Assistant Attorney General for the Justice Department's Civil Division Tony West said Amersham Health Inc. violated the False Claims Act by causing Medicare to overpay for Myoview, a radiopharmaceutical used in certain cardiac diagnostic imaging procedures.
Nuclear pharmacies mix the powder with a radioactive agent to prepare individual doses that are injected into patients as part of the cardiac imaging procedures.
Certain Medicare payment rates for Myoview were based, in part, on the number of doses available from vials of Myoview. Prosecutors allege Amersham Health provided false or misleading information to Medicare regarding the number of doses available from vials, causing Medicare to pay artificially inflated prices for Myoview.
"It's important for drug manufacturers to provide accurate pricing information to Medicare so that taxpayers aren't overcharged for medicines purchased with their dollar," West said in a statement.
The allegations arise from a lawsuit that was brought under the whistle-blower provisions of the False Claims Act, which permit private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery.
Whistle-blower James Wagel received $5.1 million from the government's recovery.