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Biogen pays $900 million in fines for improper physician payments

On Behalf of | Oct 13, 2022 | False Claims Act, Medicare / Medicaid Fraud, Qui Tam Cases

The pharmaceutical company Biogen Inc. out of Cambridge, Massachusetts, agreed to pay $900 million to settle allegations that the company caused false billing submissions to Medicare and Medicaid. The company was accused of paying illegal kickbacks to doctors who prescribed its drugs to patients. The Department of Justice announced the settlement on September 26.

The qui tam lawsuit was filed by former Biogen employee, relator and whistleblower Michael Bawduniak, who litigated the case on behalf of the United States. Filed in the District of Massachusetts, the relator complaint alleged that the kickbacks involved Biogen’s multiple sclerosis medications Avonex, Tysabri and Tecfidera.

The alleged misconduct

Between January 1, 2009, to March 18, 2014, Biogen offered and paid remuneration to doctors in the form of speaker honoraria, speaker training fees, consulting fees, and money for meals. The doctors attended or presented at Biogen’s speaker programs. While this was not a basic cash payment, it still violates the federal government’s Anti-Kickback Statute, which prohibits offering or paying anything of value for the referral of business that is subsequently reimbursed by federal health care programs.

“The relator diligently pursued this matter on behalf of the United States for over seven years,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The settlement announced today underscores the critical role that whistleblowers play in complementing the United States’ use of the False Claims Act to combat fraud affecting federal health care programs.”

Bawduniak gets about 29.6% ($266,400,000) of the federal proceeds from the settlement that pays $843,805,187 to the United States and $56,194,813 to 15 states.