- A federal jury has convicted Rita Luthra, a Springfield, Massachusetts-based gynecologist, of a criminal HIPAA violation and obstructing a criminal healthcare investigation, US Department of Justice (DoJ) announced April 30.
DoJ alleged that Luthra allowed a sales representative from drug company Warner Chilcott to access protected health information (PHI) in her patients’ medical files and later provided false information to federal agents when interviewed about her relationship with Warner Chilcott.
The HIPAA violation charge carries a sentence of up to one year in prison and/or a fine of $50,000 and one year of supervised release. The obstruction charge carries a penalty of up to five years in prison, a fine of $250,000, and three years of supervised release.
Stephen Spelman, Luthra’s attorney said that US District Judge Mark Mastroianni would consider an appeal of the verdict on May 16.
“The prosecution and conviction of this physician serve as a stark reminder to all health care providers that HIPAA is more than just a privacy and security framework: it also establishes criminal liability for wrongful disclosures of individually identifiable health information,” commented Conor Duffy, a data privacy and security attorney with Robinson+Cole.
“The case also emphasizes that the DoJ continues to scrutinize pharmaceutical marketing practices and physician-manufacturer interactions that can affect health care decision-making,” Duffy added.
The prosecution of Luthra stems from a DoJ probe into Warner Chilcott’s marketing practices. In 2015, the DoJ reached a $125 million settlement with the company in which it pled guilty to felony healthcare fraud. The company received a $22.94 million criminal fine and a $102.1 million civil fine, of which $91.5 million went to the federal government and $10.6 went to the Massachusetts state government.
DoJ alleged that the company paid kickbacks to physicians to get them to prescribe its drugs, manipulated prior authorizations to induce insurance companies to pay for prescriptions of osteoporosis drug Atelvia, and made unsubstantiated marketing claims about the osteoporosis drug Actonel.
In addition, two former district managers, Jeffrey Podolsky and Timothy Garcia, pled guilty to conspiracy to commit health care fraud and HIPAA violations. A third former district manager, Landon Eckles, was criminally charged for alleged HIPAA violations.
The company’s former president, W. Carl Reichel, was acquitted of charges that he conspired to pay kickbacks to physicians.
“Placing financial gain above the legitimate needs of patients is deplorable,” said HHS Inspector General Daniel R. Levinson. “Paying kickbacks and even providing instructions on how to defraud Medicare are practices that will not be tolerated.”
“Doctors’ medical judgment should be based on what is best for the patient, and not clouded by expensive meals and other pharmaceutical company kickbacks,” said then US Attorney Carmen M. Ortiz for the District of Massachusetts.
“Pharmaceutical company executives and employees should not be involved with treatment decisions or submissions to a patient’s insurance company. Today’s enforcement actions demonstrate that the government will seek not only to hold companies accountable but will identify and charge corporate officials responsible for the fraud,” Ortiz said.
The prosecution of Luthra stemmed from that investigation. The DoJ alleged that the gynecologist accepted around $23,500 from Warner Chilcott for speaking at “medical education events” that actually took place in her office and were only attended by a company sales representative, who sat there for 30 minutes and provided food. The fees were provided to induce Luthra to prescribe more Warner Chilcott drugs.
Warner Chilcott also worked with the physician and her assistant in preparing the prior authorization paperwork for insurance companies to cover prescriptions for the company’s brand name drugs. Because of this cooperation, HHS agents interviewed the physician about whether she shared patients’ confidential medical information with the drug company.
Luthra denied sharing confidential patient information and told her assistant to tell the HHS agents the same thing. She allegedly told the assistant that there could be hefty fines for both of them for violating HIPAA.