EyePoint, Inc., formerly EyePoint Pharmaceuticals, Inc., has agreed to pay $4,678,981 to resolve allegations that it paid kickbacks to Ambulatory Surgery Centers (ASCs) to induce them to purchase its drug, DEXYCU, according to a July 15 announcement by the United States Attorney’s Office in Boston. The government alleges that these actions violated the Anti-Kickback Statute and the False Claims Act between January 2019 and March 2023.
The settlement resolves claims that EyePoint made illegal payments through an “Assurance Program” by covering ASCs’ costs when federal insurance programs denied coverage of DEXYCU—either by paying cash or providing free replacement doses—and also gave thousands of free samples used on patients whose commercial health insurance would not pay for the drug. According to the government, these practices induced ASCs to purchase and dispense DEXYCU reimbursed by Medicare, Medicaid and TRICARE by removing potential financial losses from insurers denying payment.
“As we have for years, our Office will continue to hold pharmaceutical manufacturers accountable for paying illegal kickbacks,” said United States Attorney Leah B. Foley. “Through these efforts, we protect patients by removing providers’ financial incentives to prescribe or dispense products that may not be medically necessary for the patient and protect the public from fraud, waste and abuse,” Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division said. “Kickbacks by pharmaceutical companies increase the cost of drugs used by patients and paid for by federal health care programs. The Civil Division will hold accountable anyone who pays unlawful kickbacks.”
Acting Deputy Inspector General for Investigations Scott J. Lampert of the U.S. Department of Health and Human Services Office of Inspector General said: “Pharmaceutical companies that attempt to boost profits through unlawful kickbacks undermine the integrity of federal health care programs and betray the patients who rely on them… We will aggressively pursue any entity that seeks to corrupt medical decision making and will not hesitate to hold them accountable.” Roberto Coviello, Special Agent in Charge at HHS OIG, added: “As alleged, EyePoint’s unlawful scheme compromised safeguards meant to ensure that treatment decisions are made in the best interests of patients, not corporate profits… This settlement demonstrates our commitment to protecting the integrity of taxpayer-funded health care programs.”
In connection with this settlement agreement, EyePoint entered into a five-year Corporate Integrity Agreement with HHS OIG; it will also pay an additional $25,478 under separate agreements with certain participating states. The claims were brought under whistleblower provisions allowing private parties (relators) a share in recoveries; here relator AFCE LLC will receive $791,768.74 from proceeds.
The U.S. Attorney for Massachusetts serves all state residents as part of its role within the United States Department of Justice; it enforces federal laws—including civil rights violations—through prosecutions from offices in Boston’s John Joseph Moakley Courthouse as well as Springfield and Worcester branches while employing over 200 attorneys and staff members, according to its official website.