Elizabeth Gurrieri, former manager of reimbursement services at Insys, was charged in a criminal complaint filed in Boston. As the leader of a special “reimbursement unit” at Insys, Ms. Gurrieri instructed staff to lie to insurers to get prior authorizations to cover the costs of Subsys, a drug prescribed to cancer patients to manage breakthrough pain, according to the article.
Reimbursement unit staff pretending to work for prescribing physicians would call insurance companies and claim patients had breakthrough pain. To make sure patients qualified to try Subsys, the Insys employees would also fraudulently tell insurers patients had a cancer diagnosis and list off medications that failed to work for patients in the past, according to the report.
According to C-HIT, Insys has denied any wrongdoing in the marketing and sale of Subsys.
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