The United States has intervened in a whistleblower suit filed in the District of Massachusetts against Boehringer Ingelheim Roxane, Inc. and various related entities, alleging that Roxane violated the False Claims Act, the Justice Department announced today. In its complaint, the government alleges that Columbus, Ohio-based Roxane engaged in a scheme to report fraudulent and inflated prices for several pharmaceutical products, knowing that federal health care programs established reimbursement rates based on those reported prices.
The government’s complaint alleges that the Ohio pharmaceutical manufacturer, from at least on or before January 1, 1996, reported prices that, in some instances, were more than 1,000 percent the actual sales prices on certain of the drugs it manufactures. The United States alleges that Medicare and Medicaid have reimbursed Roxane’s customers in excess of $500 million for the drugs which are the subject of the complaint. Roxane sells generic drugs that are reimbursed by the two federal health care programs.
The difference between the inflated government reimbursement rates and the actual price paid by healthcare providers for a drug is referred to as the “spread.” The larger the spread on a drug, the larger the profit or return on investment for the provider. The government alleges that Roxane used artificially inflated spreads to market, promote and sell the drugs to existing and potential customers. Because reimbursement from federal programs was based on the fraudulent inflated prices, the United States contends that Roxane caused false and fraudulent claims to be submitted to federal healthcare programs.

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California patients are at the mercy of HMOs and insurance companies that drop patients to boost their bottom line, putting profit far ahead of patient care. For example, Blue Cross of California, the health insurers against whom hundreds of patient complaints have been filed, paid $1.4 billion in shareholder dividends to its parent company since 2002.
The Department of Managed Health Care recently announced it will write new regulations to tighten scrutiny of the illegal practice in response to a petition by FTCR.
Read Los Angeles Times coverage: “Sick but Insured? Think Again,” available at: http://www.consumerwatchdog.org/healthcare/nw/?postId=6833
Read more about illegal insurance cancellations at: http://www.consumerwatchdog.org/healthcare/StopCancellations/

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During Feb. 2003, the unthinkable happened at Duke University Hospitals: a patient received a heart and double lung transplant with organs of the incorrect blood type. Then, another unthinkable event happened: The Duke staff disclosed the error to the family. The transplant error and subsequent disclosure became national news.
The Duke disclosure story will be featured at a national conference on transparency and disclosure hosted in Las Vegas Mar. 19 and 20 by The Risk Management and Patient Safety Institute (RM&PSI).
“Disclosure has become an extremely hot topic today, and we want to share our disclosure experiences – both good and bad – with people. We are excited to be part of this conference to help educate healthcare, insurance, and legal professionals about transparency and disclosure,” said Douglas Borg, director of insurance for Duke University Health System.
“Disclosure is the right thing to do, but a lot of thought needs to be put into it. Thanks to the growing disclosure movement many organizations are beginning the process of developing disclosure programs, and that’s good for our patients. We hope telling our story through this conference can help these organizations,” added Borg.
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United States Attorney Michael J. Sullivan; Mark Dragonetti, Resident Agent in Charge of the U.S. Food and Drug Administration, Office of Criminal Investigations in New England; Joseph C. Moraski, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of the Inspector General for New England; and Paul J. Cote, Jr., Commissioner of the Massachusetts Department of Public Health, announced today that DEBORAH STELLA, age 39, of Lawrence, Massachusetts, was charged in an indictment with one count of tampering with consumer products and two counts of making false statements.
The indictment alleges that STELLA was employed as a registered nurse at Lawrence General Hospital located in Lawrence, Massachusetts. The indictment alleges that STELLA tampered with three vials of the Schedule II narcotic, Morphine Sulfate Injection, by removing morphine sulfate from the vials and replacing the removed liquid with another solution. Morphine sulfate is used to manage pain in patients. The indictment further alleges that STELLA falsely stated to federal law enforcement officials that she had not taken any medications from Lawrence General Hospital, and that she falsely stated that she had not tampered with any drugs at Lawrence General Hospital

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Notre Dame coach Charlie Weis’ medical malpractice suit against two Boston doctors is scheduled to go to trial next month.Weis nearly died after undergoing gastric bypass surgery in June 2002, when he was the offensive coordinator for the New England Patriots. Weis had the operation to lose weight after battling chronic obesity for years.

Weis began bleeding internally soon after the operation and was in a coma for two weeks.

His lawsuit alleges that Massachusetts General Hospital physicians Charles Ferguson and Richard Hodin acted negligently. The doctors deny they did anything wrong.

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