The Wall Street Journal: Anthem sues Insys, claiming fraud over fentanyl reimbursements

Health-insurer Anthem Inc. has filed a civil suit alleging that drugmaker Insys Therapeutics Inc. engaged in “fraudulent schemes” to secure reimbursement for the company’s fentanyl painkiller Subsys.

The suit, filed Wednesday in federal court in Arizona, alleges that Insys INSY, +3.40% bribed doctors and lied to Anthem ANTM, -0.51% about patients’ diagnoses to win reimbursement for prescriptions that wouldn’t have been covered otherwise.

Anthem alleges that as a result of the fraud, it paid in excess of $19 million for Subsys prescriptions that shouldn’t have been reimbursed. A spokeswoman for Insys didn’t immediately respond for comment.

Anthem, based in Indianapolis, is seeking unspecified compensatory and punitive damages to be determined at trial, as well as an injunction barring Insys from continuing to engage in the alleged fraudulent conduct.

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