If your viscosupplement supplier is offering products at impossibly low prices, be wary. It could be a sign the supplier is illegally reimporting the medications. That means you may not seek reimbursement from a government payer (such as Medicare or Medicaid) for injecting them.
Three orthopedic clinics in California and Nevada learned that lesson the hard way and will be paying hundreds of thousands of dollars each to settle state and federal False Claims Act allegations that they improperly billed federal health care programs for the supplements, according to the Department of Justice (DOJ).
The clinics “knowingly purchased deeply discounted viscosupplements that were reimported from foreign countries and billed them to state and federal health care programs in order to profit from the reimbursement system, when such reimported viscosupplements were not reimbursable by those programs,” the DOJ states.
The government takes a dim view of reimported products, in part because they lack assurances that they had not been tampered with, or that they were stored appropriately, according to the DOJ.
“Medicare will not put the health of its beneficiaries at risk by paying for items that have been ‘reimported’ to this country by foreign suppliers,” said HHS Office of Inspector General Special Agent in Charge Steven J. Ryan in the DOJ release. “Once a product leaves the U.S., there is no accountability for whether it is the actual medication being billed, whether it has been properly stored or whether it could be too old to be useful. We will vigorously pursue providers who use and bill for these substances.”
As a result of their settlements, Orthopedic Associates of Northern California in Chico will pay $815,794, San Bernardino Medical Orthopaedic Group Inc. in Redlands, Calif., will pay $971,903, and Reno Orthopaedic Clinic in Reno, Nev. will pay $602,335.
The case was originally brought as a
qui tam lawsuit by an employee at Sanofi S.A., which manufactures the viscosupplement Synvisc.