Involves a kickback scheme initiated by Insys Therapeutics in which practitioners were incentivized to prescribe Subsys by receiving payments through a sham “Speaker Program.”
A former Insys Therapeutics sales representative, whose trial had commenced, pleaded guilty in the Southern District of Ohio to conspiracy to defraud the United States for her involvement in a scheme to pay kickbacks to a doctor to induce him to prescribe Subsys, a dangerous sublingual fentanyl spray.
According to court documents and evidence presented in court, Nicole Georges, 43, of Columbus, Ohio, admitted to her involvement in a kickback scheme initiated by Insys Therapeutics in which practitioners were incentivized to prescribe Subsys by receiving payments through a sham “Speaker Program.” Georges facilitated “speaker payments” to her co-defendant, Dr. Jimmy Henry, whose prescribing of Subsys dramatically rose during the period in which he received payments from Insys, despite not engaging in many of these speaking events. Georges also assisted in facilitating insurance paperwork through Insys to assure that the Subsys prescriptions issued by Henry would be reimbursed by insurance programs, including Medicare and Ohio Medicaid. Georges received significant bonuses for her so-called “sales” of Subsys. For his part, Henry pleaded guilty to the distribution of controlled substances and violating the Anti-Kickback Statute on Sept. 8.
Georges faces a statutory maximum penalty of 60 months’ imprisonment. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division, Acting U.S. Attorney Vipal J. Patel for the Southern District of Ohio, Special Agent in Charge J. William Rivers of the FBI’s Cincinnati Field Office, and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.
The FBI, HHS-OIG, Ohio Medicaid Fraud Control Unit, and Ohio Bureau of Workers’ Compensation investigated the case.
Trial Attorneys Christopher Jason and Katherine Pridemore of the Criminal Division’s Fraud Section are prosecuting the case.
The Fraud Section leads the Appalachian Regional Prescription Opioid (ARPO) Strike Force. Since its inception in October 2018, the ARPO Strike Force, which operates in 10 districts, has charged more than 90 defendants who are collectively responsible for distributing more than 105 million pills. Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,600 defendants who have collectively billed the Medicare program for approximately $23 billion. In addition, the Health and Human Services Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.Healthcare Fraud Insurance Fraud Kickbacks Medically Unnecessary Opioid Crisis Rx Fraud