Senior writer and co-founder of C-HIT, Lisa Chedekel is an award-winning investigative reporter who wrote for the Hartford Courant for 15 years, covering a wide range of beats, from politics to healthcare. In 1999, she was among a team of reporters awarded the Pulitzer Prize for breaking news reporting. In 2002, she was among a handful of U.S. journalists who visited Saudi Arabia in the year after 9/11 to report on the aftermath of the terrorist attacks. More recently, she co-authored a series on mental health in the military that won a George Polk Award, the Selden Ring Award for Investigative Reporting, and was a 2007 finalist for the Pulitzer in Investigative Reporting. Before writing for The Courant, she was a staff writer and columnist for the New Haven Register. You can contact Lisa at chedekel at c-hit.org
At the Fresh River Healthcare nursing home in East Windsor, the chance that a short-stay patient will end up back in the hospital within 30 days of arriving at the facility is less than eight percent. Meanwhile, 12 miles away at the Greensprings Healthcare and Rehabilitation nursing home in East Hartford, more than a third of patients who came from hospitals will be readmitted in 30 days. The wide swing in nursing home patients’ re-hospitalization rates has a lot to do with the condition patients are in when they are discharged from inpatient stays, as well as the planning that goes into the transition to other care. The federal government has been penalizing hospitals since 2012 for high rates of patients returning within 30 days of discharge. But now, nursing homes (or skilled nursing facilities) also are being held accountable for hospital readmissions.
In an unusual move, the FBI is reaching out publicly to patients who were prescribed the powerful narcotic medication Subsys, which federal agents allege was improperly dispensed by practitioners across the country, including a nurse in Derby. In a posting on its Victim Assistance Program website, the FBI asks people who were prescribed Subsys between March 2012 and December 2016 to complete a brief questionnaire that will assist in a federal probe of Insys Therapeutics, the company that makes Subsys. The appeal follows the indictments in December of six top executives and managers of Insys on charges they led a nationwide conspiracy to bribe doctors and nurses to prescribe Subsys, which is approved for treating cancer patients suffering episodes of breakthrough pain. In exchange for bribes and kickbacks, the practitioners wrote large numbers of prescriptions for patients, most of whom were not diagnosed with cancer, the indictments allege. One of the practitioners named in the indictments is Heather Alfonso, formerly an advanced practice registered nurse (APRN) at the Comprehensive Pain and Headache Treatment Center in Derby. She has pleaded guilty to accepting kickbacks from Insys through a sham “speakers’ program,” in exchange for prescribing Subsys.
Six top pharmaceutical executives and managers, formerly employed by Insys Therapeutics, Inc., were arrested Thursday on charges that they led a nationwide conspiracy to bribe medical practitioners, including a nurse at a pain clinic in Derby. In a sweeping indictment filed in U.S. District Court in Massachusetts, federal prosecutors charged the former CEO and president of the Arizona-based company, Michael Babich, two former vice presidents, and three other managers with paying kickbacks to practitioners in several states, many of whom operated pain clinics, in order to get them to prescribe a fentanyl-based pain medication. The medication, Subsys, is a powerful narcotic intended to treat cancer patients suffering intense episodes of breakthrough pain. In exchange for kickbacks, the practitioners wrote large numbers of prescriptions for the patients, most of whom were not diagnosed with cancer, the indictment says. Prosecutors also allege that the former executives conspired to mislead and defraud health insurance providers, who were reluctant to approve payment for the drug when it was prescribed for non-cancer patients. One of the 10 practitioners referenced in the indictment is Heather Alfonso, formerly an advanced practice registered nurse (APRN) at the Comprehensive Pain and Headache Treatment Center in Derby, who has pleaded guilty to accepting kickbacks from Insys, through a sham “speakers’ program,” in exchange for prescribing Subsys.
Connecticut saw one of the highest increases in the nation in preventable deaths from unintentional injuries from 2010 to 2014, mainly because of a spike in opioid overdoses, according to a new report from the Centers for Disease Control and Prevention (CDC). An analysis of the report shows that the state’s rate of potentially preventable deaths from accidental injuries jumped 97 percent – the sixth- highest increase nationally, after Maryland, Massachusetts, New Jersey, New York and Virginia. Nationally, preventable deaths from accidents – namely, overdoses from prescription and illicit drugs, as well as falls – rose 23 percent. Connecticut had 1,142 unintentional injury deaths in 2014— the second highest in New England, after Massachusetts. About half (568) were accidental drug intoxication deaths, according to the Office of the Chief Medical Examiner.
Ten Connecticut prescribers, including a Derby nurse who is at the center of a federal kickback probe, were responsible for more than 23 percent of the state’s Medicare spending on opioids in 2014, suggesting that the largest share of those prescriptions is concentrated among a small number of clinicians. Recently released federal Medicare data show that Heather Alfonso, formerly a nurse with the Comprehensive Pain & Headache Treatment Centers, LLC, in Derby, and four other advanced practice registered nurses (APRNs) at the clinic in 2014 dispensed more than $8.4 million in opioids in the Medicare program – accounting for a full 15 percent of all such prescriptions in the state. They were among the top 10 opioid prescribers in 2014, who accounted for $13 million of the $56 million spent on the drugs, the data show. More than 4,800 Connecticut clinicians, mostly physicians, wrote Medicare prescriptions for oxycodone, fentanyl and other opioids. But the prescribing was not evenly spread out – only two-dozen prescribers wrote out more than $250,000 worth of prescriptions.
The state has taken custody of more than 860 children since 2011 because their families could not access or provide “specialized care” for their mental health or physical conditions, according to judicial department data.
A former executive of Insys Therapeutics has been criminally charged for leading a special “reimbursement unit” at the company that defrauded insurers into paying for a potent opioid pain medication by falsely claiming patients had cancer and other conditions needed for pre-approval. Elizabeth Gurrieri, a former manager of reimbursement services for Arizona-based Insys, was charged with wire fraud conspiracy in a criminal complaint filed in federal court in Boston. The complaint sheds light on a Connecticut case involving a Derby nurse who has been charged with taking kickbacks from Insys in exchange for prescribing the company’s fentanyl spray, Subsys. The nurse, Heather Alfonso, has been cooperating with investigators in Boston and Connecticut in an ongoing probe of Insys’ sales tactics. The complaint against Gurrieri notes that patients needed prior authorizations from insurance companies to cover the costs of Subsys, an expensive drug approved by the Food and Drug Administration in 2012 for the management of breakthrough pain in patients with cancer who already were receiving opioid pain treatment.
Ten years have gone by, but Lisa Vincent and her son, Jose, flash back to their goodbye with fresh anguish and faltering voices. He is 21 now, but the 11-year-old boy he was back then easily re-surfaces, all anger and confusion. “I didn’t understand. I was under the assumption I was going back to her,” Jose says. “For a long time, I felt that whole ‘she gave up on me like everyone else did.’ Now, I realize it wasn’t her.
Fifteen months after a Derby nurse admitted taking drug-company kickbacks in exchange for prescribing a powerful opioid painkiller, a former district sales manager for the company was arrested Thursday on federal charges that he helped to orchestrate the kickback scheme. Jeffrey Pearlman, of Edgewood, NJ, who was district sales manager for the New York region for Insys Therapeutics through 2015, and the sales representatives he managed “induced certain physicians, advanced practice registered nurses (APRNs) and physician assistants to prescribe the pharmaceutical company’s fentanyl spray by paying them to participate in hundreds of sham ‘Speaker Programs,’” according to a release from the U.S Attorney’s Office for Connecticut. The scheme “defrauded federal healthcare programs” of millions of dollars that was paid out improperly for the drug, Subsys, which is approved for use only in cancer patients with breakthrough pain. Federal prosecutors allege that Pearlman “personally profited” from the scheme through inflated quarterly bonuses he received that were based, in large part, on the sales results of the employees he managed. Pearlman, who is no longer employed by Insys, could not be reached for comment Thursday.
Four nurses, all of them affiliated with a Derby pain clinic, were responsible for nearly all of the state’s 2014 Medicare spending on the powerful opioid painkiller Subsys, which is at the center of a kickback probe. New Medicare data for 2014 show the four nurses, all who worked at the Comprehensive Pain and Headache Treatment Center of Derby, were responsible for 279 claims for Subsys, at a cost of $2.3 million. The highest prescriber was Heather Alfonso, an advanced practice registered nurse (APRN) formerly employed by the clinic who is awaiting sentencing on charges she took kickbacks from Arizona-based Insys Therapeutics for dispensing Subsys to patients. The new data is the first indication that the propensity to prescribe Subsys extended beyond Alfonso, to other clinic staff. None of the other three nurses has been implicated in an ongoing federal probe of Insys’ marketing of Subsys that resulted in the criminal charges against Alfonso.