BOSTON - Pharmaceutical company WARNER CHILCOTT has agreed to plead guilty to health care fraud and pay $125 million to resolve criminal and civil liability arising from the illegal promotion of various drugs. A portion of the illegal conduct related to the manipulation of “prior authorizations" for the osteoporosis medications Actonel® and Atelvia®. A prior authorization is a medical form that some insurance companies require when a physician prescribes a drug that the insurance company does not ordinarily cover. A prior authorization generally contains a medical justification for the prescription of the drug. In some instances, WARNER CHILCOTT sales representatives falsified prior authorizations for Actonel® and Atelvia®, using false medical justifications, so that insurance companies would pay for these drugs.
Insurance companies who paid for Actonel® and/or Atelvia®, or individuals who paid co-payments for these drugs, based on manipulated prior authorizations between June 2010 and February 2012, may be eligible for restitution. For information on submitting a victim restitution claim, please visit the U.S. Attorney’s Office website http://www.justice.gov/usao-ma/united-states-v-warner-chilcott-sales-us-llc to access the link for the Warner Chilcott case. Potentially affected individuals/companies have until March 31, 2016 to submit the restitution claim form.
Source: U.S. Department of Justice, Office of the United States Attorneys
