PROVIDENCE – Dr. Jerrold N. Rosenberg, 62, of North Providence, was sentenced by U.S. District Court Judge John J. McConnell Jr. Friday to four years in federal prison for 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.
Rosenberg pleaded guilty to the charges Oct. 25. He had faced 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, he agreed to pay $754,736 in restitution.
Subsys is manufactured by Arizona-based Insys Therapeutics Inc., according to the office of U.S. Attorney Stephen G. Dambruch. The spray was approved by the 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.” As a result, many insurance companies require a diagnosis of breakthrough cancer pain before approving coverage of the drug, which costs approximately $2,000 to more than $16,000 for a 30-day supply.
At the time of his guilty plea, Rosenberg admitted to the court that between 2012 and 2015, he carried out a health care fraud scheme in which he made false representations to insurers, both private and government funded, claiming patients met the insurance criteria of having breakthrough cancer pain when he knew they in fact did not, in order to secure approvals and payment for prescriptions of Subsys. Rosenberg admitted that, in total, the health care fraud scheme resulted in losses of more than $750,000; in many cases, the cost of the drug was reimbursed, at least in part, by the Medicare program.
Additionally, Rosenberg 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 more than $188,000. In addition, according to court documents, Rosenberg’s son was a sales representative for Insys Therapeutics from June 2012 to September 2013, and made substantial amounts in commissions as a result of the defendant’s prescribing Subsys to his patients. Rosenberg admitted the speaking fees he received from Insys were a significant motivating factor in his decision to prescribe Subsys to his patients.
At Friday’s sentencing hearing, three former patients of Rosenberg testified about the severe and debilitating effects they experienced from taking Subsys. Some witnesses testified to the doctor’s indifference to their complaints and pleas to be taken off the drug.
The case was prosecuted by Assistant U.S. Attorneys Lee H. Vilker and Zachary A. Cunha.
The matter was investigated by the U.S. Attorney’s Office for the District of Rhode Island, the U.S. Department of Health and Human Services Office of Inspector General and the R.I. Department of Attorney General’s Medicaid Fraud and Patient Abuse Unit.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.