PROVIDENCE – Jerrold N. Rosenberg, 62, of North Providence, indicted in U.S. District Court in February on health care fraud and conspiring to solicit and receive kickbacks in connection with his prescribing of Subsys, a highly-addictive version of the opioid Fentanyl administered as an under-the-tongue spray, pleaded guilty to the charges Wednesday.
Rosenberg faces a combined total of 15 years in prison on the charges, and $500,000 in fines. Under the terms of a plea agreement filed with the Court, Rosenberg has agreed to the entry of a restitution order in the amount of $754,736.
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Subsys is manufactured by Arizona-based company Insys Therapeutics, Inc. The spray was approved by the U.S. Food and Drug Administration in 2012 exclusively for “the management of breakthrough cancer pain in… patients who are already receiving and who are already tolerant of opioid therapy for their underlying persistent cancer pain.” Many insurance companies require a diagnosis of breakthrough cancer pain before approving coverage of the drug, which costs approximately $2,000 to over $16,000 for a thirty-day supply, according to Acting U.S. Attorney for the District of Rhode Island Stephen G. Dambruch’s office.
Rosenberg admitted to the Court before U.S. District Judge John J. McConnell, Jr., that he participated in a healthcare fraud scheme in which he falsely and fraudulently indicated that his patients had breakthrough pain from cancer when they did not, as a means to secure insurance approvals for prescriptions of Subsys.
Rosenberg admitted that in 2012, as part of the scheme, he falsely claimed that one patient suffered from cancer pain from basal cell carcinoma. While the patient had in fact had a potential skin cancer lesion on his nose removed many years before, it had not recurred, and was wholly unrelated to his pain. Rosenberg admitted that, in total, the healthcare fraud scheme resulted in losses of over $750,000; in many cases, the cost of the drug was reimbursed, at least in part, by the Medicare program.
Rosenberg also admitted that, between 2012 and 2015, he conspired with Insys officials to receive kickbacks, in the form of purported speaker fees, from the manufacturer of the spray. Rosenberg admitted that he accepted these payments, which totaled over $188,000. In addition, according to court documents, Rosenberg’s son was a sales representative for Insys Therapeutics from June 2012 – September 2013 and made substantial amounts in commissions as a result of the defendant’s prescribing Subsys to his patients. Rosenberg admitted that the speaking fees he received from Insys were a significant motivating factor in his decision to prescribe Subsys to his patients.
“Doctors who engage in healthcare fraud violate their oaths and put greed ahead of their patients,” Deputy Attorney General Rod Rosenstein said.
“Patients trusted Dr. Rosenberg to make medical decisions based on the best available treatment, not based on speaker fees, kickbacks and other financial incentives. He violated the law and his oath as a physician to do no harm when he placed greed over patient care, thinking little of the long-term consequences of patients taking this extremely powerful, highly-addictive opioid,” said R.I. Attorney General Peter F. Kilmartin. “Our office, working with our federal, state and local law enforcement partners, is committed to rooting out fraud and abuse in our healthcare system.”
Rosenberg is scheduled to be sentenced on Jan. 16, 2018. The statutory maximum sentence with respect to the healthcare fraud scheme is up to 10 years imprisonment; a maximum sentence of five years imprisonment on the charge of conspiracy to accept kickbacks, followed by up to three years of supervised release and a fine of up to $250,000 on each charge.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
