Deferred Prosecution Agreement

Compliance News in Review, July 14, 2016

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The Serious Fraud Office has its second application for a DPA approved, CMS solicits feedback, and experts are dismissed from an advisory panel due to perceived conflicts.

It’s hot, it’s humid, and the editorial staff at the New Jersey AND Georgia offices of the Compliance News in Review is already desperately seeking safety from the sun’s intense rays. The dog days of summer have arrived with gusto. If you’re looking for a good reason to spend a few more minutes in the comfortable confines of an air conditioned office or home, we suggest a deep dive into the cool waters of this edition of the CNIR, and all of the compliance news fit to blog.

Deferred Prosecution Agreements (DPAs) seem to be no sweat for the Serious Fraud Office (SFO). The agency has had its second application for a DPA approved in a case that involves violations of the UK Bribery Act. The company involved agreed to pay $8.48 million in fines and disgorgement. It must also report annually on its third-party intermediary transactions and compliance programs, and continue to cooperate with the SFO. The DPA remains in effect until 2020, but it may be terminated in 2018 if the company meets its financial obligations by then.

The Centers for Medicare and Medicaid Services (CMS) is basking in the Sunshine these days. In the proposed 2017 Physician Fee schedule, the agency solicited feedback for a number of questions related to the Open Payments program. The questions cover record retention, issues related to teaching hospitals, and the nature of payment categorization. Of particular note, the agency is seeking feedback about the benefits of pre-vetting payments with covered recipients and issues related to uploading data to Open Payments.

In an indication that their relationships with industry were a little too hot to handle, several experts have been removed from a panel that is responsible for advising the FDA about painkillers. The panel was created by the National Academies of Science, Engineering and Medicine, a larger advisory group to the FDA. The removal of the panel members appears to have been spurred by a letter Senator Ron Wyden sent to the Academy of Medicine complaining that some panelists had received support (in the form of grants) from pharmaceutical companies. One panelist, Dr. Mary Lynn McPherson, says the support in question did not go to her directly, it went to the university where she is on staff, and was in the form of unrestricted grants so the pharmaceutical companies never had input on how the money was used. Another of the dismissed panelists, Dr. Gregory Terman, says he was removed because the nonprofit group he heads received funding from several pharmaceutical companies. Terman says his association with the nonprofit was well known, and he has gone out of his way to avoid conflicts of interest.

The last story serves as a reminder that much of the data regarding the relationship between healthcare professionals and the industry is presented with little context as to the nature and reasons for the payments. HCPs are understandably sensitive about receiving certain transfers of value, and they have questions about how those TOVs are disclosed. Your transparency training should remind learners that they need to be sensitive about these concerns, and educate them on the proper protocol for addressing HCP questions about data.

With that, we close this mid-summer edition of the Compliance News in Review. Stay compliant and stay cool.

Compliance News in Review, April 13, 2016

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Industry companies in Canada announce plans to voluntarily disclose payment data. Massachusetts institutes new disclosure requirements, the DOJ offers smaller penalties in exchange for self-reporting, an administrative court in France recommends the provision for allowing DPAs be removed from bribery legislation, and Shionogi receives a warning letter for a co-pay coupon.

April showers bring May flowers, and outside the News in Review offices, we’re already feeling the brunt of that whimsical rhyme. But, the bright colors and fragrant blooms are just around the bend, so we’ll tolerate a bit of turbulent transitional weather for the opportunity to soon enjoy nature’s bountiful beauty. In the meantime, after you dry out the umbrellas and shake off the cold rain, we offer the latest in the compliance news fit to blog, with this edition of the Compliance News in Review.

There’s only Sunshine on the horizon in Canada. Ten of the country’s top drug firms plan to voluntarily disclose aggregate physician and healthcare organization payment data. The movement was started by GSK Canada, and they were joined by other multinational firms including, Abbvie, Purdue, BMS and Lilly. Canada’s industry trade organization praises the initiative. Critics claim the plan will yield no meaningful information, and are pressuring Canadian lawmakers to pass a U.S.-style Sunshine Act.

New disclosure requirements are blooming for physicians in Massachusetts. The state’s Medical Society is now requiring its members to disclose financial ties to industry, including the receipt of free goods or services from companies, when they post information or review a medical procedure or service on the Internet. The requirement comes as a result of growing concern about physicians promoting treatments on social media platforms.

Could a respite from the bribery enforcement storm be on the horizon? The Department of Justice announced a one year pilot program for companies to self-report violations of the FCPA, in exchange for reduced penalties. Under the program, companies that self-report and take steps to remediate identified problems will be eligible for significantly lower fines. The head of the agency’s fraud unit says the program draws a line between companies that self-report and those that cooperate once violations are identified by the DOJ.

There’s a light rain falling on France’s new anti-bribery efforts. The country’s highest administrative court has recommended removal of the provision for Deferred Prosecution Agreements in foreign bribery legislation. The recommendation did not come as a surprise, considering the calls from numerous organizations to remove the provision.

A co-pay coupon brought out the dreary side of the FDA for Shionogi. The company received a warning letter for omitting risk information on a co-pay coupon for a drug approved to treat lice. The FDA says the coupon touted the efficacy of the product without stating any of the risks. The coupon did provide the website addresses where consumers could read the full prescribing information but the letter claims that is not enough to address the full risk information requirement.

The FDA’s position on truthful off-label statements has been the focus of recent headlines. Ensuring that colleagues are trained on the requirements related to promotional statements is critical. According to a study, the FDA cited omission of risk in 60% of the untitled and warning letters that were issued between 2013 and 2015. You can read about our observations on those letters here. Everything from press releases to statements made by hired speakers is subject to FDA oversight, providing training to all who are in a position to make promotional statements is important.

Well, that’s the news for now. We look forward to seeing you, rain or shine, for the next edition of the Compliance News in Review.

Compliance News in Review, March 8, 2016

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A bill is introduced in the Senate to end DTC advertising, Endo settles with New York over alleged marketing violations, and Olympus settles multiple False Claims Act, Anti0kickback, and FCPA charges.

March has certainly roared in like a lion, but will it go out like a lamb? Or will it go out more like a Blue Devil, a Jayhawk, a Cardinal, or a Wolverine? March Madness is almost here, so rise up bracketologists! Whether you employ a highly-scientific method for filling out your brackets, or you make your picks based on which team colors, it’s time to put pen to paper (or fingers to keyboard) and make you selections official. Before you get completely engrossed in what sixteen seed might have a shot at the huge upset in the first round, let’s take a look at what has dribbled through the newswires lately, as we tip off on this edition of the Compliance News in Review.

Senator Al Franken is the latest to join the “Ban DTC Advertising” team. The Senator has introduced a bill that would end the DTC advertising tax break for drug companies. Franken argues the costs of the ads are increasing the costs of drugs, and they encourage consumers to seek new, expensive medications, over cheaper alternatives. A spokesperson for PhRMA said the legislation “ignores the value of information patients about their health care and treatment options,” and it may have the unintended consequence of a patient not seeking medical attention for chronic conditions that can be managed more cost effectively when treatment begins early.

Endo has resolved a marketing foul with the state of New York. The company reached a settlement with the State over its marketing of an opioid pain medication. According to the state’s Attorney General, Endo claimed its painkiller, Opana ER, was crush resistant and it underplayed the addictive nature of the drug. The AG said the misleading marketing led to increased sales of the drug because it created a “false sense of security.” The company agreed to pay $200,000 and to cease marketing the drug as crush resistant. Additionally, Endo must create a program to keep its sales team from promoting the drug to healthcare providers who may be prescribing it in an abusive manner.

Olympus Corporation of the Americas (OCA), has agreed to pay $646 million to settle criminal and civil charges related to violations of the False Claims Act, the federal Anti-kickback Statue and the FCPA. The endoscope maker was accused of paying kickbacks in the form of consulting payments; free endoscopes; travel; meals; and grants. The company will pay $312 million to settle charges of paying kickbacks and $310 million to resolve the False Claims Act charges. The company’s Latin American subsidiary is accused of making payments to healthcare providers working in government-owned hospitals in Central and South America in order to secure business. The company will pay $22.4 million to resolve charges it violated the FCPA and it has entered into a three year Deferred Prosecution Agreement (DPA) and a Corporate Integrity Agreement (CIA). The DPA requires the establishment of a confidential hotline, improvements to the compliance training and the establishment of a program to recoup executive performance pay for those who participate in misconduct or fail to promote compliance. The CIA requirements include the implementation of a healthcare code of conduct; specific training and education; and requirements around grants and charitable contributions, consulting arrangements, and travel expenses.

The DOJ noted in its press release about the Olympus settlement that “the criminal complaint alleges that the improper payments happened while Olympus lacked training and compliance programs.” A “subpar compliance program,” was also noted by prosecutors in the recent SciClone FCPA case and the Sweett Group UK Bribery Act case. Regular and effective training is a key element of any effective compliance program, and helps reduce the risk of violations. While laws such as the False Claims Act of the FCPA may not change often, training on these laws cannot be conducted in a “one and done” manner. It should be reviewed and refreshed regularly, and highlight real-world examples applicable to the industry to keep it relevant and fresh.

With that, the buzzer has sounded on this edition of the Compliance News in Review. If you have a rooting interest, good luck to your team(s) in the upcoming tournament.

Stay compliant and we’ll see you right back here for the next edition