Recently, the OIG released a new report, “Medicare’s Oversight of Ambulatory Surgery Centers: A Data Brief” that uncovered some instances of grave deficiency on the part of ASCs. Dr. CJ Wolf breaks down the report in our latest issue of Deeper than the Headlines. Go deeper here >>