Multistate Doctor Bribery Scheme Uncovered
A doctor operating in both New Jersey and Pennsylvania was charged in an indictment unsealed this week in an alleged scheme to received bribes and kickbacks from a pharmaceutical company in exchange for prescribing large volumes of a powerful fentanyl narcotic. Kenneth Sun, M.D., 58, of Easton, Pennsylvania, was charged with one count of conspiracy to defraud the United States and to pay and receive health care kickbacks and four counts of receiving health care kickbacks.
According to a Department of Justice (DOJ) report, Sun owned and maintained a pain management medical practice called Progressive Pain Solutions with locations in New Jersey and Pennsylvania. Sun is alleged to have “solicited and received more than $140,000 in bribes and kickbacks from Insys Therapeutics, a pharmaceutical company based in Arizona, in exchange for prescribing more than 28 million micrograms of Subsys, a powerful opioid narcotic designed to rapidly enter a patient’s bloodstream upon being sprayed under the tongue.”
Subsys contains fentanyl, a synthetic opioid pain reliever which is approximately 50 to 100 times more potent than morphine. The U.S. Food and Drug Administration approved Subsys solely for the “management of breakthrough pain in cancer patients who are already receiving and who are tolerant to around the clock therapy for their underlying persistent cancer pain”.
Sun is alleged to have prescribed the medication when not medically necessary and to patients who were not eligible for insurance reimbursement and/or did not desire the medication.
The payments made to Sun were disguised as “honoraria” for educational presentation regarding Subsys that Sun purportedly provided to licensed practitioners.
The DOJ explains, “In reality, the indictment alleges, these presentations were a sham: they lacked the appropriate audience of licensed practitioners, there was no presentation about Subsys whatsoever, the same individuals attended over and over again and Sun did not attend some of the presentations at all. Sun caused Medicare to pay more than $847,000 for Subsys prescriptions that were medically unnecessary, procured through the payment of kickbacks and bribes, and not eligible for Medicare reimbursement.”
The FBI, HHS-OIG and the DEA investigated this case.