Pain Doc and Pharma Exec Caught in Bribery Scandal

Jerrold Rosenberg, M.D., a physiatrist of North Providence, Rhode Island, advertised that he can treat joint and back pain without surgery.

On Wednesday, October 25, 2017, Rosenberg pleaded guilty to healthcare fraud and conspiring to receive kickbacks from Arizona-based pharmaceutical company Insys Therapeutics Inc. to unnecessarily prescribe a spray version of the highly addictive painkiller, Fentanyl.

The feds are not screwing around when it comes to the Opioid Crisis.

Rosenberg’s copping a plea comes at the same time the feds in Boston announced the arrest of billionaire John N. Kapoor, Ph.D., the founder of Insys. Kapoor is charged with using bribes and fraud to cause the illegal distribution of the Fentanyl spray intended for cancer patients experiencing breakthrough pain.

Kapoor’s indictment also includes additional allegations against several former Insys executives and managers who were initially indicted in December 2016.

According to Rosenberg’s indictment, the FDA approved Insys’ application in 2012 to market the spray to treat breakthrough cancer pain. That same year, the company established a program in which it would pay doctors to provide educational “speaking” programs to other healthcare providers.

“NO SCRIPTS, NO PROGRAMS”

The Providence Journal reported that Rosenberg did 91 such presentations from July 2012 through July 2015, raking in over $188,000. Many of those programs were attended by Rosenberg’s family members, Insys sales representatives, or colleagues and friends. Many attended the dinners over and over. In some instances, Rosenberg forged signatures to make it appear that actual medical professionals were present.

Insys sales representatives directed Rosenberg to prescribe more of the Fentanyl spray, called Subsys, if he wanted to engage in more “speaking” programs, the indictment says. An Insys district manager urged sales reps by email to lean on prescribers, writing, “NO SCRIPTS, NO PROGRAMS.”

In exchange for bribes and kickbacks, the practitioners wrote large numbers of prescriptions for the patients, most of whom were not diagnosed with cancer.

Kapoor’s indictment also alleges that Kapoor and six former executives conspired to mislead and defraud health insurance providers who were reluctant to approve payment for the drug when it was prescribed for non-cancer patients. They achieved this goal by setting up the “reimbursement unit,” which was dedicated to obtaining prior authorization directly from insurers and pharmacy benefit managers.

FBI: “No Better Than Street-Level Drug Dealers”

Harold Shaw, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division, said “The allegations of selling a highly addictive opioid cancer pain drug to patients who did not have cancer, make them no better than street-level drug dealers.”

In March 2017, Rosenberg signed a voluntary agreement not to practice medicine in Rhode Island. His lawyer said that while his client was pleading guilty to conspiracy, he was not making any admissions with regard to his son, identified in the indictment as Insys sales representative A.R.

The Department of Justice notes the details contained in the charging documents are allegations. The defendants are presumed innocent unless and until proven guilty beyond a reasonable doubt.

The arrest of the pharma exec and Rosenberg’s guilty plea should send a clear message to all physicians treating joint and back pain that the prosecution of healthcare fraud has moved from the orthopedic device companies by Chris Christie a few years ago to pharma companies peddling pain meds. The lesson is that if you take money from industry, it better be for a real and appropriate purpose to benefit your patient.