Kaleo, a small and controversial company, agreed to pay $12.7 million to resolve allegations that it used gifts to persuade doctors to prescribe its high-priced Evzio opioid overdose antidote, which led U.S. health care programs to overpay for the treatment.
The federal government maintained that, from March 2017 through April 2020, Kaleo directed doctors to send Evzio prescriptions to certain pharmacies. In turn, the pharmacies submitted false paperwork to insurers suggesting patients had previously tried or failed less expensive alternative treatments. Kaleo also allegedly knew pharmacies dispensed its medication but did not collect co-payments from patients. And pharmacies also submitted false prior authorization requests that falsely indicated to insurers that the doctors had submitted requests.
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