Kickbacks and Co-pays: Ex-BioTek Boss Faces Fed Health Care Program Ban

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PHILADELPHIA, PA — The former Chief Marketing Officer of BioTek reMEDys Inc., Carla Sparkler, has found herself at the epicenter of a nationwide scandal. The United States Attorney Jacqueline C. Romero divulged on Friday that Sparkler has made an agreement to resolve allegations accusing her of violating the False Claims Act. How, you ask? By allegedly paying unlawful kickbacks to both patients and physicians.

This bold move was allegedly designed to keep the Delaware-based healthcare company’s revenue stream intact and flourishing. But the cost was to be a six-year ban for Sparkler from any federal healthcare program, including the most prominent one, Medicare.

To understand this convoluted narrative, here are the basics: when a Medicare beneficiary gets a prescription drug covered by Medicare, he or she might have to make a partial payment, known as a “copay”. The federal Anti-Kickback Statute forbids offering, paying, soliciting, or accepting anything of value to make a referral for services or items payable by a federal health care program. The law also extends to any company habitually waiving copays of Medicare patients without any financial need determination.

Here lies the crux of the matter: between August 2015 and May 2020, BioTek, under Sparkler’s leadership, allegedly routinely waived the copayments of patients. Why? To coax them into buying their specialty drugs and services. BioTek’s high-end drugs were pricey and asked patients for significant copays. To bypass this obstacle, Sparkler is accused of masterminding a scheme to regularly waive these large copays without considering whether the patients had financial hardship.

But waiving copays wasn’t the only accusation on Sparkler’s record. She also allegedly provided remuneration – in the form of gifts, dinners, free support services – to physicians, especially Pennsylvania neurologist Dr. David Tabby, to motivate them to refer patients to BioTek. Dr. Tabby is accused of knowingly soliciting and accepting these kickbacks in exchange for patient referrals.

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While Sparkler is being held accountable, she is not the only one paying for this alleged deceit. Dr. Tabby has paid $480,000 to settle these accusations, and BioTek, with its chief executive officer, Chaitanya Gadde, has agreed to cough up a whopping $20 million to resolve allegations of their violation of the False Claims Act.

US Attorney Romero of the Eastern District of Pennsylvania notes, “BioTek’s alleged scheme, orchestrated and implemented by Sparkler to routinely waive copays ensured a steady revenue stream for BioTek and undermined patient care.” The EDPA promises to continue its vigilance against corrupt healthcare practices.

In addition to the six-year exclusion from federal health care programs, the settlement resolves allegations that Sparkler architected BioTek’s scheme to provide kickbacks, particularly by improperly waiving copays, to encourage physicians to use its services, says U.S. Attorney David C. Weiss for the District of Delaware.

This tale of healthcare fraud serves as a stark reminder of the importance of integrity within our healthcare system. The case highlights the government’s determined focus on combating healthcare fraud. Sparkler’s case underlines the administrative will to punish those who, for personal gain, violate established federal healthcare program rules and thereby raise costs for everyone while doing a great disservice to their patients.

Please be aware that the assertions made by the United States are merely allegations, and no liability has been established.

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