Pharma Giant And Speciality Pharmacy Settle Case Alleging False Claims Violations
Dec 17, 2020, 15:10 ET
BOSTON, Dec. 17, 2020 /PRNewswire/ -- One of the world's largest pharmaceutical companies, Biogen, Inc., and a large specialty pharmacy, Advanced Care Scripts, Inc. (ACS), will pay a combined $23.4 million to settle allegations under the Federal False Claims Act that kickbacks were used to induce the sale of drugs used to treat multiple sclerosis. Biogen will pay $22 million and ACS will pay $1.4 million.
The settlement was reached in United States of America ex rel. Paul Nee v. Biogen, Inc., et. al., 17-CV-10192-MLW, pending in the United States District Court for the District of Massachusetts. The complaint – filed by a whistleblower under the False Claims Act – alleged that Defendants profited from "engaging in a kickback scheme that uses it free drug program and so called financial assistance to charities as conduits to induce and steer" patients to the drugs Avonex and Tysabri, which are drugs reimbursed under the federal Medicare program.
According to a settlement agreement between the United States Government, the whistleblower, and Biogen, the Government alleges that:
Biogen used third-party foundations Chronic Disease Fund ("CDF") and The Assistance Fund ("TAF") as conduits to pay the copay obligations of Medicare patients taking Avonex and Tysabri. Medicare then subsequently paid these patients' claims for Avonex and Tysabri.
With respect to Biogen's payment of copays through CDF for Avonex patients in 2011, Biogen identified for its vendor, Advanced Care Scripts ("ACS"), Avonex Medicare beneficiaries whom Biogen could transfer from Biogen's free drug program to CDF so that CDF could pay the Medicare copays for these patients and Biogen could receive Medicare revenue from the resulting Medicare claims for Avonex.
The 68-page False Claims Act complaint was filed on February 3, 2017 by the firm of Guttman, Buschner & Brooks, PLLC (GBB). GBB attorneys have been involved in some of the nation's largest recoveries under the federal and state False Claims Acts.
"This case has further exposed how the pharmaceutical industry has used charitable organizations in kickback schemes that can have the impact of compromising medical decision-making and draining precious healthcare dollars," said Reuben Guttman of GBB.
"Biogen's conduct, which many other pharmaceutical companies engage in as well, is one of the main reasons medications like Avonex and Tysabri can cost as much as $80,000 a year per patient. If the patient pays no co-payment, there is no voice to object," said Elizabeth Shofner, one of GBB's principal attorneys on the case.
GBB Attorneys working on the case included Shofner, Guttman, Nancy Gertner, Traci Buschner, and Justin Brooks. Boston co-counsel included William Fick and Daniel Marx of Fick & Marx LLP.
Guttman, Buschner & Brooks PLLC is a boutique firm whose attorneys have worked on cases recovering nearly $6 billion for state and federal governments under the False Claims Act. In addition to its False Claims Act practice, the firm maintains an active civil rights practice. This year the firm served as lead counsel in a case against the South Carolina Department of Corrections that resulted in a consent order requiring the department to test and treat nearly 20,000 prison inmates for Hepatitis C. (Contact Mimi Ramirez – [email protected], www.gbblegal.com www.whistleblowerlaws.com).
SOURCE Guttman, Buschner & Brooks PLLC
