Doctor got paid to peddle needless drug to dementia patients in Alabama, feds say
More than half of all Medicare claims submitted from the state of Alabama in 2015 for a drug that treats involuntary laughing or crying belonged to a single geriatric psychiatrist in Tuscaloosa, according to federal court filings.
That’s because he was getting paid to prescribe it, the government said.
Dr. Charles T. Nevels, who works in several Alabama nursing homes, was accused of violating the False Claims Act by billing Medicare and Medicaid for the prescription drug Nuedexta on behalf of patients who didn’t need it — namely those with dementia — the U.S. Attorney’s Office in the Northern District of Alabama said in a news release.
The FCA bars individuals from knowingly submitting fraudulent claims to the federal government for payment.
“The Department of Justice will fight to protect nursing home residents, including by ensuring that prescribing decisions affecting them are free from undue influence, and the medications they receive are medically appropriate for them,” U.S Attorney Prim F. Escalona said in the release.
Nevels could not be reached for comment by McClatchy News, and information regarding his attorney was not immediately available as of Feb. 4.
The civil lawsuit centers on the drug Nuedexta, which is used to treat pseudobulbar affect, or PBA. PBA is a neurological condition that often manifests itself as “episodes of sudden uncontrollable and inappropriate laughing or crying,” according to the Mayo Clinic. It’s sometimes mistaken for a mood disorder.
Anywhere from 2 to 7 million people in the U.S. have PBA, the Cleveland Clinic said, and it has been associated with Alzheimer’s and other forms of dementia.
Nuedexta is not, however, approved to treat Alzheimer’s and dementia, the government said, nor has it been shown to be a “safe and effective” method of treatment.
The allegations against Nevels tie into a larger False Claims Act suit against California-based Avanir Pharmaceuticals, which manufactures Nuedexta. Avanir agreed to settle the case for $95 million in 2019 after the government accused it of “false and misleading marketing” that involved pushing long-term care facilities to prescribe Nuedexta to dementia patients.
Nevels has been practicing medicine for more than 30 years, according to court documents, and has contracted with local nursing homes and long-term care facilities since the early 2000s.
In 2011, Nevels met a sales representative for Nuedexta who nominated him to become a speaker for the drug’s manufacturer. In reality, the government said, the speaking engagements were a cover for kickbacks Nevels received to prescribe Nuedexta.
It started with Nevels receiving “valuable patient referrals” for prescribing Nuedexta. According to the complaint, a sales representative would come to the facilities where he worked and persuade the staff to refer Nevels patients, particularly those with dementia.
The sales representative reportedly told company executives that Nevels said “he has no problem writing Nuedexta for any resident that is put in front of him, he just needs the names to see them.”
By 2015, Nevels had entered a lucrative contract with Avanir to give regular “presentations” about Nuedexta, the government said. He reportedly received more than $400,000 over the next four years to give roughly 178 presentations — some of which had no one in the audience.
On top of those fees, the government said, Nevels got $36,000 to cover “expenses” related to giving the presentations.
In the meantime, the number of Nuedexta prescriptions signed by Nevels was skyrocketing. Of the $1.3 million Medicare paid in 2015 for Nuedexta prescriptions in Alabama, $740,000 came from patients treated by Nevels, according to the complaint.
His share of all Nuedexta prescriptions for Medicare beneficiaries in the state of Alabama accounted for 20% between 2015 and 2019. All while Alabama had “more Nuedexta prescriptions written per Medicare beneficiary then almost every other state or territory,” the government said.
According to the complaint, the government ultimately paid more than $800,000 for Nuedexta prescriptions on behalf of Nevels’ patients.
This story was originally published February 4, 2022 at 5:56 PM with the headline "Doctor got paid to peddle needless drug to dementia patients in Alabama, feds say."
