The U.S. Attorney’s Office has reached a $3.5 million settlement with specialty pharmacy Advanced Care Scripts, Inc, to resolve allegations that ACS conspired with pharmaceutical manufacturer Teva Neuroscience, Inc. to enable Teva to pay kickbacks to Medicare patients taking Copaxone, a Teva drug approved for treatment of multiple sclerosis.

When a Medicare beneficiary obtains a prescription drug covered by Medicare Part B or Part D, the beneficiary may be required to make a partial payment, which may take the form of a co-payment, co-insurance, or deductible. These co-pay obligations may be substantial for expensive medications.

Congress included co-pay requirements in these programs to encourage market forces to serve as a check on health care costs, including the prices that pharmaceutical manufacturers can demand for their drugs.

The Anti-Kickback Statute prohibits pharmaceutical companies from offering or paying, directly or indirectly, any remuneration – which includes money or any other thing of value – to induce Medicare patients to purchase the companies’ drugs.

Advanced Care Scripts served as a contracted vendor for Teva and provided, among other things, benefits investigation services to certain patients who had been prescribed Copaxone. As part of the settlement, the company acknowledged certain facts.

Advanced Care Scripts knowingly enabled a large pharmaceutical manufacturer to pay kickbacks to Medicare patients taking its expensive drug. Prosecutors say that such conduct undermined the Medicare program’s co-pay structure, which Congress created as a safeguard against inflated drug prices.

“Advanced Care Scripts (ACS) willingly served as a pawn in a kickback scheme, putting profit over patient needs, by helping Teva to time its foundation payments to boost sales of Teva’s own drug, which ACS then dispensed,” said Joseph R. Bonavolonta, Special Agent in Charge of the FBI Boston Division.