Insys Therapeutics Facing Down Fraud and Criminal Charges
Posted By Schick Shadel Hospital || Oct 10, 2016
Subsys Fentanyl, an opioid manufactured by Insys Therapeutics, has a lot more than a CNBC investigation and a place on the United States Department of Health and Human Services list of “dugs of concern” to worry about. Wayne Automatic Fire Sprinklers, a family-owned company located in central Florida, filed a lawsuit against the billion-dollar publicly traded company that alleges that one of their employee’s spouses covered by their health insurance plan became addicted to opioids after fraudulent Subsys prescriptions. According to the lawsuit, the company:
“[engaged in a] massive fraud scheme and criminal enterprise to obtain money from Wayne for illegally prescribed painkillers through Wayne's employee health insurance plan."
We have covered the dangers of fentanyl in the past. This drug is 100 times more potent than morphine, and the United States Food and Drug Administration (FDA) recommends that it should only be prescribed to patients suffering from late-stage breakthrough cancer pain. The case against Insys alleges that the company worked to pull of their scheme with the help of Florida-based physician Dr. Edward Lubin and Gessler Clinic. According to the lawsuit:
“Dr. Lubin and the Practice illegally prescribed Subsys to an individual [the spouse of a Wayne employee] who was covered under Wayne's employee health insurance plan but did not have cancer, let alone breakthrough cancer pain."
Two companies, OptumRX and UMR, were hired as third-party administrators who mostly evaluated and processed benefits and insurance claims, and are listed as defendants alongside Insys Therapeutics on the lawsuit. According to the lawsuit, in order to be reimbursed for Sybsys, an individual only identified as “David” told OptumRX’s prior authorization department that Dr. Lubin had diagnosed the patient in question with malignant cancer pain.
Wayne Automatic Fire Sprinklers discovered that the patient was never actually diagnosed with said cancer, and was in fact addicted to the drug. It took until November of 2014 for OptumRX and UMR to acknowledge that the patient was never diagnosed with cancer, and this acknowledgement allegedly only came after Wayne Automatic Fire Sprinklers pressed with concerns over a lengthy period of time.
It doesn’t matter how you first became addicted. At Schick Shadel Hospital, the most important thing is getting you the help and treatment you need to overcome your addiction and reclaim control over your life. Our counter conditioning program has allowed us to help more than 65,000 patients over the past 80 plus years, and continues to help more people every single day. Send us a confidential message through our online form, or give us a call at (888) 802-4206 to start yourself on the road to recovery today.