There are a number of kickbacks schemes that involve physicians. We are they are incentivized to write prescriptions for certain drugs. There are speaker programs, honorariums that are paid, round table discussions at dinners and lunches.
I saw more and more of that in the role that I had with the customer solutions specialists, and it just got worse, started going downhill very fast. It was it was around the summer of 2007, we had multiple programs and I would get angry calls from managers, “hey, why didn’t you get my family care physician in the speaker training,” and “we need this guy on board.” They were clamoring to get – I want to get this guy speaker trained, I want this guy to be speaker trained, this guy – everyone was speaker trained. And then they started speaker training family practice physicians, folks who aren’t even thought leaders at all. These are supposed to be well respected specialists that go out and bring new pieces of information to the medical community – and it wasn’t that way – it turned into an absolute joke. It was a circus.
There are subcultures within companies. Some are ethical some aren’t. We interface with the ones that aren’t.
Kickbacks from pharmaceutical companies cloud the medical judgment of health care providers and run afoul of federal and state anti-kickback laws. Most prominently, the federal Anti-kickback Act (AKS) was specifically designed to ensure that physicians prescribe drugs based on patient need, not personal greed.
The AKS is violated when a person or entity makes or accepts payment for referring, recommending or arranging for federally-funded medical items or services, including items or services provided under the Medicare, Medicaid, and TRICARE programs. Violations of the AKS are per se violations of the federal False Claims Act, the government’s primary pharmaceutical fraud-fighting weapon.
Dishonest drug companies will skirt the AKS, knowing their bribes will influence prescribing habits and, in turn, result in the provision of pharmaceutical products that are more expensive and/or medically unnecessary or even harmful to a vulnerable patient population. Over the last fifteen years, dozens of pharmaceutical companies have shelled out multimillion dollar settlement checks to quiet allegations that they showered doctors with illegal kickbacks.
In recent years, some companies have become increasingly cleaver in disguising illegal kickbacks. For example, companies regularly employ massive speaker bureaus and advisory boards, all in an attempt to disguise excessive payments as fees for “speaking engagements,” “consulting services” or “training sessions.” Typically, instead of recruiting speakers and consultants based on their experience or credentials, dishonest companies will target physicians based on their potential prescription-writing volume. Furthermore, once physicians are accepted into their programs, wayward marketing and sales executives will require speakers to meet minimum prescription levels.
Whistleblowers are needed to unmask illegal payments. The government simply doesn’t have the resources to unravel these schemes, unless pharmaceutical employees and health care providers courageously provide the necessary inside information. For those who do take this stand, the rewards are potentially worth millions.