U.S. alleges doctor improperly prescribed fentanyl
Medically unnecessary prescriptions cost health care programs $300,000, official says
Federal prosecutors allege a Lehighton doctor prescribed a costly fentanyl-based medication to patients who had no medical need for the drug, costing two government health care programs hundreds of thousands of dollars.
The U.S. attorney’s office in Harrisburg filed a civil lawsuit this week against Dr. Peter J. Baddick III, who saw patients at his Lehighton practice, Penn Medical Group, until it ceased operations in 2019.
The suit alleges Baddick violated the
False Claims Act by writing medically unnecessary prescriptions for Subsys, a fentanyl-based spray used to treat breakthrough cancer pain. The patients who received prescriptions for the drug did not have cancer, the U.S. attorney’s office said.
Between April and December 2015, Baddick wrote 18 prescriptions for Subsys for two patients that were submitted to Medicare and TRICARE, the government health insurance program for uniformed service members. The programs paid $308,702 for the prescriptions, the U.S. attorney’s office said.
“The Department of Justice has a duty to protect the health and welfare of our citizens and to ensure that the taxpayer dollars that fund the federal healthcare programs are only expended for necessary medical services,” U.S. Attorney John Gurganus said in a statement.
Subsys is a potent and addictive opioid approved to treat cancer patients when other pain medications no longer work. Gurganus said improper prescriptions put patients’ lives at risk at taxpayers’ expense.
The Department of Justice criminally prosecuted Insys, which makes Subsys, in federal court in Massachusetts. As part of a civil settlement, Insys agreed to pay $195 million. It also entered a deferred prosecution agreement with the government, pleading guilty to five counts of mail fraud and paying a $2 million fine and forfeiting $28 million in profits.
The case was investigated by the U.S. Department of Defense inspector general’s office, the Defense Criminal Investigative Service and the U.S. attorney’s office with assistance from the U.S. Health and Human Services Department. It is being handled by Assistant U.S. Attorney Brian Simpson.