Federal health officials, prosecutors switch focus to physicians in illegal kickback cases

Federal health officials and prosecutors have begun to investigate physicians who receive money from drug and medical device makers for using their products, in an attempt to halt the illegal kickbacks, the New York Times reports.

According to the Times, the investigations are part of a "diverse campaign to curb industry marketing tactics that enrich doctors but increase health care costs and sometimes endanger patients."

Officials and prosecutors for years have avoided pursuing physicians in the campaign against illegal kickbacks because they thought juries might "sympathize with respected clinicians," according to the Times. Instead, prosecutors typically have focused on companies. The Times reports that prosecutors in the past year have significantly increased fines that are part of plea agreements with drug and device companies charged with illegal marketing tactics. However, despite "winning record fines from a record number of companies," prosecutors realized they needed to expand their efforts, the Times reports. Michael Sullivan, U.S. attorney for Massachusetts, said, "The strategy of looking at the companies alone was not completely successful in terms of our objective to deter health care fraud."

Prosecutors already have begun forcing some drug and device makers to post publicly all payments made to physicians who have served as consultants or speakers, in the hope that such public disclosures will make criminal conduct more apparent and more difficult to commit and deter physicians from taking money or gifts from companies. According to the Times, the online postings might have "considerable effects" because "a substantial share" of physicians accept money from drug or device makers. Prosecutors will now also focus on individual physicians. Physicians who are convicted could lose their license for a period of time, be excluded from Medicare and Medicaid programs, and/or receive fines or jail time. "What we need to do is make examples of a couple of doctors so that their colleagues see that this isn't worth it," Lewis Morris, chief counsel to the inspector general of HHS, said. He added, "We want to send the message to the physician community -- particularly surgeons -- that you can't do this."

The changing focus of fraud investigations to physicians has some people in the medical industry concerned. Charles Rosen, an orthopedic surgeon and president of the Association for Medical Ethics, said investigations of certain physicians would hurt the image of the entire field. "The abuse of the public trust by the few will hurt the many," Rosen said. Richard Grimm, a Minnesota researcher, said he is worried that there will be an "automatic assumption that if you make money from a drug company, you must be corrupt" (Harris, New York Times, 3/4).

Request for Pfizer Payment Details

In related news, Sen. Chuck Grassley (R-Iowa) on Tuesday asked Pfizer to provide details of its payments to at least 149 Harvard Medical School faculty members dating back to Jan. 1, 2007, the Times reports. Grassley also asked for information on communications regarding some medical school students since Jan. 1, 2008. According to the Times, the request "expands Mr. Grassley's investigation of industry payments to three Harvard psychiatrists who had promoted antipsychotic medicines for children." Pfizer spokesperson Ray Kerins said the company "will fully cooperate" with the request. Grassley asked for the information to be delivered by next Wednesday, the Times reports (Wilson, New York Times, 3/4).