Manatt Partner Interviewed on Illegal Payments in Healthcare
"Doctors of Interest"
August 18, 2012 - Modern Healthcare interviewed Manatt's Jacqueline Wolff, co-chair of the firm's Corporate Investigations & White Collar Defense Practice, on the challenges of prosecuting a physician suspected of accepting payments from prescription drug manufacturers.
As reported by Modern Healthcare, billions of dollars have flowed into federal coffers in recent years from pharmaceutical companies accused of manipulating how doctors prescribe drugs, whether through alleged violations of the Anti-Kickback Statute, the False Claims Act or the Foreign Corrupt Practices Act.
Historically, the recipients of illegal payments in healthcare have faced fewer legal consequences than the corporations accused of offering the bribes. However, industry insiders say there is reason to expect that scrutiny will trickle down to individual physicians and other providers, though cases against doctors pose tougher challenges and provide smaller rewards than charges against companies.
Wolff said the chances are better of digging up incriminating evidence against a company that might have hundreds of employee e-mail accounts to scour for messages casually discussing kickback arrangements, as compared with a single doctor's correspondences.
And under the federal Anti-Kickback Statute, a prosecutor must prove a doctor knew he or she had willingly received or solicited payments in exchange for purchasing goods that were later billed to Medicare - a high evidentiary bar to meet without direct evidence, such as e-mails.
"You'll have a doctor who will say, 'I have been given a consulting agreement because I'm an expert in the field, and I prescribe this drug, and I believe in this drug, and that is the only reason why,' " Wolff said. "That makes it a much more difficult case to bring against a physician."
Read the article here.