Express Scripts has agreed to pay $60 million to resolve allegations by U.S. authorities that a business unit participated in a kickback scheme with Novartis that caused federal health care programs to pay for a medicine based on false claims, according to court documents and a regulatory filing.
The U.S. Department of Justice alleged that Novartis offered patient referrals to Accredo Health Group, which is a specialty pharmacy run by Express Scripts, in exchange for bolstering refills of Exjade, a drug used for reducing excess iron in patients who undergo blood transfusions, says the documents filed in federal court in New York.
As a result of the arrangement, which ran from 2008 through 2012, Medicare, Medicaid and other programs were defrauded, according to the documents. A spokesman for Express Scripts, which is the nation’s largest pharmacy benefits manager, says the Accredo unit did not admit to any wrongdoing.
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