Former CT Woman Sentenced In Medicare Fraud Scheme

NEW HAVEN, CT — A South Carolina woman was recently sentenced in New Haven Superior Court to three years of probation for her part in a kickback scheme related to fentanyl spray prescriptions, according to a statement from federal prosecutors.

Heather Alfonso, 46, formerly of Connecticut, was employed as an Advanced Practice Nurse at Comprehensive Pain and Headache Center in Derby. As part of her practice, Alfonso prescribed various controlled substances, including Subsys, a fentanyl-based spray approved by the Food and Drug Administration solely for the management of breakthrough pain in cancer patients.

A review of Medicare Part D prescription drug records showed that Alfonso was responsible for approximately $2.5 million in claims for Subsys and was the highest prescriber of the drug in Connecticut, according to the statement.

Alfonso’s conduct resulted in a loss to Medicare of more than $2.5 million. She was ordered by the court to pay full restitution along with other defendants convicted in this scheme.

Interviews with several of Alfonso’s patients, who were Medicare Part D beneficiaries and were prescribed Subsys, revealed that most of them did not have cancer, but had taken the drug to treat their chronic pain, according to the statement.

An investigation revealed that the drug manufacturer's representatives were inducing medical practitioners around the country to prescribe Subsys over other similar medications by paying the medical practitioners to participate in hundreds of sham “Speaker Programs.”

Between approximately January 2013 and March 2015, Subsys' manufacturer, Inys Therapeutics, paid Alfonso approximately $83,000 to act as a “speaker” for more than 70 dinner programs.

Several other people across the country have been charged in connection with the kickback scheme. In June 2019, Insys Therapeutics agreed to pay a total of $225 million to resolve criminal and civil investigations of the company.