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November 27, 2019

Former nurse at Derby business avoids prison in kickback scheme

PHOTO | New Haven Biz U.S. District Court in New Haven
By Michelle Tuccitto Sullo

A nurse who formerly worked at the Comprehensive Pain and Headache Treatment Center in Derby was sentenced Tuesday to three years of probation for her role in a kickback scheme involving fentanyl spray prescriptions.

U.S. District Court Judge Janet Bond Arterton imposed the sentence on Heather Alfonso, 46, now a South Carolina resident, in a proceeding in New Haven.

According to the U.S. Attorney’s office, Alfonso’s conduct resulted in Medicare losing $2.5 million. Arterton ordered Alfonso to pay restitution.

Alfonso previously pleaded guilty to one count of receiving kickbacks in relation to a federal health-care program.

According to federal prosecutors, at the time of the offense, Alfonso worked as an advanced practice registered nurse (APRN) at the Derby facility. She prescribed Subsys, a fentanyl-based sublingual spray that was approved by the Food & Drug Administration solely for the management of breakthrough pain in cancer patients. 

Insys Therapeutics, an Arizona-based pharmaceutical company, manufactured and sold the drug. 

Alfonso drew the attention of investigators when a Medicare Part D review revealed she was responsible for approximately $2.5 million in claims and was the highest prescriber of Subsys in Connecticut, according to the U.S. Attorney’s office.

Investigators interviewed Alfonso’s patients, and most did not have cancer, but took the drug to treat chronic pain. Medicare and most private insurers do not cover Subsys for patients who don’t have cancer.

Arterton, when sentencing Alfonso, cited her acceptance of responsibility and cooperation with the government’s prosecution of others involved in the scheme.

Alfonso’s defense attorney, Ryan McGuigan of Hartford, had asked for leniency in a pre-sentencing memorandum to the court. 

According to McGuigan, his client was terminated from her job after her arrest, and she had to surrender her nursing license. He noted she had no prior criminal history and is “remorseful.”

“She has gone further than expressions of regret and swift acceptance of responsibility, by actively assisting the government in its efforts to bring to justice those higher up the ladder who committed wrongdoing,” McGuigan wrote, in the document.

He further noted that she has lost her vocation and likely will never earn a comparable livelihood again. 

According to McGuigan, because of her “greed,” Alfonso has gone from making $100,000 a year to “being banished from her profession.”

According to the U.S. Attorney’s office, Insys Therapeutics representatives induced medical practitioners to prescribe Subsys by paying them to participate in sham “Speaker Programs.” Between 2013 and 2015, Insys Therapeutics paid Alfonso approximately $83,000 to act as a “speaker” for more than 70 dinner programs. In many instances, the dinner programs were attended only by Alfonso and an Insys Therapeutics sales representative, according to the government. 

The kickback scheme has resulted in several other charges and convictions in Connecticut and around the country. In May, a federal jury in Boston found John N. Kapoor, the founder and former executive chairman of Insys Therapeutics, and four other former Insys executives guilty of racketeering conspiracy. In June 2019, Insys Therapeutics agreed to pay a total of $225 million to resolve criminal and civil investigations of the company.

Contact Michelle Tuccitto Sullo at msullo@newhavenbiz.com

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