Warner Chilcott managers sentenced for HIPAA violations

HIPAA document

Three former sales managers at Warner Chilcott were sentenced for using protected patient information to obtain prior authorization for osteoporosis drugs as part of a scheme to increase sales.

The three managers told members of the sales team to access protected health information in order to obtain prior authorization for Atelvia and Actonel, two osteoporosis drugs that weren’t covered by most insurance companies at the time, according to an announcement from the Massachusetts U.S. Attorney’s Office.

One manager instructed his team to use false clinical justifications on the prior authorization forms in an effort to ensure insurance companies would approve coverage. Another sales leader from the Rockaway, New jersey-based drug marketer instructed staff members to ensure that medical charts in physicians’ offices were flagged with Atelvia brochures.

All told, private and public payers spent at least $200,000 on Atelvia and Actonel prescriptions linked to the fabricated prior authorization forms. All three managers--who received bonuses ranging from $60,000 to $100,000--avoided jail time, but now face probation, house arrest, and nearly $70,000 in fines as part of the sentencing.

The sentencing comes almost a year after Warner Chilcott agreed to pay $125 million in civil and criminal fines for paying kickbacks to physicians to prescribe certain medications, and several months after the company’s former president was acquitted of allegations of overseeing the kickback scheme.