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Government Cracks Down on Healthcare Fraud Involving Speaker Programs

The Health and Human Services Office of Inspector General (HHS-OIG) has issued a Special Fraud Alert to warn the community about illegal kickbacks paid to physicians in the guise of speaking program fees. Pharmaceutical companies and makers of medical devices have been known to incentivize doctors to prescribe their products by paying them exorbitant fees to speak at sham company-sponsored events.

Government Cracks Down on Healthcare Fraud Involving Speaker Programs

Regulators have settled many cases where doctors were paid thousands of dollars in speaking fees for attending dinners and other events where no medical information was shared. Some doctors have received hundreds of thousands over the course of a couple of years.

Speaker programs sponsored by drugmakers and medical device companies are often used to educate physicians about the benefits of medications and other related products. Unfortunately, in many cases, the honorariums paid to doctors are directly linked with their ability to prescribe the sponsoring companies’ products. This constitutes a violation of the Anti-Kickback Statute (AKS).

According to the Inspector General, speaker programs carry "inherent fraud and abuse risks," and "at least one purpose of remuneration associated with speaker programs is often to induce or reward referrals."

Physicians are often offered lavish dinners and luxury trips to purported “conferences” with the sole purpose of incentivizing referrals. Under the AKS, it is a felony to knowingly offer, pay, solicit, or receive remuneration in exchange for referrals or prescriptions for drugs, devices, or services that will be reimbursed by government programs.

The OIG’s Fraud Alert states that "[t]his remuneration to [health care professionals] may skew their clinical decision making in favor of their own and the company’s financial interests, rather than the patient’s best interests."’

When prescriptions and referrals respond to financial interests, the government overpays for products and services, and patients suffer. Sometimes, Medicare beneficiaries receive medication they don’t need or overpriced drugs that cost the health care program hundreds of thousands of dollars a year.

Under the AKS, even a pharma company paying for a prescribing doctor’s meal may constitute a violation. A recent court decision in Pennsylvania illustrates the full extent of the legislation. Sanofi, a pharmaceutical company, organized frequent seminars for speakers in places like Las Vegas and luxury Caribbean resorts. The company paid the physicians’ travel expenses, and attendees received a fee for undergoing training. The court opined that these purported ‘training’ programs induced false claims and violated the FCA and the AKS.

Under the Sunshine Act of 2010, pharma companies must disclose information about honorariums paid to physicians. But regulators report these requirements have not caused a significant drop in illegal kickback cases.

The OIG said it is "skeptical about the educational value of [sponsored speaker] programs" and made a few recommendations to ensure programs do not incur violations.

Signs that Speaker Programs May Violate The AKS

  • Events attended by friends, relatives, or employees of the speaker’s medical practice
  • Events held at locations “unconducive to the exchange of educational information,” such as fancy restaurants or entertainment venues
  • Events often held with no updated information
  • Expensive meals
  • Free alcohol offered during meals
  • Repetition of health care professional attendees even when there is no new information
  • Speaker fees above market rate
  • Speakers selected based on “expected revenue”
  • Too many programs on the same product or topic

If you are aware that a medical device maker or pharmaceutical company has participated in fraudulent speaker programs, call our healthcare fraud hotline at 888.742.7248. Whistleblowers who provide original information about fraud can receive awards amounting to up to 30 of any resulting recoveries.

Medicaid Fraud Hotline: 888.742.7248 or Report Online
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