APRN Admits Receiving Kickbacks From Drug Company For Prescribing Pain Medication
HARTFORD, Conn. - Michael J. Ferguson Special Agent in Charge for the Drug Enforcement Administration for New England and Deirdre M. Daly, United States Attorney for the District of Connecticut, announced that Heather Alfonso, 42, of Middlebury, waived her right to indictment and pleaded guilty today before U.S. District Judge Michael P. Shea in Hartford to receiving kickbacks in relation to a federal healthcare program.
According to court documents and statements made in court, Alfonso was employed as an Advanced Practice Registered (APRN) at Comprehensive Pain and Headache Treatment (CPHTC) located in Derby. As part of her practice, Alfonso prescribed various controlled substances to clients of the treatment center.
The investigation revealed that Alfonso was a heavy prescriber of a drug that is used to treat cancer pain. A review of Medicare Part D prescription drug events for prescribers of the drug showed that Alfonso was responsible for more than $1 million in claims and was the highest prescriber of the drug in Connecticut. Interviews with several of Alfonso’s patients, who are Medicare Part D beneficiaries and who were prescribed the drug, revealed that most of them did not have cancer, but were taking the drug to treat their chronic pain. Medicare and most private insurers will not pay for the drug unless the patient has an active cancer diagnosis and an explanation that the drug is needed to manage the patient’s cancer pain.
The investigation further revealed that the manufacturer of the drug paid Alfonso as a speaker for more than 70 dinner programs at a rate of approximately $1,000 per event. In many instances, the dinner programs were only attended by Alfonso and a sales representative for the drug manufacturer. In other instances, the programs were attended by individuals, including office staff and friends, who did not have licenses to prescribe controlled substances. For the majority of these dinner programs, Alfonso did not give any kind of presentation about the drug at all.
From January 2013 until March 2015, Alfonso was paid $83,000 by the drug manufacturer. In pleading guilty, Alfonso admitted that the money she was paid influenced her prescribing of the drug.
The charge of receipt of kickbacks in relation to a federal healthcare program carries a maximum term of imprisonment of five years and a fine of up to $250,000. Judge Shea scheduled sentencing for September 17, 2015.
U.S. Attorney Daly stated that the investigation is ongoing.
This investigation is being conducted by the U.S. Department of Health and Human Services Office of the Inspector General and the Federal Bureau of Investigation, with the assistance of the Drug Enforcement Administration’s Diversion Squad. The case is being prosecuted by Assistant U.S. Attorneys Douglas P. Morabito and Richard M. Molot
U.S. Attorney Daly stated that the investigation is ongoing.
U.S. Attorney Daly encouraged individuals who suspect health care fraud to report it by calling the Health Care Fraud Task (203) 785-9270 or 1-800-HHS-TIPS.
