tci Medicare Compliance & Reimbursement - 2003 Issue 27

PBMs: PBM TARGETED IN NEW WHISTLEBLOWER SUIT

Enforcement trends spell trouble for drug industry and its business partners "Follow the money" may be code for "follow the drugs" when it comes to the latest trends in health care fraud enforcement. Pharmaceutical manufacturers are getting busted for average wholesale price shenanigans and Medicaid rebate snafus, physicians are getting nailed on pharma-related kickback charges, and pharmacy benefit managers appear to be in the crosshairs as well. The latest development: The Department of Justice June 23 partially intervened in a pair of whistleblower suits accusing Franklin Lakes, NJ-based PBM Medco Health Solutions Inc. of violating the False Claims Act...

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