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.
The family of a Meriden man who died in 2013 at age 56 is suing Derby nurse practitioner Heather Alfonso and the pain clinic where she worked, alleging that her rampant overprescribing of narcotics contributed to his death. Joseph Torchia’s wife and son claim in a lawsuit filed in Waterbury Superior Court that Alfonso, who was recently charged by federal prosecutors with accepting kickbacks from a drug company, prescribed “unlawfully high” doses of narcotics to Torchia for more than a year, ignoring signs that he was suffering from liver cirrhosis, gallbladder disease, internal bleeding and narcotics’ dependency. The suit alleges that Alfonso’s reckless prescribing weakened Torchia’s medical condition, so that his ability to recover from gallbladder surgery on Jan. 14, 2013, was compromised. He died three weeks after that surgery.
Federal charges against Derby nurse Heather Alfonso center on a powerful and addictive painkiller called Subsys, which has been heavily marketed by the Arizona-based manufacturer Insys Therapeutics, federal officials confirmed Wednesday. 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 a 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 prosecuting the case. Receiving kickbacks in exchange for billing charges to a federal health care program is illegal. While the company and drug are not named in the indictment, a prosecutor revealed in court Tuesday that the case involves Subsys and Insys Therapeutics.
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.
The medical director of a pain clinic in Derby was reprimanded and fined $7,500 on Tuesday by the state Medical Examining Board for writing prescriptions for patients based on assessments of their appearance or behavior conducted by unlicensed medical assistants. Dr. Mark Thimineur, medical director of the privately run Comprehensive Pain & Headache Treatment Centers, LLC, housed at Griffin Hospital, signed a consent order on June 1 agreeing to the punishment. In the order, he did not contest the findings by the board and the state Department of Public Health. The consent order states that from 2011 to the present, Thimineur failed to meet the standard of care when treating one or more patients for chronic pain. It said he wrote prescriptions for patients based on assessments by unlicensed medical assistants of the patients’ physical appearance, behavior, pain levels or lab test results.
Ten Connecticut prescribers, including a Derby nurse practitioner who is under investigation by the state, were responsible for more than 22 percent of the state’s Medicare spending on potent narcotics in 2013, new federal data show. More than 4,300 Connecticut clinicians, mostly physicians, wrote Medicare prescriptions for oxycodone, morphine and other Schedule II drugs, which have a high potential for abuse and addiction, at a total cost of $40 million. But a handful of those providers accounted for the largest share of those prescriptions, an analysis of the data show. Topping the list, in both the number of prescriptions and cost, was Heather Alfonso, an advanced practice registered nurse (APRN) at the Comprehensive Pain & Headache Treatment Centers, LLC, in Derby, who wrote out 8,523 prescriptions, at a cost of $2.7 million. Statewide, the average number of prescriptions per clinician was 104, and no other prescriber had more than 5,000 Schedule II claims. The average cost per prescriber was $9,138; the next closest individual cost was $1.8 million.
A Derby nurse practitioner whose prolific prescribing of potent narcotics was the subject of a February story by C-HIT has surrendered her state and federal licenses to prescribe controlled substances and is the subject of an “open investigation” by the state health department, officials said Monday. Heather Alfonso, an advanced practice registered nurse (APRN) at the Comprehensive Pain & Headache Treatment Centers, LLC, in Derby, surrendered her controlled substance registration after a recent probe by the Drug Control Division of the Department of Consumer Protection, a spokeswoman for the department confirmed. “The controlled substance registration of this provider has been turned in,” said the spokeswoman, Claudette Carveth. She said the agency had no further comment. Meanwhile, William Gerrish, a spokesman for the Department of Public Health, said his agency has an ongoing investigation into Alfonso’s APRN license, which is separate from her prescribing registration.
A Derby nurse practitioner was among the top 10 prescribers nationally of the most potent controlled substances in Medicare’s drug program in 2012 – an anomaly in a state where Medicare records show nurse practitioners rarely prescribe such drugs, which have a high potential for abuse. Heather Alfonso, an advanced practice registered nurse (APRN) at the Comprehensive Pain & Headache Treatment Centers, LLC, wrote out 8,705 prescriptions for opioids and other Schedule II drugs in 2012 – the most prolific prescriber among all Connecticut practitioners, including pain specialists and other physicians, according to Medicare data compiled by ProPublica. She wrote out more prescriptions for the opioid Exalgo than any other Medicare provider in the country, and was the seventh highest prescriber nationally of Oxycontin, writing out more than twice as many prescriptions for that narcotic as the next highest prescriber in Connecticut. She also was the 10th highest prescriber nationally of Avinza, a morphine product. There is no indication that Alfonso’s unusual prescribing frequency drew scrutiny from state or federal officials.