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Five doctors plead guilty to health care fraud. An important lesson for practitioners

The United States in Boston announced Attorney Recently, the solution of a fraud case of health care involving five urologists and TAP Pharmaceutical Products, Inc., a leading pharmaceutical manufacturer. The U.S. government said that the urologists received illegal inducements to prescribe TAP's drugs Lupron to doctors S.à € ™ 1990A convicted of fraud in health care, and TAP agreed to pay $ 875 million to settle allegations of price of drugs and fraud Marketing Lupron.

TAP markets Lupron for treatment of advanced prostate cancer. TOP U.S. Attorney opened an investigation into € ™ s of the pricing and marketing of Lupron in 1997 after a urologist employed by an HMO informed the police that he was offered an educational grant for overturn a decision on behalf of the HMO to exclude coverage for Lupron.

To encourage doctors to prescribe Lupron instead of an alternative cheaper, TAP gave doctors free samples of drugs, worth up to $ 40,000, as a form of volume discount. average cost of a monthly dose of Lupron were $ 400 to $ 600. Because Lupron is injected under the supervision of a doctor, medicare, generally non-reimbursed medicines, doctors reimburse 80% of his administration COST.O The remaining 20% were paid by the patient as a co-payment. TAP has the firm intention and is expected to free doctors to prescribe Lupron to patients and then billed patients and insurers, the average wholesale price drug. is precisely what doctors did.

As an added incentive to encourage doctors to prescribe Lupron, TAP has provided free counseling, free trips to golf and ski slopes, and the money disguised subsidies œeducational â €, â € that physicians use to pay for cocktail parties, office Christmas, medical equipment, and travel expenses. The government described these items as kickbacks and bribes to influence doctors to prescribe Lupron.

If the APR is likely to have a significant impact on marketing practices of pharmaceutical companies are not only, but in all vendors. health physicians, the message must be strong and Clear.

First, physicians should carefully consider some of the benefits they are accustomed to obtaining health products service vendors. incentives and the federal government cited as many illegal trade practices normally used by pharmaceutical companies and suppliers health care, including: "Free, free counseling, trips to golf and ski slopes and silver to a supposed € € œeducational subsidies, but used for other purposes. Thus, doctors who accept free services, free products or money suppliers risk criminal charges and civil liability.

It is a crime under the Medicare-Medicaid Anti Corruption statute (42 USC 1320A-7B) for receiving or soliciting payment for ordering an item as a prescription drug, reimbursable by Medicare or Medicaid. This law has been expanded to cover all federal health care programs in health care Portability and Accountability Act (HIPAA).

In terms of liability, physicians who knowingly submit false claims for reimbursement by the federal government can incur civil penalties of up to $ 10,000 per claim, plus treble damages under the Federal False Claims (31 USC 3729-3732). , A $ 10,000 per claim, civil monetary penalties often reach millions of dollars. For example, TAPA € ™ s worth 875 million dollars included over 559 million dollars to settle its federal civil False Claims Act liability in the case Lupron.

Second Instead, physicians should be aware that the government is attentive to their interactions with manufacturers and sellers of products for healthcare and TAP services.it Case highlights the government â € ™ s greater vigilance in investigating and prosecuting violations of laws against fraud and abuse. In a within six months (April-September 2001), the government has recovered more than 1.22 billion dollars through both monetary Civil Law False Claims Act civil settlements.

Physicians must remain vigilant to developments in this field.

About the Author

Shirin E. Harrell represents individuals injured by the negligence of physicians, hospitals and other health care provider. She founded the law firm of HARRELL & NOWAK Lawyers in New Orleans, Lawyers in Louisiana.



Do I have to urinate so much?

Over the last seven hours I had to go to the bathroom 7 times to urinate. Acquired the fact that he drank five to six cans of juice, and three bottles of 16 oz of water, I'm always nervous, because I remember hearing about possible symptoms may urinate constant prostate cancer or diabetes. btw, I'm 15. Thank you in advance.

It is normal … I used the bathroom 13 times in 5 hours after … I drank so much that day. In the days I drink about 1 bottle of water per day do not use the toilet at all. It's actually better than urinate more than less.

Greater Chicago Prostate Cancer Run Walk and Roll 2008

Filed under: Prostate

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