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Analysis

Pain Management Doc Allegedly Took Bribes, Kickbacks to Prescribe Fentanyl

By John Commins  
   June 26, 2019

Sun allegedly received $140,000 in bribes and kickbacks from Insys Therapeutics in exchange for prescribing more than 28 million micrograms of Subsys.

A pain management physician has been indicted for allegedly taking more than $140,000 in bribes and kickbacks from the drug maker Insys Therapeutics in exchange for prescribing the company's fentanyl product.

Kenneth Sun, MD, 58, of Easton, Pennsylvania, was arrested Tuesday and charged with one count of conspiracy to defraud the federal government and four counts of receiving health care kickbacks, the Department of Justice said.

A trial date has not been set.

Sun was the owner of Progressive Pain Solutions, LLC, a pain management medical practice with clinics in Phillipsburg, New Jersey, and Wind Gap, Pennsylvania.

According to the indictment, Sun allegedly asked for and got more than $140,000 in bribes and kickbacks from Arizona-based Insys Therapeutics in exchange for prescribing more than 28 million micrograms of Subsys, a fast-acting and expensive opioid that is sprayed under a patient's tongue.

Subsys, which costs thousands of dollars for a month's supply, contains fentanyl, a synthetic opioid pain reliever which is much more potent than morphine, DOJ said.

The Food and Drug Administration approved Subsys only for the "management of breakthrough pain in cancer patients who are already receiving and who are tolerant to around the clock therapy for their underlying persistent cancer pain," DOJ said.

The indictment alleges that Sun prescribed Subsys to patients for whom the drug was medically unnecessary, and for whom the drug was not covered by insurance. In some cases, the drug was prescribed to patients who didn't want it, DOJ said. 

The bribes and kickbacks that Sun allegedly received from Insys Therapeutics were disguised as "honoraria" for "sham" Subsys educational presentations, DOJ said.

The indictment said that the presentations were often held in upscale restaurants, attended by the same people, most of whom were not licensed clinicians, and that in some cases Sun did not even attend the presentations.

The end result of the scheme was that Sun's allegedly bogus prescribing of Subsys caused Medicare to pay more than $847,000 for a drug that was medically unnecessary, procured illegally, and not eligible for Medicare reimbursement, the indictment said. 

Several people affiliated with Insys and medical practitioners involved in the kickback scheme already have been charged and convicted in Connecticut and other states. 

On Tuesday, a federal judge in Connecticut on sentenced the wife of Insys CEO Michael Babich to five years of probation for her role in the company's widespread kickback scheme.

Natalie Devine, 35, of Scottsdale, Arizona, worked for Insys in 2013 and 2014, as a sales rep in New England. She pleaded guilty last year to one count of conspiracy to violate the Anti-Kickback Law.

Babich pleaded guilty in January to federal conspiracy and fraud charges stemming from the scheme. He awaits sentencing.

On May 2, Insys founder John N. Kapoor and four other former Insys executives were found guilty of racketeering conspiracy.

Earlier this month, Insys Therapeutics agreed to pay a $225 million to resolve criminal and civil investigations of the company. The company filed for bankruptcy protection on June 10.

 

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

Sun allegedly prescribed Subsys to patients for whom the drug was medically unnecessary, and for whom the drug was not covered by insurance. 

The bribes that Sun allegedly received from Insys were disguised as 'honoraria' for 'sham' Subsys educational presentations.

In a related case, Natalie Devine, the wife of Insys CEO Michael Babich, was sentenced on Tuesday to five years of probation for her role in the multistate scheme.


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