A Derby nurse who admitted taking kickbacks from a drug company that makes the powerful opioid painkiller Subsys is cooperating with federal investigators, who recently charged two drug company employees with violating kickback laws, court documents show. Documents filed earlier this year show that Heather Alfonso, a nurse formerly employed by a Derby pain clinic, requested a delay in sentencing because she was “actively cooperating in an ongoing investigation in several jurisdictions, including Connecticut,” in which arrests were expected. “Ms. Alfonso’s cooperation with both state and federal investigations is significant when qualifying her character and conduct, relative to sentencing,” her attorney said in filings in U.S. District Court in Hartford. A judge agreed to delay Alfonso’s sentencing until Sept. 13.
A Derby nurse who admitted taking kickbacks from a drug company that makes the powerful painkiller Subsys was pressured by sales representatives to increase her prescribing “so that the Subsys numbers would also increase,” according to court documents. In a hearing transcript recently made public, federal prosecutors charged that Heather Alfonso “continued to increase her prescribing of Subsys and to find more patients for whom she could prescribe the drugs” in exchange for a series of $1,000 kickbacks, totaling $83,000, from the company, Insys Therapeutics. Although the potent narcotic is approved only for cancer patients, some of the patients given Subsys by Alfonso “did not have a cancer diagnosis,” which would have meant that Medicare and private insurers would have refused to pay claims, federal prosecutors said. But “prior authorizations” submitted on behalf of patients falsely represented that they had cancer, misleading insurers into paying for the drug. It is not clear in the testimony who was involved in submitting the false authorizations to Medicare and insurers.
The company alleged to have paid kickbacks to a Derby nurse in exchange for her prescribing of a potent pain medication has agreed to pay $1.1 million to settle a case brought by the state of Oregon, which accused the firm of deceptive marketing and kickback payments involving the same drug. In a notice of unlawful trade practices filed against the Arizona-based drug maker Insys, the Oregon attorney general’s office charged that the company used an “unconscionable tactic by making payments to doctors that you intended to be a kickback to incentivize the doctor to prescribe Subsys.” The attorney general also charged Insys with using “unconscionable, false and deceptive sales tactics” designed to increase the “off-label” use of Subsys, which is approved only to treat breakthrough cancer pain. The case in Oregon comes as Connecticut nurse practitioner Heather Alfonso, formerly with the Comprehensive Pain and Headache Treatment Center in Derby, awaits sentencing on charges she received $83,000 in kickbacks from Insys from 2013 to 2015. In pleading guilty, Alfonso, 42, admitted that the money she was paid for attending “dinner programs” as a speaker — many of them sham dinners, with just an Insys sales representative or her friends or co-workers — influenced her prescribing of the drug, according to the U.S. Attorney’s Office for Connecticut. The charge of receipt of kickbacks in relation to a federal healthcare program carries a maximum term of imprisonment of five years and a fine of up to $250,000.
Eight of the top 10 prescribers of a potent narcotic used for cancer pain were paid more than $870,000 in speaking fees by the drug maker in 2013 and 2014 — indicating that Derby nurse Heather Alfonso was not the only high prescriber compensated by the company. Alfonso, an advanced practice registered nurse (APRN) who worked at the Comprehensive Pain and Headache Treatment Center in Derby, pleaded guilty last month to accepting $83,000 in kickbacks from 2013 to March 2015 from the drug company Insys Therapeutics, which has heavily marketed a painkiller called Subsys, a sublingual fentanyl spray approved only for cancer patients. Alfonso was paid to speak about Subsys at more than 70 “dinner programs,” but most of those programs were attended only by her and a sales representative for Insys, or by Alfonso’s colleagues and friends who had no authority to prescribe the drug, according to the U.S. Attorney’s Office for Connecticut. Alfonso faces a maximum prison term of five years and a fine of up to $250,000 on the charge of receiving kickbacks in connection with a federal healthcare program. In pleading guilty, she admitted that the money she was paid influenced her prescribing of Subsys, often to non-cancer patients, federal investigators said.
A Derby nurse practitioner identified as the state’s highest Medicare prescriber of potent narcotics has admitted taking kickbacks from a drug company in exchange for prescribing pain medication. Heather Alfonso, 42, of Middlebury, pleaded guilty Tuesday in U.S District Court in Hartford to receiving $83,000 in kickbacks from January 2013 until March 2015 from an unnamed pharmaceutical company that makes a drug used to treat cancer pain. In pleading guilty, Alfonso admitted that the money she was paid influenced her prescribing of the drug, according to the U.S. Attorney’s Office for Connecticut, which is handling the case. The charge of receipt of kickbacks in relation to a federal healthcare program carries a maximum term of imprisonment of five years and a fine of up to $250,000. U.S. District Judge Michael P. Shea scheduled sentencing for Sept. 17, 2015.