USA, Hanks Vs Amgen, US Oncology Et Al

UNITED STATES DISTRICT COURT
FOR THE EASTERN DISTRICT OF NEW YORK
UNITED STATES OF AMERICA )

ex rel. [UNDER SEAL] )
) UNDER SEAL
Plaintiffs, )
) FOURTH AMENDED COMPLAINT
v. )
) Civil Action No. CV-08-3096
[UNDER SEAL] )
)
Defendants. ) (Johnson, J.)
) (Levy, M.J.)
Defendants. )
)
FILED IN CAMERA AND UNDER SEAL PURSUANT TO COURT ORDER


ex rel. [UNDER SEAL] )
) UNDER SEAL
Plaintiffs, )
) FOURTH AMENDED COMPLAINT
v. )
) Civil Action No. CV-08-3096
[UNDER SEAL] )
)
Defendants. ) (Johnson, J.)
) (Levy, M.J.)
Defendants. )
)
FILED IN CAMERA AND UNDER SEAL PURSUANT TO COURT ORDER


ex rel. DON HANKS, )
)
Plaintiffs, )
) [PROPOSED] FOURTH AMENDED
v. ) COMPLAINT
)
AMGEN, INC.; UNITED STATES ) Civil Action No. CV-08-3096
ONCOLOGY SPECIALITY, LLP; )
)
[Alabama] ) (Johnson, J.)
MONTGOMERY CANCER CENTER; ) (Levy, M.J.)
ONCOLOGY SPECIALITIES, P.C.; )
BIRMINGHAM HEMATOLOGY - )
ONCOLOGY ASSOCIATES; SOUTHEAST )
CANCER NETWORK; THE KIRKLIN )
ONCOLOGY CLINIC; RADIATION )
THERAPY ONCOLOGY, P.C.; )
NORTHWEST ALABAMA CANCER )
CENTER; )
)
[Arizona] )
PALO VERDE HEMATOLOGY- )
ONCOLOGY, INC.; IRONWOOD CANCER )
AND RESEARCH CENTERS; DESERT )
ONCOLOGY; ARIZONA CENTER FOR )
HEMATOLOGY AND ONCOLOGY, P.C.; )
SOUTHWEST HEMATOLOGY )
ONCOLOGY; ARIZONA MEDICAL )
CLINIC; ARIZONA )
HEMATOLOGY/ONCOLOGY - )
NORTHWEST CANCER CENTER; )
)
[Arkansas] )
LITTLE ROCK HEMATOLOGY- )
ONCOLOGY ASSOCIATES; HIGHLANDS )
ONCOLOGY GROUP, P.A.; )
[Colorado] )
COLORADO HEMATOLOGY )
ONCOLOGY; LOVELAND )
HEMATOLOGY ONCOLOGY; )
)
[Connecticut] )
MEDICAL ONCOLOGY AND )
HEMATOLOGY, P.C.; ONCOLOGY )
ASSOCIATES, P.C., HEMATOLOGY )
ONCOLOGY, P.C.; EASTERN )
CONNECTICUT HEMATOLOGY AND )
ONCOLOGY; BLACK ROCK TURNPIKE )
MEDICAL GROUP, P.C.; ONCOLOGY )
ASSOCIATES OF BRIDGEPORT; )
ONCOLOGY HEMATOLOGY )
ASSOCIATES; CONNECTICUT )
ONCOLOGY GROUP; )
)
[Iowa] )
MEDICAL ONCOLOGY AND )
HEMATOLOGY ASSOCIATES; )
SIOUXLAND HEMATOLOGY AND )
ONCOLOGY; )
)
[Kansas] )
CANCER CENTER OF KANSAS; )
HUTCHINSON CLINIC; )
)
[Kentucky] )
COMMONWEALTH CANCER CENTER; )
)
[Maine] )
MAINE CENTER FOR CANCER )
MEDICINE; )
)
[Maryland] )
ONCOLOGY-HEMATOLOGY )
ASSOCIATES, P.C.; CHESAPEAKE )
ASSOCIATES; MARYLAND )
HEMATOLOGY AND ONCOLOGY; )
CENTER FOR CANCER AND BLOOD )
DISORDERS; FREDERICK )
ONCOLOGY/HEMATOLOGY )
ASSOCIATES; ANNAPOLIS MEDICAL )
SPECIALISTS D/B/A ANNAPOLIS )
ONCOLOGY CENTER; FREDERICK P. )
SMITH, M.C., P.C.; COMMUNITY )
HEMATOLOGY ONCOLOGY )
PRACTITIONERS; DAVID H. SMITH, )
M.D.; )
)
[Minnesota] )
MAYO CLINIC; NORTH MEMORIAL )
HEALTH CARE; PARK NICOLLET )
CLINIC; FAIRVIEW SOUTHDALE )
BREAST CENTER; )
)
[Mississippi] )
JACKSON ONCOLOGY ASSOCIATES, )
PLLC; HATTIESBURG CLINIC, P.A.; )
MERIDIAN ONCOLOGY ASSOCIATES, )
P.L.L.C.; )
)
[Missouri] )
WASHINGTON UNIVERSITY; ST. LOUIS )
CANCER CENTER; MERCY CANCER )
CARE; MIDWEST HEMATOLOGY )
ONCOLOGY CONSULTANTS, LTD. )
D/B/A HEMATOLOGY ONCOLOGY )
CONSULTANTS, INC.; ST. JOHNS CLINIC )
CANCER AND HEMATOLOGY; )
)
[Montana] )
HEMATOLOGY ONCOLOGY CENTERS )
OF THE NORTHERN ROCKIES; )
)
[Nebraska] )
CONSULTANTS, P.C.; NEBRASKA )
HEMATOLOGY ONCOLOGY, P.C.; )
)
[North Carolina] )
PIEDMONT HEMATOLOGY ONCOLOGY )
ASSOCIATES; SOUTHEASTERN )
MEDICAL ONCOLOGY CENTER; )
GASTON HEMATOLOGY AND )
ONCOLOGY ASSOCIATES; HANOVER )
MEDICAL SPECIALISTS, P.A.; )
NORTHWESTER CAROLINA )
ONCOLOGY AND HEMATOLOGY; )
CAROLINAS PHYSICIANS NETWORK )
d/b/a CAROLINAS HEMATOLOGY )
ONCOLOGY ASSOCIATES; NORTHEAST )
ONCOLOGY ASSOCIATES; CAROLINAS )
CANCER CARE; )
)
[North Dakota] )
MERITCARE MEDICAL GROUP D/B/A )
ROGER MARIS CANCER CENTER; )
)
[Ohio] )
ONCOLOGY HEMATOLOGY CARE, INC.; )
HEMATOLOGY ONCOLOGY OF )
DAYTON; MID-OHIO ONCOLOGY )
HEMATOLOGY; CINCINNATI )
HEMATOLOGY ONCOLOGY, INC.; )
HEMATOLOGY ONCOLOGY CENTER, )
INC.; BLOOD AND CANCER CENTER; )
COLUMBUS ONCOLOGY ASSOCIATES, )
INC.; OHIO CANCER SPECIALISTS; )
NORTHCOAST CANCER CARE; NASHAT )
Y. GABRAIL, M.D.; HOPE CANCER )
CENTER OF NORTHWEST OHIO, INC.; )
)
[Oregon] )
PACIFIC ONCOLOGY, PC; )
ASSOCIATES, P.C.; HEMATOLOGY )
ONCOLOGY OF SALEM, LLP; )
)
[Pennsylvania] )
MEDICAL CENTER CLINIC; )
CONSULTANTS IN MEDICAL )
ONCOLOGY AND HEMATOLOGY; )
ABINGTON HEMATOLOGY-ONCOLOGY )
ASSOCIATES, INC.; CANCER CARE )
ASSOCIATES OF YORK; )
PENNSYLVANIA ONCOLOGY )
HEMATOLOGY ASSOCIATES; BRYN )
MAWR MEDICAL SPECIALISTS; )
GREATER PHILADELPHIA CANCER )
AND HEMATOLOGY SPECIALISTS; )
ASSOCIATES OF NORTHEAST )
PENNSYLVANIA; CHESTER COUNTY )
HEMATOLOGY AND ONCOLOGY )
SERVICES; BUX-MON ONCOLOGY- )
HEMATOLOGY MEDICAL ASSOCIATES; )
REGIONAL CANCER CENTER; )
REGIONAL HEMATOLOGY ONCOLOGY )
ASSOCIATES; CANTOR, BIERMANN, )
FELLIN AND ASSOCIATES; )
ASSOCIATES IN HEMATOLOGY )
ONCOLOGY, P.C.; JEFFERSON )
HEMATOLOGY/MEDICAL ONCOLOGY )
ASSOCIATES; SHAH, GIANGIULIO AND )
CORMIER, M.D.S.; CANCER CARE OF )
CENTRAL PENNSYLVANIA; )
ASSOCIATES; ONCOLOGY- )
HEMATOLOGY OF LEHIGH VALLEY; )
CONEMAUGH CANCER CARE CENTER; )
HEMATOLOGY-ONCOLOGY GROUP, )
P.C.; CENTRAL PENNSYLVANIA )
HEMATOLOGY AND MEDICAL )
ONCOLOGY ASSOCIATES; MAINLINE )
ASSOCIATES AT LANKENAU )
HOSPITAL; LEHIGH VALLEY WOMENS )
CANCER CENTER; )
)
[South Carolina] )
SOUTH CAROLINA ONCOLOGY )
ASSOCIATES, P.A.; COASTAL CANCER )
CENTER; PALMETTO HEMATOLOGY )
ONCOLOGY, P.C.; CHARLESTON )
HEMATOLOGY AND ONCOLOGY; )
LOWCOUNTRY HEMATOLOGY AND )
ONCOLOGY; )
)
[South Dakota] )
SIOUX VALLEY ONCOLOGY CLINIC; )
)
[Utah] )
UTAH CANCER SPECIALISTS; CENTRAL )
UTAH CLINIC; )
)
[Washington] )
WESTERN WASHINGTON ONCOLOGY; )
NORTHWEST MEDICAL SPECIALTY; )
RANIER ONCOLOGY PROFESSIONAL )
SERVICES; WENATCHEE VALLEY )
CLINIC; CASCADE CANCER CENTER; )
COLUMBIA BASIN HEMATOLOGY )
ONCOLOGY, P.L.L.C., )
)
Defendants; )
)
)
)
UNITED STATES OF AMERICA, )
ex rel. DON HANKS, and )
STATE OF CALIFORNIA, )
)
Plaintiffs, )
)
v. )
)
REDWOOD REGIONAL ONCOLOGY; )
TOWER HEMATOLOGY ONCOLOGY )
MEDICAL GROUP; CANCER )
ASSOCIATES OF FRESNO MEDICAL )
GROUP, INC.; PACIFIC ONCOLOGY )
HEMATOLOGY ASSOCIATES, INC.; )
PACIFIC SHORES MEDICAL GROUP, )
INC.; SANTA BARBARA HEMATOLOGY- )
ONCOLOGY MEDICAL GROUP, INC.; )
THE BREAST CARE CENTER )
ONCOLOGY CENTER; EAST BAY )
MEDICAL ONCOLOGY HEMATOLOGY )
ASSOCIATES; ORANGE COAST )
ONCOLOGY; CANCER CARE )
ASSOCIATES MEDICAL GROUP, INC.; )
VENTURA COUNTY HEMATOLOGY- )
ONCOLOGY SPECIALISTS, INC.; )
VALLEY MEDICAL ONCOLOGY )
CONSULTANTS; WILSHIRE ONCOLOGY )
MEDICAL GROUP; NORTH ONCOLOGY )
GROUP; STOCKTON HEMATOLOGY )
ONCOLOGY; MEDICAL GROUP OF )
NORTH COUNTY; SOUTHBAY )
ONCOLOGY HEMATOLOGY PARTNERS; )
CANCER CARE CONSULTANTS; )
MEDICAL ONCOLOGY ASSOCIATES OF)
SAN DIEGO; HEMATOLOGY )
ONCOLOGY MEDICAL GROUP OF )
ORANGE COUNTY; VALLEY TUMOR )
MEDICAL GROUP D/B/A ANTELOP )
VALLEY CANCER CENTER; THE )
ANGELES CLINIC AND RESEARCH )
INSTITUTE; LOS PALOS ONCOLOGY )
AND HEMATOLOGY; CAPITOL )
HEMATOLOGY/ONCOLOGY; NORTH )
VALLEY HEMATOLOGY ONCOLOGY )
MEDICAL GROUP; PACIFIC )
ASSOCIATES; PALO ALTO MEDICAL )
FOUNDATION, )
)
Defendants; )
)
)
STATE OF DELAWARE, )
)
Plaintiffs, )
)
v. )
)
MEDICAL ONCOLOGY HEMATOLOGY )
CONSULTANTS, P.A., )
)
Defendant; )
)
)
DISTRICT OF COLUMBIA, )
)
Plaintiffs, )
)
v. )
)
)
)
GEORGE WASHINGTON UNIVERSITY )
MEDICAL FACULTY ASSOCIATES, INC., )
)
Defendant; )
)
)
STATE OF FLORIDA, )
)
Plaintiffs, )
)
v. )
)
FLORIDA CANCER SPECIALISTS; )
GULFCOAST ONCOLOGY ASSOCIATES; )
INTEGRATED COMMUNITY )
ONCOLOGY NETWORK, LLC.; )
ONCOLOGY HEMATOLOGY RADIATION)
CARE, LLC d/b/a ADVANCE MEDICAL )
SPECIALISTS; PALM BEACH CANCER )
INSTITUTE; HEMATOLOGY AND )
ONCOLOGY CONSULTANTS; FLORIDA )
SPECIALISTS; HEMATOLOGY AND )
ONCOLOGY ASSOCIATES OF THE )
TREASURE COAST; MID FLORIDA )
CENTERS; PASCO HERNANDO )
ONCOLOGY ASSOCIATES, P.A.; )
REGIONAL CONSULTANTS IN )
HEMATOLOGY AND ONCOLOGY; BOCA)
RATON COMMUNITY HOSPITAL, INC.; )
CANCER INSTITUTE OF FLORIDA, P.A.; )
and SOUTH FLORIDA ONCOLOGY )
HEMATOLOGY; COASTAL ONCOLOGY, )
PL; ONCOLOGY PHYSICIANS; STUART )
ONCOLOGY; NEIL FINKLER AND )
ROBERT HOLLOWAY, M.D.S.; AYUB, )
SOKOI, MATZKOWITZ AND )
SENNABAUM D/B/A NEW HOPE )
CANCER CENTER; HEMATOLOGY AND )
MEDICAL ONCOLOGY OF SOUTHERN )
)
PALM BEACH COUNTY; DAVID )
DRESDNER, M.D., )
)
Defendants; )
)
)
)
STATE OF GEORGIA, )
)
Plaintiffs, )
)
v. )
)
AMGEN, INC.; GEORGIA CANCER )
SPECIALISTS; NORTHWEST GEORGIA )
ONCOLOGY CENTERS; AUGUSTA )
ONCOLOGY ASSOCIATES; CENTRAL )
GEORGIA CANCER CARE; NORTHEAST )
GEORGIA CANCER CARE; SOUTHEAST )
GEORGIA HEMATOLOGY/ONCOLOGY; )
SOUTHEASTER GYNECOLOGIC )
ONCOLOGY; THE LONGSTREET CLINIC,)
P.C., )
)
Defendants; )
)
)
STATE OF HAWAII, )
)
Plaintiffs, )
)
v. )
)
ONCARE HAWAII, INC., )
)
Defendant; )
)
)
STATE OF ILLINOIS, )
)
Plaintiffs, )
)
v. )
)
ASSOCIATES OF CENTRAL ILLINOIS; )
PRAIRIE ONCOLOGY MANAGEMENT )
SERVICES, LLC; INTERMED )
ONCOLOGY; NORTHWEST ONCOLOGY )
AND HEMATOLOGY; NORTHWESTERN )
MEDICAL FACULTY FOUNDATION; )
JOLIET ONCOLOGY HEMATOLOGY )
ASSOCIATES, INC.; and FOX VALLEY )
HEMATOLOGY AND ONCOLOGY, LTD.; )
MEDICAL ARTS ASSOCIATES, LTD., )
NORTHSHORE ONCOLOGY- )
HEMATOLOGY ASSOCIATES, LTD.; )
EDWARD CANCER CENTER; )
ASSOCIATES IN MEDICAL ONCOLOGY, )
)
Defendants; )
)
)
STATE OF INDIANA, )
)
Plaintiffs, )
)
v. )
)
MICHIANA HEMATOLOGY-ONCOLOGY, )
INC.; HEMATOLOGY-ONCOLOGY OF )
INDIANA, P.C.; ONCOLOGY )
HEMATOLOGY ASSOCIATES OF SOUTH )
WEST INDIANA; CANCER HEALTH )
TREATMENT CENTERS, P.C.; FORT )
WAYNE MEDICAL ONCOLOGY AND )
HEMATOLOGY; AMERICAN HEALTH )
NETWORK HEMATOLOGY )
ASSOCIATES; CANCER CARE CENTER,)
INC.; ARNETT CANCER CARE; AP. AND
)
S. CLINIC, LLC; MEDICAL )
CONSULTANTS; AMERICAN HEALTH )
NETWORK; INTERNAL MEDICINE )
ASSOCIATES, )
)
Defendants; )
)
)
STATE OF LOUISIANA, )
)
Plaintiffs, )
)
v. )
)
ONCOLOGY RX; LOUISIANA )
ONCOLOGY ASSOCIATES; LOUISIANA )
ASSOCIATES, )
)
Defendants; )
)
)
COMMONWEALTH OF )
MASSACHUSETTS, )
)
Plaintiffs, )
)
v. )
)
BERKSHIRE HEMATOLOGY )
ONCOLOGY, P.C., )
)
Defendants; )
)
)
)
STATE OF MICHIGAN, )
)
Plaintiffs, )
)
v. )
)
CANCER AND HEMATOLOGY CENTERS )
OF WESTERN MICHIGAN; CANCER )
CARE ASSOCIATES; THE OAKLAND )
MEDICAL GROUP; GREAT LAKES )
CANCER MANAGEMENT SPECIALISTS; )
SINGH AND ARORA ONCOLOGY )
HEMATOLOGY, P.C.; GENESSEE )
CANCER AND BLOOD DISEASE )
TREATMENT CENTER, INC.; )
ONCOLOGY CARE ASSOCIATES; WEST )
MICHIGAN CANCER CENTER; )
MICHIGAN HEMATOLOGY ONCOLOGY, )
P.C.; HEMATOLOGY ONCOLOGY )
CONSULTANTS; and NEWLAND )
MEDICAL ASSOCIATES; ANN ARBOR )
ASSOCIATES, P.C.; GENESEE )
HEMATOLOGY-ONCOLOGY, P.C., )
)
Defendants; )
)
)
STATE OF NEW MEXICO, )
)
Plaintiffs, )
)
v. )
)
NEW MEXICO ONCOLOGY )
HEMATOLOGY CONSULTANTS, )
)
Defendants; )
)
)
STATE OF NEW JERSEY, )
)
Plaintiffs, )
)
v. )
)
MEDICAL ONCOLOGY-HEMATOLOGY )
SPECIALISTS; HEMATOLOGY- )
ONCOLOGY ASSOCIATES OF )
NORTHERN NEW JERSEY; )
HEMATOLOGY-ONCOLOGY OF )
CENTRAL NEW JERSEY; COOPER )
CANCER INSTITUTE; SOUTHERN )
ASSOCIATES, P.A.; MEDICAL )
DIAGNOSTIC ASSOCIATES; KENNETH )
D. HAHUM, M.D.; HUNTERDON )
HEMATOLOGY ONCOLOGY GROUP; )
PRINCETON MEDICAL GROUP; )
CENTRAL JERSEY ONCOLOGY )
CENTER, P.A.; ATLANTIC )
ASSOCIATES; HOPE COMMUNITY )
CANCER CENTER; HEMATOLOGY )
ONCOLOGY ASSOCIATES OF NEW )
JERSEY, )
)
Defendants; )
)
)
STATE OF NEW YORK, )
)
Plaintiffs, )
)
v. )
)
NORTH SHORE HEMATOLOGY )
ONCOLOGY ASSOCIATES, P.C.; )
BROOME ONCOLOGY; HEMATOLOGY )
ONCOLOGY ASSOCIATES OF CENTRAL )
NEW YORK, P.C.; HUDSON VALLEY )
HEMATOLOGY ONCOLOGY; QUEENS )
LONG ISLAND MEDICAL GROUP, P.C.; )
PARK SLOPE MEDICINE; BUFFALO )
MEDICAL GROUP; and CENTURY )
MEDICAL ASSOCIATES; SOUTH SHORE )
ASSOCIATES; TOMAO, MARINO AND )
MCNELIS, M.D.S. DEPARTMENT OF )
MEDICINE MEDICAL SERVICE GROUP )
AT SUNY HSC, D/B/A UNIVERSITY )
PHYSICIANS; HEMATOLOGY )
ONCOLOGY ASSOCIATES OF WESTERN )
SUFFOLK; HEMATOLOGY AND )
MEDICAL ONCOLOGY; HEMATOLOGY- )
ONCOLOGY ASSOCIATES OF )
ROCKLAND, )
)
Defendants; )
)
)
STATE OF NEVADA, )
)
Plaintiffs, )
)
v. )
)
NEVADA CANCER CENTER; CANCER )
AND BLOOD SPECIALISTS OF NEVADA, )
)
Defendants; )
)
)
STATE OF OKLAHOMA, )
)
Plaintiffs, )
)
v. )
)
OKLAHOMA ONCOLOGY AND )
HEMATOLOGY ASSOCIATES, INC. d/b/a
)
CANCER CARE ASSOCIATES; )
OKLAHOMA ONCOLOGY )
INCORPORATED, )
)
Defendants; )
)
)
STATE OF TENNESSEE, )
)
Plaintiffs, )
)
v. )
)
TENNESSEE ONCOLOGY, PLLC; THE )
WEST CLINIC; TENNESSEE CANCER )
SPECIALISTS; BOSTON BASKIN )
CANCER GROUP; KINGSPORT )
HEMATOLOGY-ONCOLOGY )
ASSOCIATES; THOMPSON ONCOLOGY )
GROUP; CHATTANOOGA ONCOLOGY )
HEMATOLOGY ASSOCIATES; and EAST )
TENNESSEE HEMATOLOGY )
ONCOLOGY ASSOCIATES; TIMOTHY )
PANELLA, M.D. D/B/A UNIVERSITY )
CANCER SPECIALISTS; WAHID T. )
HANNA, M.D., )
)
Defendants; )
)
)
)
STATE OF TEXAS, )
)
Plaintiffs, )
)
v. )
)
)
SOUTH TEXAS ONCOLOGY AND )
HEMATOLOGY ASSOCIATES; )
HOUSTON CANCER CLINIC; )
ONCOLOGY CONSULTANTS; TYLER )
HEMATOLOGY ONCOLOGY; )
METROPLEX HEMATOLOGY/ )
ONCOLOGY ASSOCIATES d/b/a )
ARLINGTON CANCER CENTER; )
SOUTHEAST TEXAS ONCOLOGY )
PARTNERS; NORTHWEST CANCER )
CENTER; and ROHIT KAPPOR, M.D., P.A.; )
TEXAS CANCER ASSOCIATES; )
UNIVERSITY OF TEXAS AT )
SOUTHWESTERN SIMMONS CANCER )
CENTER; ABILENE HEMATOLOGY- )
ONCOLOGY GROUP; LONE STAR )
ONCOLOGY CONSULTANTS, P.A. )
KELSEY SEYBOLD CLINIC; BLOOD AND)
CANCER CENTER OF EAST TEXAS; )
COASTAL BEND CANCER CENTER; )
SOUTH TEXAS INSTITUTE OF CANCER )
AND BLOOD DISORDERS, )
)
Defendants; )
)
)
COMMONWEALTH OF VIRGINIA )
)
Plaintiffs, )
)
v. )
)
VIRGINIA CANCER INSTITUTE; )
HEMATOLOGY ONCOLOGY PATIENT )
ENTERPRISES (HOPE); LYNCHBURG )
HEMATOLOGY ONCOLOGY CLINIC; )
PENINSULA CANCER INSTITUTE; )
CANCER OUTREACH ASSOCIATES; )
DANVILLE HEMATOLOGY-ONCOLOGY )
CLINIC; SHENANDOAH ONCOLOGY )
ASSOCIATES; DELTA )
)
)
HEMATOLOGY/ONCOLOGY )
ASSOCIATES, )
)
Defendants; )
)
)
STATE OF WISCONSIN )
)
Plaintiffs, )
)
v. )
)
)
ONCOLOGY ALLIANCE; MARSHFIELD )
CLINIC; FOX VALLEY HEMATOLOGY )
AND ONCOLOGY; AUROA SHEBOYGAN )
CLINIC; and GREEN BAY ONCOLOGY )
LIMITED; MEDICAL CONSULTANTS )
LIMITED, )
)
Defendants. )
TABLE OF CONTENTS
I. INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
II. JURISDICTION AND VENUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
III. THE PARTIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
A. Plaintiff/Relator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
B. Defendants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
IV. FACTUAL ALLEGATIONS RELATED TO SPECIFIC DEFENDANTS . . . . . . . . . . .10
A. Amgen, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
B. US Oncology Specialty, LP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
C. Defendant Oncology Practices by Individual States of Practice . . . . . . . . . . . . . .14
Alabama Oncology Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Arizona Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
Arkansas Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
California Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Colorado Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Connecticut Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Delaware Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
District of Columbia Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Florida Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36
Georgia Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
Hawaii Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
i
TABLE OF CONTENTS
(continued)
Illinois Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Indiana Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Iowa Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Kansas Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60
Kentucky Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
Louisiana Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
Maine Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Maryland Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Massachusetts Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Michigan Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
Minnesota Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Mississippi Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
Missouri Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Montana Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Nebraska Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
New Jersey Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
New Mexico Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
New York Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Nevada Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
North Carolina Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
North Dakota Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
ii
TABLE OF CONTENTS
(continued)
Ohio Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Oklahoma Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Oregon Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
Pennsylvania Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
South Carolina Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
South Dakota Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Tennessee Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Texas Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120
Utah Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126
Virginia Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
Washington Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Wisconsin Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
IV. FACTUAL ALLEGATIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136
A. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
B. Marketing Aranesp to Defendant Oncology Practices. . . . . . . . . . . . . . . . . . . . .139
C. Payments for Drugs Furnished by Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . .152
D. Overstating Costs to Increase Reimbursements. . . . . . . . . . . . . . . . . . . . . . . . . .153
E. Rules on Acceptance of Discounts in Healthcare Services. . . . . . . . . . . . . . . . . 157
F. Fraudulent Reporting of ASP by Defendant Oncology Practices . . . . . . . . . . . .166
G. Overprescribing of the Covered Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
iii
TABLE OF CONTENTS
(continued)
H. Other Illegal Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
1. Tying the Purchase of Aranesp to the Purchase of Neupogen

and Neulasta. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
2. Off-Invoice discounts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
3. Use and marketing of overfill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
4. Price protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
5. Free goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180
6. Marketing the spread . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
7. Other improper financial incentives provided to oncology practices . . . 183
8. Use for off-label indications due to marketing and promotion . . . . . . . .184
9. Defendants fraudulent activities have threatened public health

and safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
I. Hub and Spoke Conspiracy to Commit Fraud . . . . . . . . . . . . . . . . . . . . . . . . . . .187
J. Affected Federal Health Care Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
COUNT ONE
Violation of False Claims Act, 31 U.S.C. 3729(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .202
COUNT TWO
Violation of California False Claims Act, Cal. Gov. Code 12650 et seq. . . . . . . . . . . . . . . . . 203
COUNT THREE
Violation of Delaware False Claims Act, 6 Del. Code 1201 et seq . . . . . . . . . . . . . . . . . . . . .206
iv
TABLE OF CONTENTS
(continued)
COUNT FOUR
Violation of District of Columbia Procurement Reform Amendment Act, D.C. Code
Ann. 2-308.13 et seq. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208
COUNT FIVE
Violation of Florida False Claims Act, Fl. Stat. 66.081 et seq. . . . . . . . . . . . . . . . . . . . . . . . . 209
COUNT SIX
Violation of Georgia False Medicaid Claims Act, O.C.G.A. 49-4-168 et seq. . . . . . . . . . . . . 212
COUNT SEVEN
Violation of Hawaii False Claims Act, Haw. Rev. Stat. 661-21 et seq. . . . . . . . . . . . . . . . . .214
COUNT EIGHT
Violation of Illinois Whistleblower Reward and Protection Act, 740 Ill. Comp. Stat.
173/1 et seq. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
COUNT NINE
Violation of Indiana False Claims and Whistleblower Act, In. Code 5-11-5.5 et seq. . . . . . . . .217
COUNT TEN
Violation of Louisiana Medical Assistance Programs Integrity Law, La. Rev. Stat.
46: 437 et seq. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
COUNT ELEVEN
Violation of Massachusetts False Claims Law, Mass. Gen. Laws Ch. 12 5(B) et seq. . . . . . . 221
COUNT TWELVE
Violation of Michigan Medicaid False Claims Act, M.C.L. 400.601 et seq. . . . . . . . . . . . . . . . 223
COUNT THIRTEEN
Violation of New Mexico Medicaid False Claims Act, N.M. Stat. 27-2F-1 et seq. . . . . . . . . 225
v
TABLE OF CONTENTS
(continued)
COUNT FOURTEEN
Violation of New Jersey False Claims Act, N.J. Stat. 2A:32C-1 et seq. . . . . . . . . . . . . . . . . . 227
COUNT FIFTEEN
Violation of New York False Claims Act, N.Y. Stat. Fin. 187 et seq . . . . . . . . . . . . . . . . . . . 229
COUNT SIXTEEN
Violation of Nevada False Claims Act, Nev. Rev. Stat. 357.040 et seq. . . . . . . . . . . . . . . . . . 231
COUNT SEVENTEEN
Violation of Oklahoma Medicaid False Claims Act, 63 OK. Stat. 5053, et seq. . . . . . . . . . . .232
COUNT EIGHTEEN
Violation of Tennessee Medicaid False Claims Act, Tenn. Stat. 75-1-181 et seq. . . . . . . . . . 234
COUNT NINETEEN
Violation of Texas Medicaid Fraud Prevention Law, Tex. Hum. Res. Code 36.002 et seq. . .236
COUNT TWENTY
Violation of Virginia False Claims Act, Va. Code Ann. 8.01-216.3(a) et seq. . . . . . . . . . . . . 238
COUNT TWENTY-ONE
Violation of Wisconsin False Claims for Medical Assistance Act , Wis. Stat.
20.931, et seq . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
COUNT TWENTY-TWO
Violation of 31 U.S.C. 3730(h). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
PRAYER FOR RELIEF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242
DEMAND FOR A JURY TRIAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
vi
I. INTRODUCTION.
1. This is a civil action is brought by Don Hanks (the Relator) on behalf of
himself, the United States of America and the State of California, the State of Delaware, the
District of Columbia, the State of Florida, the State of Georgia, the State of Hawaii, the State of
Illinois, the State of Indiana, the State of Louisiana, the Commonwealth of Massachusetts, the
State of Michigan, the State of New Mexico, the State of New Jersey, the State of New York, the
State of Nevada, the State of Oklahoma, the State of Tennessee, the State of Texas, the
Commonwealth of Virginia and the State of Wisconsin for treble damages and civil penalties
arising from defendants false statements and fraudulent claims, in violation of the Federal Civil
False Claims Act, 31 U.S.C. 3729, et seq. (FCA). This action is also brought pursuant to
the various statutes of the several state plaintiffs named above, as further identified in this
Complaint.
2. The actions alleged to have violated the FCA all occurred during the period
September 1, 2001 to at least September 30, 2011 (Covered Period). The defendants in this
action are all Oncology Practices that specialize in the treatment of cancer or the drug purchasing
organizations of such practices (together, Oncology Practices). The defendant Oncology
Practices include out-patient clinics and hospitals, many specializing in the treatment of specific
forms of cancer.
3. Amgen, Inc. (Amgen), a Delaware corporation headquartered in Thousand
Oaks, Ventura County, California, is a large biotechnology and drug manufacturing company.
Drugs manufactured by Amgen are used in a number of different therapies. The most important
of these involve supportive cancer care, renal therapy and autoimmune diseases, including
treatment of anemia caused by chemotherapy in the treatment of cancer. In 2010, Amgen had
net income of $4.6 billion on total revenues of $15.1 billion.
1
4. On December 20, 2012, Amgen entered into a Settlement Agreement with the
United States and various states that resolved claims made against it in the original Complaint
filed in this action as well as in a number of related cases. This Settlement Agreement
specifically excluded any and all allegations that Amgen marketed to spread or otherwise
promoted its oncology drugs based upon the profit that doctors could make per patient by
prescribing these drugs. Amgen is named in this complaint as jointly and severally liable for the
fraudulent conduct of the oncology practices based upon a hub and spoke conspiracy to
commit fraud. Amgen is also named as a defendant as to Plaintiffs claim for retaliation
pursuant to 31 U.S.C. 3730(h) (County Twenty-Two).
5. During the Covered Period, a substantial percentage of Amgens U.S. sales
revenues and profits were accounted for by three drugs: Aranesp, Neupogen and Neulasta.
These names are registered trademarks of Amgen. Together, the three drugs are hereinafter
referred to as the Covered Drugs. A major use of the Covered Drugs is in supportive cancer
care. Aranesp (biologic name, darbepoetin alfa) and another Amgen drug, Epogen (biologic
name, epoetin alfa), are classified as erythropoiesis-stimulating agents (ESAs); they stimulate
the production of red blood cells. Neupogen (biologic name, filgrastim) and Neulasta (biologic
name, pegfilgrastim), selectively stimulate the production of neutrophils (a type of white blood
cell that helps the body fight infection. Neupogen and Neulasta are granulocyte colony-
stimulating agents (GSAs).
6. Chemotherapy treatments for cancer often deplete the supply of red blood cells in
the body, leading to anemia. Red blood cells, which are made by the bone marrow, are the
principal means by which oxygen is delivered to body tissues. Without adequate amounts of
erythropoietin, red blood cell count is reduced, which, in turn, diminishes the ability of the blood
to deliver sufficient amounts of oxygen to the body, leading to anemia. Severe or long-lasting
2
anemia can damage the heart, brain and other body organs. In its most severe form, anemia may
lead to death. It has been theorized but not proven that one possible side effect of ESAs is that
they reduce the number of white blood cells circulating in a patients blood, contributing to, if
not causing the need to administer Neupogen or Neulasta.
7. Epogen (epoetin alfa) is indicated, i.e., is medically accepted or useful, as a
treatment for anemia associated with chronic renal failure, anemia in HIV patients being treated
with AZT (Zidovudine), anemia of cancer associated with treatment both for patients on dialysis
and for patients not on dialysis and parasurgery. Aranesp is indicated for the treatment of
chemotherapy-induced anemia in patients with non-myeloid malignancies, meaning anemia not
caused by cancer. Neupogen and Neulasta are used to counteract the reduction in white blood
cells. This reduction in white blood cells can be caused by chemotherapy used in the treatment
of cancer. White blood cells serve as the bodys primary defense against infections. They work
by destroying bacteria in the blood. Neupogen and Neulasta stimulate the production of new
white blood cells from the bone marrow.
8. Sales of Amgens principal products are highly dependent on the extent of
coverage and reimbursement patients receive from third-party payers, including, most
significantly, the federal and state governments via various government-funded healthcare
programs. Such programs are referred to herein, jointly, as Government Healthcare Programs.
The two largest and best known federal healthcare programs are Medicare and Medicaid, both of
which are administered by the Centers for Medicare and Medicaid Services (hereinafter CMS),
an agency of the U.S. Department of Health and Human Services.
9. During the Covered Period, on information and belief, the defendants were major
buyers of the Covered Drugs. For patients eligible to receive benefits under Government
Healthcare Programs, such programs generally paid all or a substantial portion of the cost of the
3
Covered Drugs. When Government Healthcare Programs pay for all or some portion of the cost
of a drug, the cost of the drug is said to have been reimbursed by the Government Healthcare
Program. During the Covered Period, medical services providers, such as the defendants,
administered drugs, including the Covered Drugs, to patients receiving benefits under
Government Healthcare Programs and had all or a substantial portion of the cost of such drugs
reimbursed to them by those programs. As alleged hereinafter in this Complaint, however, with
respect to the Covered Drugs, as aided and abetted by Amgen, the defendants, through a variety
of means, submitted either manually or electronically and obtained reimbursement of the
Covered Drugs that far exceeded the defendants reimbursable cost of these drugs, in violation of
the Government Healthcare Program rules.
10. Sales of the Covered Drugs, plus Epogen an ESA made by Amgen accounted
for the majority of Amgens domestic revenues and profits during the Covered Period. Amgens
domestic revenues from the sale of the Covered Drugs and Epogen, by year and by drug type,
between 2002 and 2011, were as shown in the table below. The term ESA Sales includes just
Epogen in 2001. In the remainder of the period, this term covers sales of both Aranesp and
Epogen. The term GSA Sales includes just Neupogen in 2001. In the remainder of the period,
this term covers sales of Neulasta and Neupogen. The rebates column reflects data maintained
by Amgen and shows the amount of money paid out by Amgen pursuant to contracts with
oncology practices that provided them with monetary incentives to by and use Amgen drugs
whose costs largely covered, i.e., paid for, by third-parties Government Healthcare Programs
and health insurance companies:
YEAR ESA SALES GSA SALES REBATES
2001 2,000,000,000 800,000,000 Not Reported.
2002 2,680,000,000 1,840,000,000 Not Reported
4
2003 3,980,000,000 2,520,000,000 Not Reported
2004 5,070,000,000 2,920,000,000 Not Reported
2005 5,610,000,000 3,500,000,000 Not Reported
2006 5,300,000,000 3,100,000,000 Not Reported
2007 4,640,000,000 3,200,000,000 2,200,000,000
2008 4,150,000,000 3,300,000,000 1,800,000,000
2009 3,900,000,000 3,400,000,000 4,100,000,000
2010 3,600,000,000 3,600,000,000 4,500,000,000
2011 3,000,000,000 4,000,000,000 4,400,000,000
11. Total sales of these drugs amounted to approximately $77 billion during the
period 2001 to 2011. Amgens ESA sales almost tripled from 2001 to 2005. Amgens GSA
sales more than quadrupled from 2001 to 2005. Amgens annual financial reports (10-Ks), filed
with the Securities and Exchange Commission, show that Amgen acknowledged spending some
$17 billion on drug sales rebates from 2007 to 2011. On information and belief, Amgen did not
disclose rebates, discounts and other financial incentives to purchase the Covered Drugs it paid
on sales of ESAs and GSAs prior to 2007. These rebates were paid directly to the medical
services providers, including the defendant Oncology Practices, not to the ultimate third-party
payer for the drugs. On information and belief, Amgen did not report any of the rebates,
discounts and other financial incentives it provided to medical services providers, including the
defendant Oncology Practices as incentives to purchase the Covered Drugs to any Government
Healthcare Programs. On information and belief, none of the defendant Oncology Practices
reported any of the rebates, discounts and other financial incentives they received from Amgen
to purchase the Covered Drugs to any Government Healthcare Programs.
5
II. JURISDICTION AND VENUE.
12. This Court has personal jurisdiction over the defendants pursuant to 31 U.S.C.
3732(a), which authorizes nationwide service of process. At least one of the defendants can be
found in, resides in, or has transacted business in the Eastern District of New York and in the
State of New York.
13. This Court has personal jurisdiction over the defendants pursuant to 31 U.S.C.
3732(a), which authorizes nationwide service of process. At least one of the defendants can be
found in, resides in, or has transacted business in the Eastern District of New York and in the
State of New York.
14. This Court has jurisdiction over the subject matter of this action pursuant to 31
U.S.C. 3730(b) and 3732(a), which specifically confer jurisdiction on this Court for actions
brought pursuant to the FCA.
15. Venue is proper in this District pursuant to 31 U.S.C. 3732(a) because one or
more defendants can be found in, resides in, or has transacted business in the Eastern District of
New York, and at least some of the alleged acts occurred in this District.
16. The material allegations of this Complaint are not based on a public disclosure of
allegations or transactions in a criminal, civil or administrative hearing, in a congressional,
administrative or General Accounting Office report, hearing audit or investigation, or from the
news media.
17. The FCA provides that any person who submits a false claim to the government is
liable for a civil penalty of between $5,500 and $11,000 for each such claim, and three times the
amount of the damages sustained by the government. The Act permits persons having
information regarding a false or fraudulent claim against the government to bring an action on
behalf of the government and to share in any recovery. As required by 31 U.S.C. 3730(b)(2),
6
the complaint must be filed in camera and under seal, without service on the defendant. The
complaint remains under seal while the government conducts an investigation of the allegations
in the complaint and determines whether to intervene in the action. This complaint has been
filed in camera and under seal to allow for the government to conduct its investigation of all of
the allegations in the complaint, taken as a whole.
18. The United States, having entered into a Settlement Agreement with Amgen on
the majority of the claims brought against it in this civil action and in related actions, has
declined to proceed against Amgen with respect to the claim related to marketing the spread
and against the defendants on any of the pending claims. The United States has reserved its right
to order any deposition transcripts and to intervene in the portion of this action in which it
initially declined to intervene, for good cause, at a later date.
III. THE PARTIES.
A. Plaintiff/Relator.
19. Plaintiff/Relator Don Hanks (Relator) is a resident of Ponte Vedra Beach, St.
Johns County, Florida. Relator was employed by Amgen or by Amgen USA, Inc., an Amgen
subsidiary as a nephrology and/or oncology sales/marketing representative from December 18,
1989 until his wrongful termination on May 23, 2007. Amgen terminated Relators employment
in retaliation for his having begun to investigate the possibility of filing a False Claims Act
complaint against Amgen. Through his employment with Amgen and Amgen USA, Inc., as is
more fully described herein, Relator gained personal knowledge of the material allegations made
in this Complaint.
20. Relator was one of Amgens most recognized and successful sales representatives
and received numerous awards for performance. Based on his expertise and product knowledge,
7
Relator was assigned to some of Amgens largest U.S. accounts. Relator served as a large
account liaison to the International Oncology Network (hereinafter ION) and to United States
Oncology Specialty, LP (hereinafter USOS). Through these and other sales duties,
Respondent gained direct and personal knowledge of Amgens implementation of nationwide
strategies and programs to market the Covered Drugs to the defendant Oncology Practices and
other medical services providers.
21. In the course of his career with Amgen, Relator saw Amgen change from a small
biotech company with patient centric culture to a large biotech company with a dollar
centric culture. While with Amgen, Relator achieved a number of notable distinctions and
recognitions. In addition, Relator was involved in several Amgen initiatives directed toward
relationship development with physicians and product launches. For most of his years with the
company, Relator was a member of Amgens Presidents Club, a distinction reserved for the top
ten percent of sales performers. He also served frequently as a trainer for new recruits to
Amgens sales force, not only in the district to which he was assigned, the Tampa district, but
also in other districts.
22. Some of these distinctions, recognitions and initiatives are noted herein below.
Relator was a member of the first Neupogen Advisory Panel and Launch Committee; a multi-
year member of the Presidents Club at Amgen; fostered and promoted great public champions
for Amgen, two of which are Dr. Alan Miller (Tufts) and Dr. Gary Lee (Arizona State
University); and, after a year of claims denials, convinced Medicare officials in Florida, in
particular, Dr. Frank Farmer, the Medical Director, to begin paying claims for Neupogen, for
which more than $500 million in claims were outstanding.
23. Relator engaged in substantial business dealings related to the sale and purchase
of the Covered Drugs with numerous Oncology Practices, including the following defendants:
8
Florida Cancer Specialists; Integrated Community Oncology Network; Tennessee Oncology;
The West Clinic; The Mayo Clinic; Gulfcoast Oncology Associates; Georgia Cancer Specialists;
Southeast Georgia Hematology and Oncology; ION (International Oncology Network); NOA
(National Oncology Alliance); Oncology Plus; and AOR/US Oncology.
B. Defendants.
24. The defendants in this action, aside from Amgen, are all either medical practices
that provide cancer treatments to patients, or group (drug) purchasing organizations (hereinafter
GPOs) of such medical practices. The defendants are identified with particularity in
paragraphs 26 to 322 of this Complaint.
25. In the paragraphs below, reference is frequently made to two categories of Amgen
customers. One group is called Platinum Amgen customers; the other is called Gold Amgen
customers. Amgen used these terms to classify its customers based on their value to Amgen.
Depending on the level purchases, a practice could expect a certain percentage reduction in the
cost of certain drugs it purchased from Amgen, although these discounts varied even within
customer classes. Typically, Platinum customers received at least a 50% reduction of the
invoiced charge, which was returned to them in the form of rebates, discounts and other
incentives, with many Platinum Oncology practices receiving rebates, discounts or other
incentives in the range of 60% of the invoiced charge. Typical Gold customers received at least
a 40% reduction of the invoiced charge, which was returned to them in the form of rebates,
discounts and other incentives, with many Gold Oncology Practices receiving rebates, discounts
and other incentives in the range of 50% of the invoiced charge.
9
IV. Factual Allegations Related to Specific Defendants.
A. Amgen, Inc.
26 Defendant Amgen is headquartered in Thousand Oaks, Ventura County,
California. Amgen claims to be the largest biologics company in the world. Amgen is a
pharmaceutical company that sells a number of very profitable injectable drugs.
27. In 2005, the total worldwide market for Amgens erythropoiesis-stimulating
agents was $10 billion. Amgens profit margin from those sales was about 60%, or $6 billion.
Since 2006, Amgen has had cumulative reported revenues greater than $50 billion from
erythropoiesis-stimulating agents in the United States alone.
28. During the Covered Period, Defendant Amgen participated in the scheme to
defraud government healthcare programs as alleged herein.
B. US Oncology Specialty, LP.
29. US Oncology Specialty, LP (USOS) is a Delaware Limited Liability
Partnership based in Fort Worth, Texas. USOS is a specialty distribution center service of US
Oncology, Inc. According to a US Oncology press release, US Oncology, Inc. launched USOS
in 2005 to facilitate the seamless flow of oncology pharmaceuticals directly from the
pharmaceutical manufacturers to its nationwide network of practices.
30. During the Covered Period, USOS purchased large quantities of the Covered
Drugs from Amgen. In 2006, USOS made purchases of Amgen drugs in excess of
approximately $1 billion.
31. During the Covered Period, USOS served as a Group Purchasing Organizing
(hereinafter GPO) for the approximately 1,000 physicians affiliated with US Oncology, Inc.
The USOS GPO pooled the purchasing power of its member physicians and Oncology Practices
10
in order to obtain even larger rebates for the Covered Drugs from Amgen than Amgen offered to
smaller practices. The terms of the contracts between the GPO and Amgen were confidential;
they were not reported to or shared with Government Healthcare Programs. Thus, the provisions
in those contracts that reduced the actual cost of the Covered Drugs to the GPO, such as price
protection, rebates, equipment donations, data management fees and other forms of discounts,
were not known to Government Healthcare Programs. The actual selling price, of the Covered
Drugs supplied by Amgen to the GPO pursuant to the confidential contracts to Government
Healthcare Program, which was considerably lower than the reported selling price, taking into
account the various discounts, rebates and other elements that reduced the actual cost to USOS
for the Covered Drugs. The failure to report the actual cost of the Covered Drugs to the GPO
caused Government Healthcare Programs to reimburse, or pay, the GPO more than it was
entitled to receive for delivering the Covered Drugs to patients whose drug costs were
reimbursable, or reimbursable in part, under Government Healthcare Programs reimbursement
rules.
32. According to a USOS press release, the GPO did not report the discounts, rebates
and other elements applied by Amgen that reduced the actual price of the drugs. USOS
acknowledged that the GPO had sought and been reimbursed by Government Healthcare
Programs on the basis of the unadjusted average selling price of the drugs, as computed by
Amgen, a figure which did not factor in the discounts, rebates and other cost-reducing elements
received by the GPO. The GPO has acknowledged that it failed to report the discounts, rebates
and other elements applied by Amgen that reduced the actual price of the drugs. According to a
USOS press release, USOS admits that the GPO had sought and been reimbursed by
Government Healthcare Programs on the basis of the unadjusted average selling price of the
11
drugs, as computed by Amgen, a figure which did not factor in the discounts, rebates and other
cost-reducing elements received by the GPO.
33. During the Covered Period, USOS supplied the Covered Drugs to the following
USOS-affiliated Oncology Practices in the Central Region: Arch Medical Services, Inc.;
Arkansas Oncology Associates, P.A.; Cancer Care Network of South Texas, P.A.; Central
Indiana Cancer Centers; Dayton Oncology & Hematology, P.A.; Hematology Oncology
Associates of Illinois, L.L.C. Kansas City Cancer Centers; Minnesota Oncology Hematology,
P.A.; Missouri Cancer Associates; and Northwest Medical Specialists, P.C.
USOS-affiliated USOS Oncology Practices in the East Region: Asheville Hematology &
Oncology Associates, P.A.; Cancer Centers of Florida, P.A.; Cancer Centers of North Carolina;
Cancer Centers of The Carolinas; Durham Regional Hematology Oncology; Fairfax-Northern
Virginia Hematology- Oncology, P.C.; Flavio Kruter, M.D., P.A.; Florida Cancer Institute, P.A.;
Interlakes Oncology Hematology, P.C.; Maryland Oncology Hematology, P.A.; New York
Oncology Hematology, P.C.; Northwestern Connecticut Onc/Hema. Assoc.; Ocala Oncology
Center, P.L.; Oncology & Hematology Associates Of Southwest Virginia, Inc.; South Florida
Oncology and Hematology Consultants; Venango Oncology Hematology Association; and
Virginia Oncology Associates.
USOS-affiliated USOS Oncology Practices in the Southwest Region: Arizona Oncology
Associates, P.C.; Cancer Care Associates; Rocky Mountain Cancer Centers, LLP; and Texas
Oncology, P.A.
USOS-affiliated USOS Oncology Practices in the West Region: Cancer Care Northwest, P.S.;
12
Comprehensive Cancer Centers of Nevada; Northwest Cancer Specialists, P.C.; Oncology
Associates of Oregon, P.C.; and Washington Cancer Centers, P.C.
USOS-affiliated USOS Oncology Practices in the Southeast Region: Advanced Care &
Treatment Medical Group, SC; Alice C. Reier, M.D.; Alpine Hematology - Oncology, P.C.;
Ashland-Bellefonte Cancer Center Associates in Oncology-Hematology, P.C.; Beckley
Oncology Associates, Inc.; Buenaventura Medical Group, Inc.; Cancer Associates of Monterey
Peninsula; Cancer Treatment Center of Oklahoma; Central Texas Oncology Associates, P.A.;
Crossville Medical Oncology; Edward Kaplan, MD & Associates; Facey Medical Foundation;
Great Falls Clinic; Gynecologic Oncology Associates, P.A.; Hannibal Clinic Operations, LLC;
Hematology-Oncology Consultants, P.A.; Highlands Cancer Center; Iowa Cancer Care; Larry G.
Strieff, M.D.; Little Rock Hematology Oncology Associates, P.A.; Mankato Clinic, Ltd.;
Medical Oncology Associates, P.S.; Melbourne Internal Medicine Associates; Midlands
Regional Cancer Center, PC; Midwest Center for Hematology/Oncology, SC; New Mexico
Cancer Care Associates; Oncology Hematology West, P.C.; Oncology-Hematology Specialists,
PA; Palo Alto Medical Foundation; Piedmont Hematology-Oncology Associates, PLLC; Pronger
Smith Medical Care Sacramento Center for Hematology & Medical Oncology, Inc.; Springfield
Clinic, LLP; The Medical Associates Clinic, P.C.; The Midsouth Cancer Center; Tri-State
Medical Center; Valley Internal Medicine, Inc. P.S.; and WVVA Health Care Alliance, P.C.
38. During the Covered Period, because of its large size, USOS was offered and
received rebates and other discounts for its purchases of the Covered Drugs that were far greater
than those generally available to other oncology practices or GPOs. On information and belief,
USOS Portfolio Contract provided extra discounts and rebates not generally available to other
13
oncology practices and GPOs upon the attainment of certain market share goals or milestones by
the GPO.
B. Defendant Oncology Practices by Individual States of Practice.
39. During the Covered Period, Amgen used an internal, computerized database to
track all forms of rebates, discounts, equipment gifts, free goods, contributions of medical
education grants, data purchases, honorarium provided, and other client oriented information.
The database was known as ACIS, for Amgen Customer Identification System. Each
Amgen customer was assigned a unique ACIS number. Amgen used this information to obtain
leverage in having defendant Oncology Practices sign Amgen Portfolio Contracts and to
purchase more of the Covered Drugs. Amgen sales representatives used the data related to
individual customers to educate customers usually under the guise of business reviews
such as the defendant Oncology Practices that suggested they were considering switching
patients from Aranesp to Procrit to the specific financial benefits of doing so based upon very
accurate profiles of the Oncology Practice. Amgen also used these ACIS numbers to track
which customers had signed an APC, their sales quota performance and their ability to maximize
their rebates through such business reviews that were tracked by Amgen in the ORION
reporting system. Orion also tracked ACIS numbers.
Alabama Oncology Practices
40. On information and belief, defendant Montgomery Cancer Center (ACIS
#214173) has an office at 4145 Carmichael Road, Montgomery, AL 36106. On information and
belief, defendant Montgomery Cancer Center bought $6,319,824 of Amgen drugs in the Fourth
Quarter of 2006 receiving a rebate from Amgen amounting to approximately 50% of all
14
purchases as a Platinum Amgen customer. On information and belief, defendant Montgomery
Cancer Center made comparable purchases of Amgen drugs and received comparable rebates for
the said products during the Covered Period and sought and received reimbursement from
Government Healthcare Programs for administration of the Covered Drugs to patients eligible to
receive government-funded healthcare benefits in amounts that exceeded the actual cost of these
products to the defendant.
41. On information and belief, defendant Oncology Specialties, P.C. (ACIS #11998)
has an office at 3601 CCI Drive, Huntsville, AL 35805. On information and belief, defendant
Oncology Specialties, P.C. bought $6,104,312 of Amgen drugs in the Fourth Quarter of 2006
receiving a rebate from Amgen amounting to approximately 50% of all purchases as a Platinum
Amgen customer. On information and belief, defendant made comparable purchases of Amgen
drugs and received comparable rebates for the said products during the Covered Period and
sought and received reimbursement from Government Healthcare Programs for administration of
the Covered Drugs to patients eligible to receive government-funded healthcare benefits in
amounts that exceeded the actual cost of these products to the defendant.
42. On information and belief, defendant Birmingham Hematology-Oncology
Associates (ACIS #214277) has an office at 810 St. Vincents Drive, Birmingham, AL 35205.
On information and belief, defendant Birmingham Hematology bought $4,166,193 of Amgen
drugs in the Fourth Quarter of 2006 receiving a rebate from Amgen amounting to
approximately 50% of all purchases as a Platinum Amgen customer. On information and belief,
defendant made comparable purchases of Amgen drugs and received comparable rebates for the
said products during the Covered Period and sought and received reimbursement from
15
43. On information and belief, defendant Southeast Cancer Network (ACIS #214306)
has an office at 1410 McFarland Boulevard, North, Tuscaloosa, AL 35406. On information and
belief, defendant Southeast Cancer Network bought $3,777,946 of Amgen drugs in the Fourth
purchases as a Platinum Amgen customer. On information and belief, defendant made
comparable purchases of Amgen drugs and received comparable rebates for the said products
during the Covered Period and sought and received reimbursement from Government Healthcare
Programs for administration of the Covered Drugs to patients eligible to receive government-
funded healthcare benefits in amounts that exceeded the actual cost of these products to the
defendant.
44. On information and belief, defendant the Kirklin Oncology Clinic (ACIS
#214318) has an office at 2000 6th Avenue South, Birmingham, AL 35233. On information and
belief, defendant the Kirklin Oncology Clinic bought $1,890,382 of Amgen drugs in the Fourth
defendant.
45. On information and belief, defendant Radiation Therapy Oncology, P.C. (ACIS
#229142) has an office at 6701 Airport Ste. T6, Mobile, AL 36608. On information and belief,
16
defendant Radiation Therapy Oncology, P.C. bought $1,777,211 of Amgen drugs in the Fourth
purchases as a Gold Amgen customer. On information and belief, defendant made comparable
purchases of Amgen drugs and received comparable rebates for the said products during the
Covered Period and sought and received reimbursement from Government Healthcare Programs
for administration of the Covered Drugs to patients eligible to receive government-funded
healthcare benefits in amounts that exceeded the actual cost of these products to the defendant.
46. On information and belief, defendant Northwest Alabama Cancer Center (ACIS
#216708) has an office at 101 Dr. W. H. Blake Jr. Drive, Muscle Shoals, AL 35661. On
information and belief, defendant Northwest Radiation Therapy Oncology, P.C. bought
$1,234,404 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from Amgen
amounts to approximately 40% of all purchases as a Gold Amgen customer. On information and
belief, defendant made comparable purchases of Amgen drugs and received comparable rebates
for the said products during the Covered Period and sought and received reimbursement from
Arizona Oncology Practices
47. On information and belief, defendant Palo Verde Hematology-Oncology, Inc.
(ACIS #215082) has an office at 5601 West Eugie Avenue, Suite 106, Glendale, AZ 85304. On
information and belief, defendant Palo Verde Hematology-Oncology, Inc. bought $5,421,998 of
Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from Amgen amounting to
17
48. On information and belief, defendant Ironwood Cancer and Research Centers
(ACIS #226645) has an office at 695 South Dobson Road, Chandler, AZ 85224. On information
and belief, defendant Ironwood Cancer and Research Centers purchased $3,928,532 of Amgen
49. On information and belief, defendant Desert Oncology (ACIS #225726) has an
office at 1432 South Dobson Road, Suite 106, Mesa, AZ 85202. On information and belief,
defendant Desert Oncology purchased $2,317,960 of Amgen drugs in the Fourth Quarter of 2006
receiving a rebate from Amgen amounting to approximately 50% of all purchases as a
Platinum Amgen customer. On information and belief, defendant made comparable purchases of
Amgen drugs and received comparable rebates for the said products during the Covered Period
and sought and received reimbursement from Government Healthcare Programs for
administration of the Covered Drugs to patients eligible to receive government-funded
18
50. On information and belief, defendant Arizona Center for Hematology and
Oncology, P.C (ACIS #223790) has an office at 5750 West Thunderbird Road, Suite C-300,
Glendale, AZ 85306. On information and belief, defendant Arizona Center for Hematology and
Oncology, P.C. bought $2,278,599 of Amgen drugs for the Fourth Quarter of 2006 receiving a
rebate from Amgen amounting to approximately 50% of all purchases as a Platinum Amgen
customer. On information and belief, defendant made comparable purchases of Amgen drugs
and received comparable rebates for the said products during the Covered Period and sought and
received reimbursement from Government Healthcare Programs for administration of the
Covered Drugs to patients eligible to receive government-funded healthcare benefits in amounts
that exceeded the actual cost of these products to the defendant.
51. On information and belief, defendant Southwest Hematology Oncology, P.C.
(ACIS #1079025) has an office at 11209 North Tatum Boulevard, Suite 260, Phoenix, AZ
85028. On information and belief, defendant Southwest Hematology Oncology, P.C. bought
amounting to approximately 40% of all purchases as a Gold Amgen customer. On information
and belief, defendant made comparable purchases of Amgen drugs and received comparable
rebates for the said products during the Covered Period and sought and received reimbursement
from Government Healthcare Programs for administration of the Covered Drugs to patients
eligible to receive government-funded healthcare benefits in amounts that exceeded the actual
cost of these products to the defendant.
52. On information and belief, defendant Arizona Medical Clinic (ACIS #215084)
has an office at13640 North Plaza Del Rio Boulevard, Peoria, AZ 85381. On information and
belief, defendant Arizona Medical Clinic bought $1,218,331 of Amgen drugs in the Fourth
19
purchases as a Gold customer. On information and belief, defendant made comparable
53. On information and belief, defendant Arizona Hematology/Oncology - Northwest
Cancer Center (ACIS #225212) has an office at 1891 West Orange Grove Road, Building 2,
Tucson, AZ 85704. On information and belief, defendant Arizona Hematology/Oncology -
Northwest Cancer Center bought $1,154,915 of Amgen drugs in the Fourth Quarter of 2006
receiving a rebate from Amgen amounting to approximately 40% of all purchases as a Gold
Arkansas Oncology Practices
54. On information and belief, defendant Little Rock Hematology-Oncology
Associates (ACIS #226108) has an office at 9500 Lile Drive, Little Rock, AR 72205. On
information and belief, defendant Little Rock Hematology-Oncology Associates bought
amounting to approximately 50% of all purchases as a Platinum Amgen customer. On
information and belief, defendant made comparable purchases of Amgen drugs and received
comparable rebates for the said products during the Covered Period and sought and received
20
reimbursement from Government Healthcare Programs for administration of the Covered Drugs
to patients eligible to receive government-funded healthcare benefits in amounts that exceeded
the actual cost of these products to the defendant.
55. On information and belief, defendant Highlands Oncology Group (ACIS
#232532), P.A. has an office at 3232 North Hills Boulevard, Fayetteville, AR 72703. On
information and belief, defendant Highlands Oncology Group, P.A. bought $1,851,030 of
approximately 40% of all purchases as a Gold Amgen customer. On information and belief,
California Oncology Practices
56. On information and belief, defendant Redwood Regional Oncology (ACIS
#221883) has an office at 121 Sotoyome Street, Suites 101 and 203, Santa Rosa, CA 95405. On
information and belief, defendant Redwood Regional Oncology bought $5,281,904 of Amgen
21
57. On information and belief, defendant Tower Hematology Oncology Medical
Group (ACIS #220396) has an office at 9090 Wilshire Boulevard, Suite 200, Beverly Hills, CA
90211. On information and belief, defendant Tower Hematology Oncology Medical Group
bought $3,346,815 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from
Amgen amounting to approximately 50% of all purchases as a Platinum Amgen customer. On
58. On information and belief, defendant Cancer Care Associates of Fresno Medical
Group, Inc. (ACIS #1104673) has an office at 1791 East Fir Avenue, Fresno, CA 93720. On
information and belief, defendant Cancer Care Associates bought $3,099,500 of Amgen drugs in
the Fourth Quarter of 2006 receiving a rebate from Amgen amounting to approximately 50%
of all purchases as a Platinum Amgen customer. On information and belief, defendant made
defendant.
59. On information and belief, defendant Pacific Oncology Hematology Associates,
Inc. - La Jolla (ACIS #223445) has an office at 9850 Genesee Avenue, Suite 830, La Jolla, CA
22
92037. On information and belief, defendant Pacific Oncology Hematology Associates, Inc.
60. On information and belief, defendant Pacific Shores Medical Group, Inc. (ACIS
#215144) has an office at 1043 Elm Avenue, Suite 104, Long Beach, CA 90813. On information
and belief, defendant Pacific Shores Medical Group bought $2,120,776 of Amgen drugs in the
Fourth Quarter of 2006 receiving a rebate from Amgen amounting to approximately 50% of all
defendant.
61. On information and belief, defendant Santa Barbara Hematology-Oncology
Medical Group, Inc. (ACIS #227981) has an office at 540 West Pueblo Street, Santa Barbara,
CA 93105. On information and belief, defendant Santa Barbara Hematology- Oncology Medical
Group, Inc. bought $1,795,297 of Amgen drugs in the Fourth Quarter of 2006 receiving a
23
62. On information and belief, defendant The Breast Care Center - Oncology Center
(ACIS #221477) has an office at 230 South Main Street, Suite 100, Orange, CA 92868. On
information and belief, defendant The Breast Care Center - Oncology Center bought $1,536,055
of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from Amgen amounting to
63. On information and belief, defendant East Bay Medical Oncology Hematology
Associates (ACIS #216613) has an office at 3220 Lone Tree Way, Suite 100, Antioch, CA
94509. On information and belief, defendant East Bay Medical Oncology Hematology
Associated bought $1,367,565 of Amgen drugs in the Fourth Quarter of 2006 receiving a
24
64. On information and belief, defendant Orange Coast Oncology (ACIS #344048)
has an office at 4000 West Pacific Coast Highway, Suite 3e, Newport Beach, CA 92663. On
information and belief, defendant Orange Coast Oncology bought $,2,282,887 of Amgen drugs
in the Fourth Quarter of 2006 receiving a rebate from Amgen amounting to approximately
40% of all purchases as a Gold Amgen customer. On information and belief, defendant made
defendant.
65. On information and belief, defendant Cancer Care Associates Medical Group,
Inc. (ACIS #216492) has an office at 514 North Prospect Avenue, Fourth Floor, Redondo Beach,
CA 90277. On information and belief, defendant Cancer Care Associates Medical Group, Inc.
Amgen amounting to approximately 40% of all purchases as a Gold Amgen customer. On
66. On information and belief, defendant Ventura County Hematology-Oncology
Specialists, Inc. (ACIS #219171) has an office at 1700 North Rose Avenue, Suite 320, Oxnard,
CA 93030. On information and belief, defendant Ventura County Hematology-Oncology
Specialists, Inc. bought $1,665,963 of Amgen drugs in the Fourth Quarter of 2006 receiving a
25
rebate from Amgen amounting to approximately 40% of all purchases as a Gold Amgen
67. On information and belief, defendant Valley Medical Oncology Consultants
(ACIS #224126) has an office at 20055 Lake Chabot Road, Suite 130, Lake Chabot Building,
Castro Valley, CA 94546. On information and belief, defendant Valley Medical Oncology
Consultants bought $1,584,378 of Amgen drugs in the Fourth Quarter of 2006 receiving a
68. On information and belief, defendant Wilshire Oncology Medical Group, Inc.
(ACIS #234913) has an office at 1910 Royalty Drive, Pomona, CA 91767. On information and
belief, defendant Wilshire Oncology Medical Group bought $1,545,668 of Amgen drugs in the
26
69. On information and belief, defendant North Oncology (ACIS #216682) has an
office at 3617 Vista Way, Oceanside, CA 92056. On information and belief, defendant North
Oncology purchased $1,544,415 of Amgen drugs in the Fourth Quarter of 2006 receiving a
70. On information and belief, defendant Stockton Hematology Oncology (ACIS
#222433) has an office at 2626 North California Street, Suite B, Stockton, CA 95204. On
information and belief, defendant Stockton Hematology Oncology bought $1,398,217 of Amgen
71. On information and belief, defendant Medical Group of North County (ACIS
#223782) has an office at 910 Sycamore Avenue, Suite 270, Vista, CA 92081. On information
and belief, defendant Medical Group of North County bought $1,389,898 of Amgen drugs in the
27
72. On information and belief, defendant Southbay Oncology Hematology Partners
(ACIS #224548) has an office at 50 East Hamilton Avenue, Suite 200, Campbell, CA 95008. On
information and belief, defendant Southbay Oncology Hematology Partners bought $1,379,573
73. On information and belief, defendant Cancer Care Consultants (ACIS #277301)
has an office at 2175 Rosaline Avenue, Redding, CA 96001. On information and belief,
defendant Cancer Care Consultants bought $1,289,938 of Amgen drugs in the Fourth Quarter of
2006 receiving a rebate from Amgen amounting to approximately 40% of all purchases as a
Gold Amgen customer. On information and belief, defendant made comparable purchases of
28
74. On information and belief, defendant Medical Oncology Associates of San Diego
(ACIS #216683) has an office at 3075 Health Center Drive, Suite 102, San Diego, CA 92123.
On information and belief, defendant Medical Oncology Associates of San Diego bought
75. On information and belief, defendant Hematology Oncology Medical Group of
Orange County (ACIS #285650) has an office at1140 West La Veta Avenue, Suite 610, St.
Joseph Medical Plaza-Building, Orange, CA 92868. On information and belief, defendant
Hematology Oncology Medical Group of Orange County bought $1,263,776 of Amgen drugs in
of all purchases as a Gold Amgen customer. On information and belief, defendant made
defendant.
76. On information and belief, defendant Valley Tumor Medical Group, d/b/a
Antelope Valley Cancer Center (ACIS #215244) has an office at 44105 15th Street West, Suite
207, Lancaster, CA 93534. On information and belief, defendant Valley Tumor Medical Group
29
d/b/a Antelope Valley Cancer Center bought $1,230,347 of Amgen drugs in the Fourth Quarter
of 2006 receiving a rebate from Amgen amounting to approximately 40% of all purchases as a
Gold Amgen customer. On information and belief, defendant, furthermore, made comparable
77. On information and belief, defendant The Angeles Clinic and Research Institute
(ACIS #231562) has an office at 2001 Santa Monica Boulevard, Suite 560w, Santa Monica, CA
90404. On information and belief, defendant The Angeles Clinic and Research Institute bought
78. On information and belief, defendant Los Palos Oncology and Hematology
(ACIS #317448) has an office at 505 East Romie Lane, Suite A, Salinas, CA 93901. On
information and belief, defendant Los Palos Oncology and Hematology bought $1,187,006 of
30
79. On information and belief, defendant Capitol Hematology/Oncology (ACIS
#215293) has an office at 2 Medical Plaza, Suite 200, Roseville, CA 95661. On information and
belief, defendant Capitol Hematology/Oncology bought $1,177,133 of Amgen drugs in the
80. On information and belief, defendant North Valley Hematology Oncology
Medical Group (ACIS #216156) has an office at 18300 Roscoe Boulevard, Leavey Cancer
Center, First Floor, Northridge, CA 91325. On information and belief, defendant North Valley
Hematology Oncology Medical Group bought $1,114,831 of Amgen drugs in the Fourth Quarter
81. On information and belief, defendant Pacific Hematology and Oncology
Associates (ACIS #219953) has an office at 2100 Webster Street, Suite 225, San Francisco, CA
31
94115. On information and belief, defendant Pacific Hematology and Oncology Associates
82. On information and belief, defendant Palo Alto Medical Foundation (ACIS
#216611) has an office at 795 El Camino Real, Palo Alto, CA 94301. On information and belief,
defendant Palo Alto Medical Foundation bought $1,080,698 of Amgen drugs in the Fourth
Colorado Oncology Practices
83. On information and belief, defendant Colorado Hematology Oncology (ACIS
#224782) has an office at 401 West Hampden Place, Suite 250, Englewood, CO 80110. On
information and belief, defendant Colorado Hematology Oncology bought $1,195,581 of Amgen
32
Government Healthcare Programs for administration of the Covered Drugs to patients
84. On information and belief, defendant Loveland Hematology Oncology Associates
(ACIS #285830) has an office at 2050 North Boise, Loveland, CO 80538. On information and
belief, defendant Loveland Hematology Oncology Associates bought $1,000,490 of Amgen
products.
Connecticut Oncology Practices
85. On information and belief, defendant Medical Oncology and Hematology, P.C.
(ACIS #216385) has an office at 1450 Chapel Street, Suite A, New Haven, CT 06511. On
information and belief, defendant Medical Oncology and Hematology, P.C. bought $1,623,004
33
86. On information and belief, defendant Oncology Associates, P.C. (ACIS #216580)
has an office at 85 Retreat Avenue, Hartford, CT, 06106. On information and belief, defendant
Oncology Associates, P.C. bought $1,762,110 of Amgen drugs in the Fourth Quarter of 2006
87. On information and belief, defendant Hematology Oncology P.C. (ACIS
#214156) has an office at 34 Shelburne Road, Stamford, CT 06902. On information and belief,
defendant Hematology Oncology, P.C. bought $1,618,712 of Amgen drugs in the Fourth Quarter
88. On information and belief, defendant Eastern Connecticut Hematology and
Oncology (ACIS #220854) has an office at 330 Washington Street, Suite 220, Norwich, CT
06360. On information and belief, defendant Eastern Connecticut Hematology and Oncology
34
Delaware Oncology Practices
89. On information and belief, defendant Medical Oncology Hematology
Consultants, P.A. (ACIS #278583) has an office at 4701 Ogletown-Stanton Road, Suite 2200,
Helen F. Graham Cancer Center, Newark, DE, 19713. On information and belief, defendant
Medical Oncology Hematology Associates, P.A. bought $1,534,287 of Amgen drugs in the
defendant.
District of Columbia Oncology Practices
90. On information and belief, defendant George Washington University Medical
Faculty Associates, Inc. (ACIS #214326) has an office at 2150 Pennsylvania Avenue, NW,
35
Washington, DC 20037. On information and belief, defendant George Washington University
Medical Faculty Associates, Inc. bought $1,196,112 of Amgen drugs in the Fourth Quarter of
2006 obtaining a rebate from Amgen amounting to approximately 50% of all purchases as a
Platinum Amgen customer. On information and belief, defendant made comparable purchases
of Amgen drugs and received comparable rebates for the said products during the Covered
Period and sought and received reimbursement from Government Healthcare Programs for
healthcare benefits in amounts that exceeded the actual cost of these products.
Florida Oncology Practices
91. On information and belief, defendant Florida Cancer Specialists (ACIS #216205),
headquartered in Fort Myers, Florida, is the largest privately-owned Oncology/Hematology
practice in Florida, with 16 offices that serve the Gulf Coast area from Brandenton to Naples.
On information and belief, defendant Florida Cancer Specialists has an office at 3840 Broadway,
Fort Myers, FL 33901. On information and belief, defendant Florida Cancer Specialists
purchased Amgen products for the following years in the dollar amounts indicated: 2004
$12.8 million; 2005 $13.5 million; 2006 $20.3 million; 2007 $39.2 million. As a Platinum
Amgen customer, defendant Florida Cancer Specialists received a rebate or discount from
Amgen amounting to approximately 50% of all purchases made from approximately 2004
through 2007. On information and belief, defendant made comparable purchases of Amgen
amounts that exceeded the actual cost of these products. Since the profit on Neupogen in
36
Medicare patients was greater than Neulasta off contract, defendant Florida Cancer Specialists
only administered Neupogen to its Medicare patients; it administered Neulasta to its private pay
and indemnity plan patients.
92. On information and belief, defendant Gulfcoast Oncology Associates (ACIS
#221641) has an office at 1201 5th Ave North, #505, St. Petersburg, FL 33705. On information
and belief, defendant Gulfcoast Oncology Associates purchased Amgen products for the
following years in the dollar amounts indicated: 2002 $ 3.2 million; 2003 $ 4.0 million;
2004 $13.6 million; 2005 $21.1 million; 2006 $30.1 million; 2007 $29.3 million. As an
Amgen Platinum customer, defendant Gulf Coast Oncology Associates received a rebate or
discount from Amgen amounting to approximately 50% of all purchases made from during the
period of approximately 2004 through 2007. On information and belief, defendant made
during the entire Covered Period and sought and received reimbursement from Government
Healthcare Programs for administration of the Covered Drugs to patients eligible to receive
government-funded healthcare benefits in amounts that exceeded the actual cost of these
products.
93. On information and belief, defendant Integrated Community Oncology Network,
LLC (ICON) through its division Florida Oncology Associates (ACIS #11998) provides
specialized care for patients with cancer and/or hematological disorders in Northeast Florida.
Defendant ICON has nine cancer centers in Duval, Clay, St. Johns and Putnam counties and a
business address of 9143 Philips Highway, Suite 560, Jacksonville, FL 32256. On information
and belief, defendant ICON made Amgen product purchases for the following years in the dollar
amounts indicated: 2002 $2.3 million; 2003 $13.3 million; 2004 $14.8 million; 2005
$15.4 million; 2006 $32.0 million; 2007 $27.0 million. On information and belief, defendant
37
made comparable purchases of Amgen drugs and received comparable rebates for the said
products during the Covered Period and sought and received reimbursement from Government
products to the defendant. During the Covered Period, defendant ICON had a GPO contract and
a special Large Physician Practice (LPP) contract with Amgen.
94. During the Covered Period, defendants ICON, Florida Cancer Specialists and
Gulf Oncology Associates were elite members of the International Oncology Network (ION)
and received even greater discounts on drug purchased from Amgen because of these
affiliations.
95. On information and belief, defendant Oncology Hematology Radiation Care, LLC
d/b/a Advance Medical Specialist (ACIS #214484) has an office at 8940 North Kendall Drive,
#300 East, Miami, FL 33176. On information and belief, defendant Oncology Hematology
Radiation Care, LLC d/b/a Advance Medical Specialist bought $6,127,664 of Amgen drugs in
funded healthcare benefits in amounts that exceeded the actual cost of these products.
96. On information and belief, defendant Palm Beach Cancer Institute (ACIS
#216540) has an office at 1309 North Flagler Drive, West Palm Beach, FL 33401. On
information and belief, defendant Palm Beach Cancer Institute bought $3,683,036 of Amgen
38
products.
97. On information and belief, defendant Hematology and Oncology Consultants
(ACIS #214461) has an office at 2501 North Orange Avenue, Suite 381, Orlando, FL, 32804.
On information and belief, defendant Hematology and Oncology Consultants bought $3,166,713
products.
98. On information and belief, defendant Florida Hematology Oncology Specialists
(ACIS #217132) has an office at 2501 North Orange Avenue, Suite 201, Orlando, FL 32804. On
information and belief, defendant Florida Hematology Oncology Specialists bought $2,850,699
39
products.
99. On information and belief, defendant Hematology and Oncology Associates of
the Treasure Coast (ACIS #214554) has an office at 1871 S.E. Tiffany Ave, Suite 100, Port St.
Lucie, FL, 34952. On information and belief, defendant Hematology and Oncology Associates
of the Treasure Coast bought $2,307,809 of Amgen drugs in the Fourth Quarter of 2006
amounts that exceeded the actual cost of these products.
100. On information and belief, defendant Mid Florida Hematology and Oncology
Centers, P.A. (ACIS #225776) has an office at 2100 West 1st Street, Sanford, FL 32771. On
information and belief, defendant Mid Florida Hematology and Oncology Centers bought
the actual cost of these products.
101. On information and belief, defendant Pasco Hernando Oncology Associates, P.A.
(ACIS #216704) has an office at 14529 Cortez Blvd, Brooksville, FL 34613. On information
40
and belief, defendant Pasco Hernando Oncology Associates, P.A. bought $1,766,348 of Amgen
products.
102. On information and belief, defendant Regional Consultants in Hematology and
Oncology (ACIS #276635) has an office at 1235 San Marco Boulevard, Suite 3, Jacksonville, FL
32207. On information and belief, defendant Regional Consultants in Hematology and
Oncology bought $1,494,671 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate
from Amgen amounting to approximately 50% of all purchases as a Platinum Amgen customer.
On information and belief, defendant made comparable purchases of Amgen drugs and received
103. On information and belief, defendant Boca Raton Community Hospital, Inc. -
Boca Raton (ACIS #236021) has an office at 1001 Northwest 13th Street, Suite 201,Boca Raton,
FL 33486. On information and belief, defendant Boca Raton Community Hospital Inc. - Boca
Raton bought $1,211,968 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate
41
104. On information and belief, defendant Cancer Institute of Florida, P.A. (ACIS
#216184) has an office at 894 East Altamonte Drive, Altamonte Springs, FL 32701. On
information and belief, defendant Cancer Institute of Florida, P.A. bought $1,884,415 of Amgen
products.
105. On information and belief, defendant South Florida Oncology Hematology (ACIS
#222362) has an office at 603 North Flamingo Road, Suite 151, Pembroke Pines, FL 33028. On
information and belief, defendant South Florida Oncology Hematology bought $1,742,102 of
products.
42
106. On information and belief, defendant Coastal Oncology, PL (ACIS #1077445)
has a location of business at 325 Clyde Morris Boulevard, Suite 450, Ormond Beach, FL 32174.
On information and belief, defendant Coastal Oncology, PL bought $1,387,285 of Amgen drugs
107. On information and belief, defendant Oncology Physicians (ACIS #226409) has
an office at 3253 McMullen Booth Road, Suite 100, Clearwater, FL 33761. On information and
belief, defendant Oncology Physicians bought $1,333,248 of Amgen drugs in the Fourth Quarter
108. On information and belief, defendant Stuart Oncology (ACIS #214555) has an
office at 501 South East Osceola Street, Suite 301, Stuart, FL 34994. On information and belief,
defendant Stuart Oncology bought $1,223,312 of Amgen drugs in the Fourth Quarter of 2006
43
109. On information and belief, defendants Neil Finkler and Robert Holloway, M.D.S.
(ACIS #278853) have an office located at 2501 North Orange Avenue, Suite 689, Orlando, FL
32804. On information and belief, defendants Neil Finkler and Robert Holloway, M.D.S. bought
and belief, defendants made comparable purchases of Amgen drugs and received comparable
cost of these products.
110. On information and belief, defendant Ayub, Sokoi, Matzkowitz and Sennabaum,
d/b/a New Hope Cancer Center (ACIS #216428) has an office at 7651 Medical Drive, Hudson,
FL 34667. On information and belief, defendant Ayub, Sokoi, Matzkowitz and Sennabaum,
d/b/a New Hope Cancer Center bought $1,152,600 of Amgen drugs in the Fourth Quarter of
44
111. On information and belief, defendant Hematology and Medical Oncology of
Southern Palm Beach County (ACIS #280445) has a business office at 2623 South Seacrest
Boulevard, Suite 216, Boynton Beach, FL 33435. On information and belief, defendant
Hematology and Medical Oncology of Southern Palm Beach County bought $1,012,382 of
products.
112. On information and belief, defendant David Dresdner, M.D. (ACIS #307671) has
an office at 1099 5th Avenue North, Suite 120, St. Petersburg, FL 33705. On information and
belief, defendant David Dresdner bought $1,004,961 of Amgen drugs in the Fourth Quarter of
Georgia Oncology Practices
113. On information and belief, defendant Georgia Cancer Specialists Administrative
Annex (ACIS #226796) has an office at 1872 Montreal Road, Tucker, GA 30084. On
45
information and belief, defendant Georgia Cancer Specialists Administrative Annex bought
114. On information and belief, defendant Northwest Georgia Oncology Centers, P.C.
(ACIS #226509) has an office at 340 Kennestone Hospital Boulevard, Suite 200, Marietta, GA
30060. On information and belief, defendant Northwest Georgia Oncology Centers, P.C. bought
115. On information and belief, defendant Augusta Oncology Associates (ACIS
#214436) has an office at 3696 Wheeler Road, Augusta, GA 30909. On information and belief,
defendant August Oncology Associates bought $2,995,248 of Amgen drugs in the Fourth
46
116. On information and belief, defendant Central Georgia Cancer Care (ACIS
#227676) has an office at 1062 Forsyth Street, Suite 1- B, Macon, GA 31201. On information
and belief, defendant Central Georgia Cancer Center bought $1,982,152 of Amgen drugs in the
117. On information and belief, defendant Northeast Georgia Cancer Care (ACIS
#214433) has an office at 3320 Old Jefferson Road, Building 700, Athens, GA 30607. On
information and belief, defendant Northeast Georgia Cancer Care bought $2,117,042 of Amgen
products.
118. On information and belief, defendant Southeast Georgia Hematology/Oncology
(ACIS #218644) has an office at 1111 Glynco Jetport Parkway, Suite 500, Brunswick, GA
47
31525. On information and belief, defendant Southeast Georgia Hematology/Oncology bought
119. On information and belief, defendant Southeastern Gynecologic Oncology (ACIS
#232559) has a business address of 980 Johnson Ferry Road, Suite 900, Atlanta, GA 30342. On
information and belief, defendant Southeastern Gynecologic Oncology bought $1,304,369 of
products.
120. On information and belief, defendant The Longstreet Clinic, P.C. (ACIS
#282126) has a business location of 725 Jesse Jewell Parkway, Suite 300, Gainesville, GA
30501. On information and belief, defendant The Longstreet Clinic, P.C. bought $1,237,083 of
48
products.
Hawaii Oncology Practices
121. On information and belief, defendant Oncare Hawaii, Inc. (ACIS #225056) has an
office at 1329 Lusitana Street, Suite 307 Physician Office Building #2, Honolulu, HI 96813. On
information and belief, defendant Oncare Hawaii, Inc. bought $1,633,183 of Amgen drugs in the
Illinois Oncology Practices
122. On information and belief, defendant Oncology-Hematology Associates of
Central Illinois (ACIS #219518) has an office at 8940 Wood Sage Road, Peoria, IL 61615. On
information and belief, defendant Oncology-Hematology Associates of Central Illinois bought
49
123. On information and belief, defendant Prairie Oncology Management Services,
LLC, d/b/a Cancer Care Specialists of Central Illinois (ACIS #229444) has an office at 210 W.
McKinley Ave., Suite 1, Decatur, IL 62526. On information and belief, defendant Prairie
Oncology Management Services, LLC, d/b/a Cancer Care Specialists of Central Illinois bought
124. On information and belief, defendant Intermed Oncology (ACIS #214811) has an
office at 17901 Governors Highway, Suite 106, Homewood, IL 60430. On information and
belief, defendant Intermed Oncology bought $3,310,809 of Amgen drugs in the Fourth Quarter
50
125. On information and belief, defendant Northwest Oncology and Hematology
(ACIS #214797) has an office at Cancer Center Institute, 800 Biesterfield Road, Suite 210, Elk
Grove Village, IL 60007. On information and belief, defendant Northwest Oncology and
Hematology bought $2,676,638 of Amgen drugs in the Fourth Quarter of 2006 receiving a
that exceeded the actual cost of these products.
126. On information and belief, defendant Northwestern Medical Faculty Foundation
(ACIS #222796) has an office at the Robert H. Lurie Comprehensive Cancer Center, 675 North
St. Claire, Suite 21-100, Chicago, IL 60611. On information and belief, defendant Northwestern
Medical Faculty Foundation bought $2,083,553 of Amgen drugs in the Fourth Quarter of 2006
127. On information and belief, defendant Joliet Oncology Hematology Associates
(ACIS #228094) has an office at 2614 West Jefferson Street, Joliet, IL 60435. On information
and belief, defendant Joliet Oncology Hematology Associates bought $1,725,518 of Amgen
51
products.
128. On information and belief, defendant Fox Valley Hematology and Oncology, Ltd.
(ACIS #235017) has an office at 1710 North Randall Road, Suite 300, Elgin, IL 60123. On
information and belief, defendant Fox Valley Hematology and Oncology, Ltd. bought
129. On information and belief, defendant Medical Arts Associates, Ltd. (ACIS
#216753) has an office at 600 John Deere Road, Suite 102, Moline, IL 61265. On information
and belief, defendant Medical Arts Associates, Ltd. bought $1,248,718 of Amgen drugs in the
52
130. On information and belief, defendant North Shore Oncology-Hematology
Associates, Ltd. (ACIS #214801) has an office at 1800 Hollister Drive, Suite 112, Libertyville,
IL 60048. On information and belief, defendant North Shore Oncology-Hematology Associates,
Ltd. bought $1,128,733 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from
131. On information and belief, defendant Edward Cancer Center (ACIS #230802) has
an office at 120 Spaulding Drive, Suite 111, Naperville, IL 60540. On information and belief,
defendant Edward Cancer Center bought $1,067,230 of Amgen drugs in the Fourth Quarter of
132. On information and belief, defendant Associates in Medical Oncology, S.C.
(ACIS #226918) has an office at 4400 West 95th Street, Suite 311, Oak Lawn, IL 60453. On
information and belief, defendant Associates in Medical Oncology, S.C. bought $1,017,769 of
53
products.
Indiana Oncology Practices
133. On information and belief, defendant Michiana Hematology-Oncology, PC (ACIS
#214684) has an office at 615 North Michigan St., South Bend, IN 46601. On information and
belief, defendant Michiana Hematology-Oncology, PC was the largest buyer of Amgen drugs in
the Nation, buying $16,828,863 of Amgen drugs in the Fourth Quarter of 2006 receiving a
134. On information and belief, defendant Hematology-Oncology of Indiana, P.C.
(ACIS #219292) has an office at 8301 Harcourt Road, Suite 200, Indianapolis, IN 46260. On
information and belief, defendant Hematology-Oncology of Indiana, P.C. bought $2,873,283 of
54
products.
135. On information and belief, defendant Oncology Hematology Associates of South
West Indiana (ACIS #2257816) has an office at 3699 Ep Road, Evansville, IN 47630. On
information and belief, defendant Oncology Hematology Associates of South West Indiana
136. On information and belief, defendant Cancer Health Treatment Centers, P.C.
(ACIS #214679) has an office at 2600 Roosevelt Road, Valparaiso, IN 46383. On information
and belief, defendant Cancer Health Treatment Centers, P.C. bought $2,684,860 of Amgen drugs
50% of all purchases as a Platinum Amgen customer. On information and belief, defendant
55
products.
137. On information and belief, defendant Fort Wayne Medical Oncology and
Hematology (ACIS #2229801) has an office at 7910 West Jefferson Blvd # 108, Fort Wayne, IN
46804. On information and belief, defendant Fort Wayne Medical Oncology and Hematology
138. On information and belief, defendant American Health Network Hematology
Oncology Associates (ACIS #285734) has an office at 6820 Parkdale Place, Suite 200,
Methodist Medical Plaza, Indianapolis, IN 46254. On information and belief, defendant
American Health Network Hematology Oncology Associates bought $1,510,076 of Amgen
products.
56
139. On information and belief, defendant Cancer Care Center, Inc. (ACIS #232959)
has a place of business at 2210 Green Valley Road, Suite 1, New Albany, IN 47150. On
information and belief, defendant Cancer Care Center bought $1,337,563 of Amgen drugs in the
140. On information and belief, defendant Arnett Cancer Care (ACIS #276455) has an
office at 420 North 26th Street, Lafayette, IN 47904. On information and belief, defendant
Arnett Cancer Care purchased $1,312,097 of Amgen drugs in the Fourth Quarter of 2006
Amgen customer. On information and belief, defendant made other comparable purchases of
141. On information and belief, defendant A P. and S. Clinic, LLC (ACIS #223192)
has an office at 1739 North 4th Street, Terre Haute, IN 47804. On information and belief,
defendant A P. and S. Clinic, LLC bought $1,263,119 of Amgen drugs in the Fourth Quarter of
57
142. On information and belief, defendant Medical Consultants (ACIS #282197) has
an office at 2401 University Avenue, Ball Cancer Center, Muncie, IN 47303. On information
and belief, defendant Medical Consultants bought $1,230,082 of Amgen drugs in the Fourth
143. On information and belief, defendant American Health Network (ACIS #216267)
has an office at 9002 North Meridian Street, Suite 214, Indianapolis, IN 46260. On information
and belief, defendant American Health Network bought $1,204,860 of Amgen drugs in the
144. On information and belief, defendant Internal Medicine Associates (ACIS
#317275) has an office at 550 Landmark Avenue, Bloomington, IN 47403. On information and
belief, defendant Internal Medicine Associates bought $1,114,499 of Amgen drugs in the Fourth
58
Iowa Oncology Practices
145. On information and belief, defendant Medical Oncology and Hematology
Associates (ACIS #214726) has an office at 1221 Pleasant Street, Suite 100, Des Moines, IA
50309. On information and belief, defendant Medical Oncology and Hematology Associates
146. On information and belief, defendant Siouxland Hematology and Oncology
(ACIS #214730) has an office at 230 Nebraska Street, Sioux City, IA. On information and
belief, defendant Siouxland Hematology and Oncology bought $2,028,564 of Amgen drugs in
59
Kansas Oncology Practices
147. On information and belief, defendant Cancer Center of Kansas (ACIS #219321)
has an office at 818 North Emporia, Suite 403, Wichita, KS 67214. On information and belief,
defendant Cancer Center of Kansas bought $5,146,553 of Amgen drugs in the Fourth Quarter of
148. On information and belief, defendant Hutchinson Clinic, (ACIS #223576) has an
office at 2101 North Waldron Street, Hutchinson, KS 67502. On information and belief,
defendant Hutchinson Clinic bought $2,840,875 of Amgen drugs in the Fourth Quarter of 2006
60
Kentucky Oncology Practices
149. On information and belief, defendant Commonwealth Cancer Center (ACIS
#230054) has an office at 520 Techwood Drive, Suite 100, Danville, KY 40422. On information
and belief, defendant Commonwealth Cancer Center bought $2,853,764 of Amgen drugs in the
Louisiana Oncology Practices
150. On information and belief, defendant Oncology Rx (ACIS #218905) has an office
at 3440 Division, Suite I., Metairie, LA 70002. On information and belief, defendant Oncology
Rx bought $3,877,978 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from
information and belief, defendant made other comparable purchases of Amgen drugs and
received comparable rebates for the said products during the Covered Period and sought and
151. On information and belief, defendant Louisiana Oncology Associates (ACIS
#214898) has an office at 4809 Ambassador Caffery Parkway, Suite 110, Lafayette, LA 70508.
On information and belief, defendant Louisiana Oncology Associates bought $1,952,998 of
61
products.
152. On information and belief, defendant Louisiana Hematology Oncology
Associates (ACIS #229326) has an office at 4950 Essen Lane, 5th Floor, Baton Rouge, LA
70809. On information and belief, defendant Louisiana Hematology Oncology Associates
Maine Oncology Practices
153. On information and belief, defendant Maine Center for Cancer Medicine (ACIS
#216577) has an office at 100 Campus Drive, Suite 108, Scarborough, ME 04074. On
information and belief, defendant Maine Center for Cancer Medicine bought $3,164,407 of
62
products.
Maryland Oncology Practices
154. On information and belief, defendant Oncology-Hematology Associates, P.A.
(ACIS #214330) has an office at 8926 Woodyard Road, Suite 201, Clinton, MD 20735. On
information and belief, defendant Oncology-Hematology Associates, P.A. bought $2,802,134 of
products.
155. On information and belief, defendant Chesapeake Oncology Hematology
Associates (ACIS #228054) has an office at 3001 South Hanover Street at the Harborview
Cancer Center-Building, Baltimore, MD 21225. On information and belief, defendant
Chesapeake Oncology Hematology Associates bought $,2,220,354 of Amgen drugs in the Fourth
63
156. On information and belief, defendant Maryland Hematology and Oncology (ACIS
#275947) has an office at 602 South Atwood Road, Suite 200, Bel Air, MD 21014. On
information and belief, defendant Maryland Hematology and Oncology bought $2,130,977 of
products.
157. On information and belief, defendant Center for Cancer and Blood Disorders
(ACIS #230353) has an office at 6420 Rockledge Drive, Suite 4100, Bethesda, MD 20817. On
information and belief, defendant Center for Cancer and Blood Disorders bought $1,812,345 of
products.
64
158. On information and belief, defendant Frederick Oncology/Hematology Associates
(ACIS #235458) has an office at 46b Thomas Johnson Drive, Frederick, MD 21702. On
information and belief, defendant Frederick Oncology/Hematology Associates bought
159. On information and belief, defendant Annapolis Medical Specialists d/b/a
Annapolis Oncology Center (ACIS #219961) has an office at 900 Bestgate Road, Suite 300,
Annapolis, MD 21401. On information and belief, defendant Annapolis Medical Specialists
d/b/a Annapolis Oncology Center bought $1,231,848 of Amgen drugs in the Fourth Quarter of
160. On information and belief, defendant Frederick P. Smith, M.D., P.C. (ACIS
#235458) has an office at 5454 Wisconsin Avenue, Suite 1300, Chevy Chase, MD 20815. On
information and belief, defendant Frederick P. Smith, M.D., P.C. bought $1,178,855 of Amgen
65
products.
161. On information and belief, defendant Community Hematology Oncology
Practitioners (ACIS #223845) has an office at 18111 Prince Philip Drive, Suite 327, Olney, MD
20832. On information and belief, defendant Community Hematology Oncology Practitioners
162. On information and belief, defendant David H. Smith, M.D. (ACIS #226541) has
an office at 29466 Pintail Drive, Suite 5, Carlton Station-Building, Easton, MD 21601. On
information and belief, defendant David H. Smith, M.D. bought $1,007,832 of Amgen drugs in
66
Massachusetts Oncology Practices
163. On information and belief, defendant Berkshire Hematology Oncology, P.C.
(ACIS #01201) has an office at 8 Conte Drive, Pittsfield, MA 01201. On information and belief,
defendant Berkshire Hematology Oncology, P.C. bought $2,563,669 of Amgen drugs in the
Michigan Oncology Practices
164. On information and belief, defendant Cancer and Hematology Centers of Western
Michigan, P.C. (ACIS #217142) has an office at Lemmen-Holton Cancer Pavilion, 145
Michigan St., NE, Suite 3100, Grand Rapids, MI 49503. On information and belief, defendant
Cancer and Hematology Centers of Western Michigan, P.C. bought $5,523,297 of Amgen drugs
50% of all purchases as a Platinum Amgen customer. On information and belief, defendant
67
products.
165. On information and belief, defendant Cancer Care Associates (ACIS #222605)
has an office at 3577 West 13 Mile Road, Suite 404 Rose Cancer Center, Royal Oak, MI 48073.
On information and belief, defendant Cancer Care Associates bought $2,919,804 of Amgen
products.
166. On information and belief, defendant The Oakland Medical Group (ACIS
#216443) has an office at 27301 Dequindre, Suite 314, Madison Heights, MI 48071. On
information and belief, defendant The Oakland Medical Group bought $2,471,681 of Amgen
products.
167. On information and belief, defendant Great Lakes Cancer Management
Specialists (ACIS #214707) has an office at 19229 Mack Avenue, Suite 24, Grosse Pointe
68
Woods, MI 48236. On information and belief, defendant Great Lakes Cancer Management
Specialists bought $2,376,034 of Amgen drugs in the Fourth Quarter of 2006 receiving a
168. On information and belief, defendant Singh and Arora Oncology Hematology,
P.C. (ACIS #320493) has an office at 4100 Beecher Road, McLaren Regional Cancer Center,
Flint, MI 48532. On information and belief, defendant Singh and Arora Oncology Hematology,
P.C. bought $2,171,651 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from
169. On information and belief, defendant Genessee Cancer and Blood Disease
Treatment Center, Inc. (ACIS #233625) has an office at 302 Kensington Avenue, First Floor,
Flint, MI 48503. On information and belief, defendant Genessee Cancer and Blood Disease
Treatment Center, Inc. bought $2,082,050 of Amgen drugs in the Fourth Quarter of 2006
69
170. On information and belief, defendant Oncology Care Associates (ACIS #288407)
has an office at 820 Lester Avenue, Suite 119, Cedarwood Medical Building, St. Joseph, MI
49085. On information and belief, defendant Oncology Care Associates bought $1,972,577 of
products.
171. On information and belief, defendant West Michigan Cancer Center (ACIS
#227513) has an office at 200 North Park Street, Kalamazoo, MI 49007. On information and
belief, defendant West Michigan Cancer Center bought $1,757,976 of Amgen drugs in the
70
172. On information and belief, defendant Michigan Hematology Oncology, PC (ACIS
#1172540) has an office at Karmanos-Crittenton Cancer Center, 1901 Star Batt Drive, Suite 200,
Rochester, MI 48309. On information and belief, defendant Michigan Hematology Oncology,
PC bought $1,714,927 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate from
173. On information and belief, defendant Hematology Oncology Consultants (ACIS
#225088) has an office at 3577 West 13 Mile Road, Suite 103, Beaumont Rose Cancer Center,
Royal Oak, MI 48073. On information and belief, defendant Hematology Oncology Consultants
174. On information and belief, defendant Newland Medical Associates (ACIS
#221347) has an office at 22301 Foster Winter Drive, 2nd Floor, Southfield, MI 48075. On
information and belief, defendant Newland Medical Associates bought $1,580,610 of Amgen
71
products.
175. On information and belief, defendant Ann Arbor Hematology Oncology
Associates, P.C. (ACIS #235995) has an office at 5301 Huron River Drive, Suite C139,
McAuley Cancer Care Building, Ypsilanti, MI, 48197. On information and belief, defendant
Ann Arbor Hematology Oncology Associates, P.C. bought $1,356,351 of Amgen drugs in the
176. On information and belief, defendant Genesee Hematology-Oncology, P.C.
(ACIS #226800) has an office at 302 Kensington Avenue, 2nd Floor Genesys Hurley Cancer
Institute, Flint, MI 48503. On information and belief, defendant Genesee Hematology-
Oncology, P.C. bought $1,028,782 of Amgen drugs in the Fourth Quarter of 2006 receiving a
72
Minnesota Oncology Practices
177. On information and belief, defendant Mayo Clinic (ACIS #215544) has a
business address of 200 First Street Southwest, Rochester, MN 55905. On information and
belief, defendant Mayo Clinic bought $4,872,568 of Amgen drugs in the Fourth Quarter of 2006
178. On information and belief, defendant North Memorial Health Care (ACIS
#1142231) has an office at 3435 West Broadway Avenue, Suite #1135, Robbinsdale, MN 55422.
On information and belief, defendant North Memorial Health Care bought $2,662,129 of Amgen
products.
73
179. On information and belief, defendant Park Nicollet Clinic - St. Louis Park (ACIS
#215542) has an office at 3800 Park Nicollet Boulevard, St. Louis Park, MN 55416. On
information and belief, defendant Park Nicollet Clinic - St. Louis Park bought $1,535,832 of
products.
180. On information and belief, defendant Fairview Southdale Breast Center (ACIS
#1112475) has an office at 6545 France Ave, S. Edina, MN 55435. On information and belief,
defendant Fairview Southdale Breast Center bought $1,514,101 of Amgen drugs in the Fourth
Mississippi Oncology Practices
181. On information and belief, defendant Jackson Oncology Associates, PLLC (ACIS
#216438) has an office at 1227 North State Street, Suite 101, Hetterman Cancer Center, Jackson,
MS 39202. On information and belief, defendant Jackson Oncology Associates, PLLC bought
74
182. On information and belief, defendant Hattiesburg Clinic, P.A. (ACIS #214607)
has an office at 415 South 28th Avenue, Hattiesburg, MS 39401. On information and belief,
defendant Hattiesburg Clinic, P.A. bought $1,398,480 of Amgen drugs in the Fourth Quarter of
183. On information and belief, defendant Meridian Oncology Associates, PLLC
(ACIS #281480) has an office at 1704 23rd Avenue, Second Floor, Meridian, MS 39301. On
information and belief, defendant Meridian Oncology Associates, P.L.L.C. bought $1,020,535 of
Government Healthcare Programs for administration of the Covered Drugs to patients
75
Missouri Oncology Practices
184. On information and belief, defendant Washington University - Siteman Cancer
Center (ACIS #216758) has an office at 4921 Parkview Place, Seventh Floor, St. Louis, MO
63110. On information and belief, defendant Washington University - Siteman Cancer Center
185. On information and belief, defendant St. Louis Cancer Care LLP (ACIS #216759)
has an office at 533 Couch Avenue, Suite G-20, Kirkwood, MO 63122. On information and
belief, defendant St. Louis Cancer Care Llp bought $2,070,596 of Amgen drugs in the Fourth
76
186. On information and belief, defendant Mercy Cancer Care (ACIS #226393) has an
office at 607 South New Ballas Road, Suite 3300, St. Louis, MO 63141. On information and
belief, defendant Mercy Cancer Care bought $2,105,802 of Amgen drugs in the Fourth Quarter
187. On information and belief, defendant Midwest Hematology Oncology
Consultants, Ltd., d/b/a/ Hematology Oncology Consultants, Inc. (ACIS #217079) has an office
at 11125 Dunn Road, Suite 100 Physicians Office Building 2, St. Louis, MO 63136. On
information and belief, defendant Midwest Hematology Oncology Consultants, Ltd., d/b/a/
Hematology Oncology Consultants, Inc. bought $1,416,236 of Amgen drugs in the Fourth
188. On information and belief, defendant St. Johns Clinic Cancer and Hematology
(ACIS #233156) has an office at 2115 South Fremont, Suite 1000, Springfield, MO 65804. On
information and belief, defendant St. Johns Clinic Cancer and Hematology bought $1,235,122 of
77
products.
Montana Oncology Practices
189. On information and belief, defendant Hematology Oncology Centers of the
Northern Rockies, P.C. (ACIS #234646) has an office at 2900 12th Avenue North, Suite 160
West, Billings, MT 59101. On information and belief, defendant Hematology Oncology Centers
of the Northern Rockies, P.C. bought $1,803,711 of Amgen drugs in the Fourth Quarter of 2006
Nebraska Oncology Practices
190. On information and belief, defendant Hematology Oncology Consultants, P.C.
(ACIS #223435) has an office at 6901 North 72nd Street, Immanuel Cancer Center, Suite 2244,
Omaha, NE 68122. On information and belief, defendant Hematology Oncology Consultants,
78
191. On information and belief, defendant Nebraska Hematology Oncology, P.C.
(ACIS #235846) has an office at 2611 South 70th Street, Lincoln, NE 68506. On information
and belief, defendant Nebraska Hematology Oncology, P.C. bought $1,090,296 of Amgen drugs
New Jersey Oncology Practices
192. On information and belief, defendant Medical Oncology-Hematology Specialists
(ACIS #214173) has an office at 420 Boulevard, Suite 201, Mountain Lakes, NJ 07046. On
information and belief, defendant Medical Oncology-Hematology Specialists bought $3,513,325
79
products.
193. On information and belief, defendant Hematology-Oncology Associates of
Northern New Jersey, P.A. (ACIS #224123) has an office at 100 Madison Avenue, Second
Floor, Carol Simon Cancer Center, Morristown, NJ 07962. On information and belief, defendant
Hematology-Oncology Associates of Northern New Jersey, P.A. bought $2,043,514 of Amgen
products.
194. On information and belief, defendant Hematology-Oncology of Central New
Jersey (ACIS #223883) has an office at 180 While Road, Suite 101, Little Silver, NJ 07739. On
information and belief, defendant Hematology-Oncology of Central New Jersey bought
80
195. On information and belief, defendant Cooper Cancer Institute - Division of
Hematology/Oncology (ACIS #219959) has an office at 900 Centennial Boulevard, Suite M.,
Voorhees, NJ 08043. On information and belief, defendant Cooper Cancer Institute - Division
of Hematology/Oncology bought $2,029,611 of Amgen drugs in the Fourth Quarter of 2006
196. On information and belief, defendant Southern Oncology-Hematology
Associates, P.A. (ACIS #219284) has an office at 1505 W. Sherman Avenue, Suite 101,
Vineland, NJ 83060. On information and belief, defendant Southern Oncology-Hematology
Associates bought $1,728,806 of Amgen drugs in the Fourth Quarter of 2006 receiving a
197. On information and belief, defendant Medical Diagnostic Associates (ACIS
#226556) has an office at 99 Beavoir Avenue, Summit, NJ 07901. On information and belief,
defendant Medical Diagnostic Associates bought $1,691,254 of Amgen drugs in the Fourth
81
198. On information and belief, defendant Kenneth D. Nahum, M.D. (ACIS #219566)
has a medical practice at 4505 Route 9 North, Howell Office Plaza, Howell, NJ 07731. On
information and belief, defendant Kenneth D. Nahum, M.D. bought $1,587,749 of Amgen drugs
199. On information and belief, defendant Hunterdon Hematology Oncology Group
(ACIS #221887) has an office at 2100 Wescott Drive, Flemington, NJ 08822. On information
and belief, defendant Hunterdon Hematology Oncology Group bought $1,514,454 of Amgen
products.
82
200. On information and belief, defendant Princeton Medical Group (ACIS #216391)
has an office at 419 North Harrison Street, Princeton, NJ 08540. On information and belief,
defendant Princeton Medical Group bought $1,485,906 of Amgen drugs in the Fourth Quarter of
201. On information and belief, defendant Central Jersey Oncology Center, P.A.
(ACIS #224722) has an office at 205 Easton Avenue, New Brunswick, NJ 08901. On
information and belief, defendant Central Jersey Oncology Center, P.A. bought $1,481,175 of
products.
202. On information and belief, defendant Atlantic Hematology Oncology Associates
(ACIS #216275) has an office at 1707 Atlantic Avenue, Manasquan, NJ 08736. On information
and belief, defendant Atlantic Hematology Oncology Associates bought $1,438,610 of Amgen
83
products.
203. On information and belief, defendant Hope Community Cancer Center (ACIS
#231195) has an office at 210 South Shore Road, Route 9, Suite 106, Marmora, NJ 08223. On
information and belief, defendant Hope Community Cancer Center bought $1,256,598 of Amgen
products.
204. On information and belief, defendant The Center for Hematology/Oncology
(ACIS #230776) has an office at 75 Veronica Avenue, Suite 201, Somerset, NJ 08873. On
information and belief, defendant The Center for Hematology/Oncology bought $1,233,144 of
84
products.
205. On information and belief, defendant Hematology Oncology Associates of New
Jersey (ACIS #214166) has an office at One Valley Health Plaza, 2nd Floor, Paramus, NJ 07652.
On information and belief, defendant Hematology Oncology Associates of New Jersey bought
New Mexico Oncology Practices
206. On information and belief, defendant New Mexico Oncology Hematology
Consultants (ACIS #217159) has an office at 4901 Lang Avenue Northeast, Albuquerque, NM
87109. On information and belief, defendant New Mexico Oncology Hematology Consultants
information and belief, defendant made other comparable purchases of Amgen drugs and
received comparable rebates for the said products during the Covered Period and sought and
85
New York Oncology Practices
207. On information and belief, defendant North Shore Hematology Oncology
Associates, P.C. (ACIS #233151) has an office at 235 North Belle Mead Road, East Setauket,
NY 11733. On information and belief, defendant North Shore Hematology Oncology
Associates, P.C. bought $4,945,940 of Amgen drugs in the Fourth Quarter of 2006 receiving a
208. On information and belief, defendant Broome Oncology (ACIS #281655) has an
office at 30 Harrison Street, Suite 100, Johnson City, NY 13790. On information and belief,
defendant Broome Oncology bought $3,742,703 of Amgen drugs in the Fourth Quarter of 2006
209. On information and belief, defendant Hematology Oncology Associates of
Central New York, P.C. (ACIS #219835) has an office at 5008 Brittonfield Parkway, Suite 700,
East Syracuse, NY 13057. On information and belief, defendant Hematology Oncology
Associates of Central New York, P.C. bought $2,996,325 of Amgen drugs in the Fourth Quarter
86
210. On information and belief, defendant Hudson Valley Hematology Oncology
(ACIS #232139) has an office at 19 Baker Avenue, Suite 100, Poughkeepsie, NY 12601. On
information and belief, defendant Hudson Valley Hematology Oncology bought $2,143,682 of
products.
211. On information and belief, defendant Queens Long Island Medical Group P.C.
(ACIS #1189227) has an office at 226 Clinton Street, Hempstead, NY 11550. On information
and belief, defendant Queens Long Island Medical Group P.C. bought $2,084,383 of Amgen
87
products.
212. On information and belief, defendant Park Slope Medicine (ACIS #235440) has
an office at 343 4th Avenue, Brooklyn, NY 11215. On information and belief, defendant Park
Slope Medicine bought $1,716,099 of Amgen drugs in the Fourth Quarter of 2006 receiving a
213. On information and belief, defendant Buffalo Medical Group (ACIS #229311)
has an office at 295 Essjay Road, Williamsville, NY 14221. On information and belief,
defendant Buffalo Medical Group bought $1,236,016 of Amgen drugs in the Fourth Quarter of
214. On information and belief, defendant Century Medical Associates (ACIS
#221489) has an office at 45 Spindrift Drive, Suite 100, Buffalo, NY 14221. On information and
belief, defendant Century Medical Associates bought $1,966,793 of Amgen drugs in the Fourth
88
215. On information and belief, defendant South Shore Hematology Oncology
Associates (ACIS #216396) has an office at 242 Merrick Road, Suite 301, Rockville Centre, NY
11570. On information and belief, defendant South Shore Hematology Oncology Associates
216. On information and belief, defendant Tomao, Marino and McNelis, M.D.S.
(ACIS #216190) has an office at 44 South Bayles Avenue, Suite 218, Port Washington, NY
11050. On information and belief, defendant Tomao, Marino and McNelis, M.D.S. bought
89
217. On information and belief, defendant the Department of Medicine Medical
Services Group at SUNY HSC d/b/a University Physicians (ACIS #319604) has an office at
1000 East Genessee Street, Suite 403, Syracuse, NY 13210. On information and belief,
defendant Department of Medicine Medical Services Group at SUNY HSC d/b/a University
Physicians bought $1,243,088 in Amgen drugs in the Fourth Quarter of 2006 receiving a rebate
from Amgen amounting to approximately 40% of all purchases as a Gold Amgen customer. On
Western Suffolk, P.C. (ACIS #216593) has an office at 24 East Main Street, Bayshore, NY
11706. On information and belief, defendant Hematology Oncology Associates of Western
Suffolk, P.C. bought $1,213,547 of Amgen drugs in the Fourth Quarter of 2006 receiving a
90
219. On information and belief, defendant Hematology and Medical Oncology (ACIS
#226967) has an office at 9920 4th Avenue, Suites 310 and 311, Brooklyn, NY 11209. On
information and belief, defendant Hematology and Medical Oncology bought $1,194,542 of
products.
220. On information and belief, defendant Hematology-Oncology Associates of
Rockland, P.C. (ACIS #220643) has an office at 500 C New Hempstead Road, New City, NY
10956. On information and belief, defendant Hematology- Oncology Associates of Rockland,
Nevada Oncology Practices
221. On information and belief, defendant Nevada Cancer Center (ACIS #221684) has
an office at 1950 East Desert Inn Road, Suite A, Las Vegas, NV 89109. On information and
91
belief, defendant Nevada Cancer Center bought $1,585,052 of Amgen drugs in the Fourth
222. On information and belief, defendant Cancer and Blood Specialists of Nevada
(ACIS #235111) has an office at 701 Shadow Lane #300, Las Vegas, NV 89102. On
information and belief, defendant Cancer and Blood Specialists of Nevada bought $1,651,938 of
products.
North Carolina Oncology Practices
223. On information and belief, defendant Piedmont Hematology Oncology Associates
(ACIS #216637) has an office at 1010 Bethesda Court, Winston-Salem, NC 27103. On
information and belief, defendant Piedmont Hematology Oncology Associates bought
92
224. On information and belief, defendant Southeastern Medical Oncology Center
(ACIS #216637) has an office at 203 Cox Boulevard, Goldsboro, NC 27534. On information
and belief, defendant Southeastern Medical Oncology Center bought $3,101,058 of Amgen
products.
225. On information and belief, defendant Gaston Hematology and Oncology
Associates (ACIS #228950) has an office at 2610 Aberdeen Boulevard, Gastonia, NC 28054.
On information and belief, defendant Gaston Hematology and Oncology Associates bought
93
226. On information and belief, defendant Hanover Medical Specialists, P.A. (ACIS
#216841) has an office at 1520 Physicians Drive, Wilmington, NC 28401. On information and
belief, defendant Hanover Medical Specialists, P.A. bought $2,560,037 of Amgen drugs in the
227. On information and belief, defendant Northwestern Carolina Oncology and
Hematology - Hickory (ACIS #216525) has an office at 225 18th Street Southeast, Hickory, NC
28602. On information and belief, defendant Northwestern Carolina Oncology and Hematology
228. On information and belief, defendant Carolinas Physicians Network d/b/a
Carolinas Hematology Oncology Associates (ACIS #342165) has an office at 1100 South Tryon
Street, Suite 400, Charlotte, NC 28203. On information and belief, defendant Carolinas
94
Physicians Network d/b/a Carolinas Hematology Oncology Associates bought $1,695,127 of
products.
229. On information and belief, defendant Northeast Oncology Associates (ACIS
#315243) has an office at the Roy Hinson Cancer Center, 945 North Fifth Street, Albemarle, NC
28002. On information and belief, defendant Northeast Oncology Associates bought $1,577,816
products.
230. On information and belief, defendant Carolinas Cancer Care (ACIS #231271) has
an office at 411 Billingsley Road, Suite 103, Charlotte, NC 28211. On information and belief,
defendant Carolinas Cancer Care bought $1,302,606 of Amgen drugs in the Fourth Quarter of
95
North Dakota Oncology Practices
231. On information and belief, defendant Meritcare Medical Group d/b/a Roger Maris
Cancer Center (ACIS #228933) has an office at 820 4th Street North, Fargo, ND 58102. On
information and belief, defendant Meritcare Medical Group d/b/a Roger Maris Cancer Center
Ohio Oncology Practices
232. On information and belief, defendant Oncology Hematology Care, Inc. (ACIS
#214665) has an office at 199 William Howard Taft Road, Cincinnati, OH 45219. On
information and belief, defendant Oncology Hematology Care, Inc. bought $8,655,785 of
96
products.
233. On information and belief, defendant Hematology Oncology of Dayton (ACIS
#214665) has an office at 9000 North Main Street, Suite G36, Dayton, OH 45415. On
information and belief, defendant Hematology Oncology of Dayton bought $3,319,023 of
products.
234. On information and belief, defendant Mid-Ohio Oncology Hematology (ACIS
#229095) has an office at 745 West State Street, Suite 550b, Columbus, OH 43222. On
information and belief, defendant Mid-Ohio Oncology Hematology bought $3,210,795 of
products.
97
235. On information and belief, defendant Cincinnati Hematology Oncology Inc.
(ACIS #216221) has an office at 2727 Madison Road, Suite 400, Cincinnati, OH 45209. On
information and belief, defendant Cincinnati Hematology Oncology Inc. bought $2,193,925 of
products.
236. On information and belief, defendant Hematology Oncology Center, Inc. (ACIS
#216440) has an office at 41201 Schadden Road, Elyria, OH 44035. On information and belief,
defendant Hematology Oncology Center, Inc. bought $2,165,264 of Amgen drugs in the Fourth
237. On information and belief, defendant Blood and Cancer Center (ACIS #216226)
has an office at 3695a Boardman Canfield Road, Canfield, OH 44406. On information and
belief, defendant Blood and Cancer Center bought $2,083,908 of Amgen drugs in the Fourth
98
238. On information and belief, defendant Columbus Oncology Associates, Inc. (ACIS
#214637) has an office at 810 Jason Way, Suite A, Columbus, OH 43214. On information and
belief, defendant Columbus Oncology Associates bought $1,811,960 of Amgen drugs in the
239. On information and belief, defendant Ohio Cancer Specialists (ACIS #214658)
has an office at 371 Cline Avenue, Mansfield, OH 44907. On information and belief, defendant
Ohio Cancer Specialists bought $1,461,185 of Amgen drugs in the Fourth Quarter of 2006
240. On information and belief, defendant Northcoast Cancer Care (ACIS #214657)
has an office at 1674 Sycamore Line, Sandusky, OH 44870. On information and belief,
99
defendant Northcoast Cancer Care bought $1,300,669 of Amgen drugs in the Fourth Quarter of
241. On information and belief, defendant Nashat Y. Gabrail, M.D. (ACIS #223827)
has an office at 4875 Higbee Avenue North West, Canton, OH 44718. On information and
belief, defendant Hashat Y. Gabrail, M.D. bought $1,069,530 of Amgen drugs in the Fourth
242. On information and belief, defendant Hope Cancer Center of Northwest Ohio,
Inc. (ACIS #347340) has an office at 825 West Market Street, Suite 260, Lima, OH 45805. On
information and belief, defendant Hope Cancer Center of Northwest Ohio bought $1,006,959 of
100
products.
Oklahoma Oncology Practices
243. On information and belief, defendant Oklahoma Oncology and Hematology
Associates Inc. d/b/a Cancer Care Associates (ACIS #217034) has an office at 1810 East 15th
Street, Tulsa, OK 74104. On information and belief, defendant Oklahoma Oncology and
Hematology Associates Inc. d/b/a Cancer Care Associates bought $9,966,750 of Amgen drugs in
244. On information and belief, defendant Oklahoma Oncology Incorporated (ACIS
#214928) has an office at 1705 East 19th Street, Suite 201, Tulsa, OK 74104. On information
and belief, defendant Oklahoma Oncology Incorporated bought $1,585,521 of Amgen drugs in
101
Oregon Oncology Practices
245. On information and belief, defendant Pacific Oncology, PC (ACIS #224096) has
an office at 1130 NW 22nd Ave, Ste. 100, Portland, OR 97210. On information and belief,
defendant Pacific Oncology, PC bought $3,684,006 of Amgen drugs in the Fourth Quarter of
246. On information and belief, defendant Hematology Oncology Associates, P.C.
(ACIS #281226) has an office at 2828 Barnett Rd, Medford, OR 97504. On information and
belief, defendant Hematology Oncology Associates, P.C. bought $2,517,096 of Amgen drugs in
247. On information and belief, defendant Hematology Oncology of Salem, LLP,
(ACIS #235125) has an office at 875 Oak Street Southeast, 4th Floor, Suite 4030, Salem, OR
97301. On information and belief, defendant Hematology Oncology of Salem, LLP, bought
102
Pennsylvania Oncology Practices
248. On information and belief, defendant Medical Center Clinic - Cercone Village
Office (ACIS #226469) has an office at 4727 Friendship Avenue, Suite 340, Pittsburgh, PA
15224. On information and belief, defendant Medical Center Clinic - Cercone Village Office
249. On information and belief, defendant Consultants in Medical Oncology and
Hematology (ACIS #216201) has an office at 2100 Keystone Avenue, Suite 502, Medical Office
Building, Drexel Hill, PA 19026. On information and belief, defendant Consultants in Medical
Oncology and Hematology bought $3,188,672 of Amgen drugs in the Fourth Quarter of 2006
103
250. On information and belief, defendant Abington Hematology-Oncology Associates
Inc. (ACIS #219505) has an office at 2510 Maryland Avenue, Suite 175, Willow Grove, PA
19090. On information and belief, defendant Abington Hematology - Oncology, Associates, Inc.
251. On information and belief, defendant Cancer Care Associates of York (ACIS
#216401) has an office at 25 Monument Road, Suite 294, York, PA 17403. On information and
belief, defendant Cancer Care Associates of York $2,796,915 bought of Amgen drugs in the
252. On information and belief, defendant Pennsylvania Oncology Hematology
Associates (ACIS #22630) has an office at 230 West Washington Square, 2nd Floor,
104
Philadelphia, PA 19106. On information and belief, defendant Pennsylvania Oncology
Hematology Associates bought $2,460,575 of Amgen drugs in the Fourth Quarter of 2006
253. On information and belief, defendant Bryn Mawr Medical Specialists (ACIS
#225591) has an office at 933 Haverford Road, Bryn Mawr, PA 19010. On information and
belief, defendant Bryn Mawr Medical Specialists bought $2,385,421 of Amgen drugs in the
254. On information and belief, defendant Greater Philadelphia Cancer and
Hematology Specialists (ACIS #214306) has an office at 3998 Red Lion Road, Suite 130,
Frankford Torresdale Cancer Center, Philadelphia, PA 19114. On information and belief,
defendant Greater Philadelphia Cancer and Hematology Specialists bought $2,273,492 of
105
products.
Northeast Pennsylvania (ACIS #317527) has an office at 1100 Meade Street, Dunmore, PA
18512. On information and belief, defendant Hematology Oncology Associates of Northeast
Pennsylvania bought $2,240,760 of Amgen drugs in the Fourth Quarter of 2006 receiving a
256. On information and belief, defendant Chester County Hematology and Oncology
Services (ACIS #214318) has an office at 440 East Marshall Street, Suite 201,West Chester, PA
19380. On information and belief, defendant Chester County Hematology and Oncology
Services bought $2,063,086 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate
106
257. On information and belief, defendant Bux-Mont Oncology-Hematology Medical
Associates (ACIS #216215) has an office at 915 Lawn Avenue, Suite 202, Sellersville, PA
18960. On information and belief, defendant Bux-Mont Oncology-Hematology Medical
Associates bought $1,999,889 of Amgen drugs in the Fourth Quarter of 2006 receiving a
258. On information and belief, defendant Regional Cancer Center (ACIS #214277)
has an office at 2500 West 12th Street, Erie, PA 16505. On information and belief, defendant
Regional Cancer Center bought $1,924,144 of Amgen drugs in the Fourth Quarter of 2006
259. On information and belief, defendant Regional Hematology Oncology Associates
(ACIS #281025) has an office at 240 Middletown Boulevard, Suite 205, Langhorne, PA 19047.
On information and belief, defendant Regional Hematology Oncology Associates bought
107
260. On information and belief, defendant Cantor, Biermann, Fellin and Associates
(ACIS #216178) has an office at 1330 Powell Street, Suite 308, Norristown, PA 19401. On
information and belief, defendant Cantor, Biermann, Fellin and Associates bought $2,097,174 of
products.
261. On information and belief, defendant Associates in Hematology Oncology, P.C.
(ACIS #224128) has an office at One Medical Center Boulevard, Suite 341, Crozer-Regional
Cancer Center, Chester, PA 19013. On information and belief, defendant Associates in
Hematology Oncology, P.C. bought $1,990,602 of Amgen drugs in the Fourth Quarter of 2006
108
262. On information and belief, defendant Jefferson Hematology/Medical Oncology
Associates (ACIS #226768) has an office at 111 South 11th Street, Gibbon Building, Suite
G4240, Philadelphia, PA 19107. On information and belief, defendant Jefferson
Hematology/Medical Oncology Associates bought $1,536,643 of Amgen drugs in the Fourth
263. On information and belief, defendant Shah, Giangiulio and Cormier, M.D.S.
(ACIS #216407) has an office at 1240 South Cedar Crest Blvd, Suite 305, Allentown, PA 18103.
On information and belief, defendant Shah, Giangiulio and Cormier, M.D.S. bought $1,471,310
products.
264. On information and belief, defendant Cancer Care of Central Pennsylvania (ACIS
#319646) has an office at 1575 North Old Trail, Selinsgrove, PA 17870. On information and
109
belief, defendant Cancer Care of Central Pennsylvania bought $1,465,427 of Amgen drugs in the
265. On information and belief, defendant Hematology Oncology Associates (ACIS
#214302) has an office at 33 Chester Pike, Ridley Park, PA 19078. On information and belief,
defendant Hematology Oncology Associates bought $1,458,467 of Amgen drugs in the Fourth
266. On information and belief, defendant Oncology-Hematology of Lehigh Valley
(ACIS #217123) has an office at 701 Ostrum Street, Suite 403, Bethlehem, PA 18015. On
information and belief, defendant Oncology-Hematology of Lehigh Valley bought $1,449,366 of
110
products.
267. On information and belief, defendant Conemaugh Cancer Care Center (ACIS
#345702) has an office at 1020 Franklin Street, Johnstown, PA 15905. On information and
belief, defendant Conemaugh Cancer Care Center bought $1,299,659 of Amgen drugs in the
268. On information and belief, defendant Hematology-Oncology Group, P.C. (ACIS
#226312) has a business location at 1205 Langhorne-Newtown Road, Suite 407, Langhorne, PA
19047. On information and belief, defendant Hematology-Oncology Group, P.C. bought
269. On information and belief, defendant Central Pennsylvania Hematology and
Medical Oncology Associates (ACIS #227149) has an office at 50 North 12th Street, Upper
Level, Lemoyne, PA 17043. On information and belief, defendant Central Pennsylvania
111
Hematology and Medical Oncology Associates bought $1,220,770 of Amgen drugs in the Fourth
270. On information and belief, defendant Mainline Oncology Hematology Associates
at Lankenau Hospital (ACIS #276706) has an office at 100 Lancaster Avenue, One Medical
Science Building, Wynnewood, PA 19096. On information and belief, defendant Mainline
Oncology Hematology Associates at Lankenau Hospital bought $1,215,396 of Amgen drugs in
271. On information and belief, defendant Lehigh Valley Womens Cancer Center
(ACIS #226473) has an office at 1611 Pond Road, Suite 101, Allentown, PA 18104. On
information and belief, defendant Lehigh Valley Womens Cancer Center bought $1,157,075 of
112
products.
South Carolina Oncology Practices
272. On information and belief, defendant South Carolina Oncology Associates, P.A.
(ACIS #276939) has an office at 166 Stoneridge Drive, Columbia, SC 29210. On information
and belief, defendant South Carolina Oncology Associates, P.A. bought $5,191,232 of Amgen
products.
273. On information and belief, defendant Coastal Cancer Center is a Division of
Associated Medical Specialists (ACIS #217016) and has an office at 8121 Rourk Street, Myrtle
Beach, SC 29572. On information and belief, defendant Coastal Cancer Center bought
113
274. On information and belief, defendant Palmetto Hematology Oncology, P.C.
(ACIS #222029) has an office at 380 Serpentine Drive, Suite 200, Spartanburg, SC 29303. On
information and belief, defendant Palmetto Hematology Oncology, P.C. bought $1,588,219 of
products.
275. On information and belief, defendant Charleston Hematology and Oncology
(ACIS #216656) has an office at 125 Doughty Street, Suite 280, Charleston, SC 29403. On
information and belief, defendant Charleston Hematology and Oncology bought $1,231,799 of
products.
276. On information and belief, defendant Lowcountry Hematology and Oncology,
P.A. (ACIS #312171) has an office at 900 Bowman Road, Suite 103, Mount Pleasant, SC 29464.
114
On information and belief, defendant Lowcountry Hematology and Oncology, P.A. bought
South Dakota Oncology Practices
277. On information and belief, defendant Sioux Valley Oncology Clinic (ACIS
#220053) has an office at 1020 West 18th Street, Sioux Falls, SD 57104. On information and
belief, defendant Sioux Valley Oncology Clinic bought $1,061,648 of Amgen drugs in the
Tennessee Oncology Practices
278. On information and belief, defendant Tennessee Oncology, PLLC (ACIS
#216711) has an office at 300 20th Avenue North, Suite 301, Nashville, TN 37203. On
information and belief, defendant Tennessee Oncology, PLLC bought $15,816,588 of Amgen
115
products.
279. On information and belief, defendant The West Clinic (ACIS #214588) has an
office at 100 North Humphreys Boulevard, Memphis, TN 38120. On information and belief,
defendant The West Clinic bought $10,059,703 of Amgen drugs in the Fourth Quarter of 2006
280. On information and belief, defendant Tennessee Cancer Specialists (ACIS
#1112298) has an office at 9430 Parkwest Blvd., Ste 120, Knoxville, TN 37923. On information
and belief, defendant Tennessee Cancer Specialists bought $6,681,301 of Amgen drugs in the
116
281. On information and belief, defendant Boston Baskin Cancer Group - University
of Tennessee Cancer Institute (ACIS #214590) has an office at 1331 Union Avenue, Suite 800,
Memphis, TN 38104. On information and belief, defendant Boston Baskin Cancer Group -
University of Tennessee Cancer Institute bought $3,478,671 of Amgen drugs in the Fourth
282. On information and belief, defendant Kingsport Hematology-Oncology
Associates (ACIS #216714) has an office at 111 West Stone Drive, Suite 300, Kingsport, TN
37660. On information and belief, defendant Kingsport Hematology-Oncology Associates
283. On information and belief, defendant Thompson Oncology Group (ACIS
#219552) has an office at 1915 White Avenue, 1st Floor, Thompson Cancer Survival Center,
117
Knoxville, TN 37916. On information and belief, defendant Thompson Oncology Group bought
and belief, defendant made other comparable purchases of Amgen drugs and received
284. On information and belief, defendant Chattanooga Oncology Hematology
Associates (ACIS #216533) has an office at 605 Glenwood Drive, Suite 200, Chattanooga, TN
37404. On information and belief, defendant Chattanooga Oncology Hematology Associates
285. On information and belief, defendant East Tennessee Hematology Oncology
Associates PC d/b/a McLeod Cancer and Blood Center (ACIS #216164) has an office at 310
State of Franklin Road, Suite 401, Johnson City, TN 37604. On information and belief,
defendant East Tennessee Hematology Oncology Associates PC d/b/a McLeod Cancer and
Blood Center bought $1,527,385 of Amgen drugs in the Fourth Quarter of 2006 receiving a
118
286. On information and belief, defendant Timothy Panella, M.D. d/b/a University
Cancer Specialists (ACIS #346822) has an office at 1934 Acoa Highway, Medical Building D,
Suite 370, Knoxville, TN 37920. On information and belief, defendant Timothy Panella, M.D.
d/b/a University Cancer Specialists bought $1,171,873 of Amgen drugs in the Fourth Quarter of
287. On information and belief, defendant Wahid T. Hanna, M.D. (ACIS #221174) has
an office at 1934 Alcoa Highway, Suite 472, Knoxville, TN 37920. On information and belief,
defendant Wahid T. Hanna, M.D. bought $1,107,461 of Amgen drugs in the Fourth Quarter of
119
Texas Oncology Practices
288. On information and belief, defendant South Texas Oncology and Hematology
Associates, P.A. (ACIS #234725) has an office at 315 North San Saba, Suite E 1160, San
Antonio, TX 78207. On information and belief, defendant South Texas Oncology and
Hematology Associates, P.A. bought $5,059,026 of Amgen drugs in the Fourth Quarter of 2006
289. On information and belief, defendant Houston Cancer Clinic (ACIS #261159) has
an office at 920 Medical Plaza, Suite 140, Spring, TX 77380. On information and belief,
defendant Houston Cancer Clinic bought $3,839,157 of Amgen drugs in the Fourth Quarter of
290. On information and belief, defendant Oncology Consultants (ACIS #214981) has
an office at 2130 W. Holcombe Blvd., 10th Floor, Houston, TX 77030. On information and
belief, defendant Oncology Consultants bought $2,607,515 of Amgen drugs in the Fourth
120
defendant.
291. On information and belief, defendant Tyler Hematology Oncology (ACIS
#225164) has an office at 721-A Clinic Drive, Tyler, TX 75701. On information and belief,
defendant Tyler Hematology Oncology bought $2,138,035 of Amgen drugs in the Fourth
defendant.
292. On information and belief, defendant Metroplex Hematology/Oncology
Associates d/b/a Arlington Cancer Center (ACIS #225829) has an office at 906 West Randol
Mill Road, Arlington, TX 76012. On information and belief, defendant Metroplex
Hematology/Oncology Associates d/b/a Arlington Cancer Center bought $1,927,917 of Amgen
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293. On information and belief, defendant Southeast Texas Oncology Partners (ACIS
#235638) has an office at 1140 Cypress Station Drive, Suite 302, Houston, TX 77090. On
information and belief, defendant Southeast Texas Oncology Partners bought $1,865,967 of
294. On information and belief, defendant Northwest Cancer Center (ACIS #216459)
has an office at 17323 Red Oak Drive, Houston, TX 77090. On information and belief,
defendant Northwest Cancer Center bought $1,805,176 of Amgen drugs in the Fourth Quarter of
295. On information and belief, defendant Rohit Kapoor, M.D., P.A. (ACIS #231675)
has an office at 12602 Toepperwein Road, Suite 202, San Antonio, TX 78233. On information
122
and belief, defendant Rohit Kapoor, M.D., P.A. bought $1,366,602 of Amgen drugs in the Fourth
defendant.
296. On information and belief, defendant Texas Cancer Associates (ACIS #214949)
has a business location at 6119 Greenville Avenue, Dallas, TX 75206. On information and
belief, defendant Texas Cancer Associates bought $1,497,479 of Amgen drugs in the Fourth
297. On information and belief, defendant University of Texas at Southwestern
Simmons Cancer Center (ACIS #233615) has an office at 2201 Inwood Road, RM Nc2.852,
Dallas, TX 75235. On information and belief, defendant University of Texas at Southwestern
Simmons Cancer Center bought $1,490,783 of Amgen drugs in the Fourth Quarter of 2006
123
298. On information and belief, defendant Abilene Hematology-Oncology Group, P.A.
(ACIS #312052) has an office at 2000 Pine Street, Hendrick Cancer Center Building, Abilene,
TX 79601. On information and belief, defendant Abilene Hematology-Oncology Group, P.A.
299. On information and belief, defendant Lone Star Oncology Consultants, P.A.
(ACIS #215031) has an office at 11044 Research Boulevard, Suite D400, Austin, TX 78759. On
information and belief, defendant Abilene Hematology-Oncology Group, P.A. bought
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300. On information and belief, defendant Kelsey Seybold Clinic (ACIS #218157) has
an office at 2727 West Holcombe Boulevard, Houston, TX 77025. On information and belief,
defendant Kelsey Seybold Clinic bought $1,254,192 of Amgen drugs in the Fourth Quarter of
301. On information and belief, defendant Blood and Cancer Center of East Texas
(ACIS #346857) has an office at 825 Medical Drive, Tyler, TX 75701. On information and
belief, defendant Blood and Cancer Center of East Texas bought $1,200,633 of Amgen drugs in
defendant.
302. On information and belief, defendant Coastal Bend Cancer Center (ACIS
#280320) has an office at 1415 Santa Fe Street, Suite C, Corpus Christi, TX 78404. On
information and belief, defendant Coastal Bend Cancer Center bought $1,192,935 of Amgen
125
303. On information and belief, defendant South Texas Institute of Cancer and Blood
Disorders (ACIS #277431) has an office at 14120 Farm Market Road 624, Corpus Christi, TX
78410. On information and belief, defendant South Texas Institute of Cancer and Blood
Disorders bought $1,011,404 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate
from Amgen amounting to approximately 40% of all purchases as a Gold Amgen customer. On
Utah Oncology Practices
304. On information and belief, defendant Utah Cancer Specialists (ACIS #224954)
has an office at 3838 South 700 East, Suite 100, Salt Lake City, UT 84106. On information and
belief, defendant Utah Cancer Specialists bought $2,728,797 of Amgen drugs in the Fourth
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defendant.
305. On information and belief, defendant Central Utah Clinic (ACIS #216209) has an
office at 1055 North 500 West, Building A Suite 202, Provo, UT 84604. On information and
belief, defendant Central Utah Clinic bought $2,331,403 of Amgen drugs in the Fourth Quarter
Virginia Oncology Practices
306. On information and belief, defendant Virginia Cancer Institute (ACIS #281890)
has an office at 6605 West Broad Street, Richmond, VA 23230. On information and belief,
defendant Virginia Cancer Institute bought $3,133,824 of Amgen drugs in the Fourth Quarter of
127
307. On information and belief, defendant Hematology Oncology Patient Enterprises
(Hope) (ACIS #216629) has an office at 459 Locust Avenue, 3rd Floor, Center for Cancer Care,
Charlottesville, VA 22902. On information and belief, defendant Hematology Oncology Patient
Enterprises bought $2,122,146 of Amgen drugs in the Fourth Quarter of 2006 receiving a
308. On information and belief, defendant Lynchburg Hematology Oncology Clinic
(ACIS #214378) has an office at 1701 Thomson Drive, Lynchburg, VA 24501. On information
and belief, defendant Lynchburg Hematology Oncology Clinic bought $1,641,757 of Amgen
309. On information and belief, defendant Peninsula Cancer Institute (ACIS
#1137788) has an office at120 Kings Way, Suite 3100, Williamsburg, VA 23185. On
information and belief, defendant Peninsula Cancer Institute bought $1,579,678 of Amgen drugs
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defendant.
310. On information and belief, defendant Cancer Outreach Associates (ACIS
#280974) has an office at 104 Abingdon Place, Abingdon, VA 24211. On information and
belief, defendant Cancer Outreach Associates bought $1,306,916 of Amgen drugs in the Fourth
311. On information and belief, defendant Danville Hematology-Oncology Clinic
(ACIS #319514) has an office at 125 Executive Drive, Suite J., Danville, VA 24541. On
information and belief, defendant Danville Hematology-Oncology Clinic bought $1,294,119 of
129
312. On information and belief, defendant Shenandoah Oncology Associates (ACIS
#229682) has an office at 1870 Amherst Street, Suite F, Medical Building #1, Winchester, VA
22601. On information and belief, defendant Shenandoah Oncology Associates bought
313. On information and belief, defendant Delta Hematology/Oncology Associates
(ACIS #279069) has an office at 355 Crawford Street, Suite 300, Portsmouth, VA 23704. On
information and belief, defendant Delta Hematology/Oncology Associates bought $1,198,618 of
products.
130
Washington Oncology Practices
314. On information and belief, defendant Western Washington Oncology (ACIS
#229348) has an office at 4525 3rd Avenue Southeast, Suite 200, Lacey, WA 98503. On
information and belief, defendant Western Washington Oncology bought $3,203,413 of Amgen
315. On information and belief, defendant Northwest Medical Specialty (ACIS
#229348) has an office at 1624 South I. Street, Tacoma, WA 98405. On information and belief,
defendant Northwest Medical Specialty bought $2,398,256 of Amgen drugs in the Fourth
defendant.
316. On information and belief, defendant Rainer Oncology Professional Services
(ACIS #223431) has an office at 400 15th Avenue Southeast, Suite D, Puyallup, WA 98372. On
information and belief, defendant Rainer Oncology Professional Services bought $1,919,907 of
131
317. On information and belief, defendant Wenatchee Valley Clinic (ACIS #222856)
has an office at 820 North Chelan Avenue, Wenatchee, WA 98801. On information and belief,
defendant Wenatchee Valley Clinic bought $1,497,164 of Amgen drugs in the Fourth Quarter of
318. On information and belief, defendant Cascade Cancer Center (ACIS #234591)
has an office at 12303 Northeast 130th Lane, Suite 120, Kirkland, WA 98034. On information
and belief, defendant Cascade Cancer Center bought $1,120,859 of Amgen drugs in the Fourth
132
319. On information and belief, defendant Columbia Basin Hematology Oncology,
PLLC (ACIS #226300) has a business location at 7350 West Deschutes Avenue, Suite B-103,
Kennewick, WA 99336. On information and belief, defendant Columbia Basin Hematology
Oncology, PLLC bought $1,024,816 of Amgen drugs in the Fourth Quarter of 2006 receiving a
Wisconsin Oncology Practices
320. On information and belief, defendant Oncology Alliance (ACIS #227922) has an
office at 4655 North Port Washington Road, Suite 200, Milwaukee, WI 53212. On information
and belief, defendant Oncology Alliance bought $6,638,191 of Amgen drugs in the Fourth
defendant.
133
321. On information and belief, defendant Marshfield Clinic (ACIS #215897) has an
office at 1000 North Oak Avenue, Marshfield, WI 54449. On information and belief, defendant
Marshfield Clinic bought $3,416,470 of Amgen drugs in the Fourth Quarter of 2006 receiving
a rebate from Amgen amounting to approximately 50% of all purchases as a Platinum Amgen
322. On information and belief, defendant Fox Valley Hematology and Oncology
(ACIS #225213) has an office at 900 East Grant Street, Martha Siekman Cancer Center,
Appleton, WI 54911. On information and belief, defendant Fox Valley Hematology and
Oncology bought $2,893,197 of Amgen drugs in the Fourth Quarter of 2006 receiving a rebate
323. On information and belief, defendant Aurora Sheboygan Clinic (ACIS #214736)
has an office at 2414 Kohler Memorial Drive, Sheboygan, WI 53081. On information and
belief, defendant Aurora Sheboygan Clinic bought $2,553,771 of Amgen drugs in the Fourth
134
defendant.
324. On information and belief, defendant Green Bay Oncology Limited (ACIS
#214748) has an office at 835 South Van Buren Street, Green Bay, WI 54301. On information
and belief, defendant Green Bay Oncology Limited bought $1,907,532 of Amgen drugs in the
325. On information and belief, defendant Medical Consultants Limited (ACIS
#221825) has an office at 2901 West Kinnickinnic River Parkway, Suite 415, Milwaukee, WI
53215. On information and belief, defendant Medical Consultants Limited bought $1,393,854 of
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V. FACTUAL ALLEGATIONS.
A. Background.
326. Erythropoiesis is the process by which the body produces erythrocytes, or red
blood cells. Red blood cells contain hemoglobin, a protein that functions primarily to transport
oxygen from the lungs to the tissues of the body. Hemoglobin levels are expressed in grams (g)
per deciliter (dL) of whole blood. An adequate supply of red blood cells is necessary to
oxygenate the body.
327. Anemia, a condition in which the blood is deficient in red blood cells or
hemoglobin, impairs the bodys ability to transfer oxygen to the tissues. Anemia has many
potential causes, including an iron-poor diet, excessive bleeding, certain cancers, certain cancer
treatments and kidney or liver failure. Erythropoeitin is a hormone that stimulates red blood cell
creation. A necessary step in the erythropoietic process is the production of erythropoietin, a
protein made in the kidneys that stimulates red blood cell formation.
328. In 1983, Amgen claimed that its scientists had managed to isolate the human
erythropoietin gene and produce the recombinant protein in hamsters. A few years later, through
the use of DNA technology, Amgen commercialized the production of erythropoietin epoetin
alfa and, later, darbepoetin alfa. Because epoetin alfa and darbepoetin alfa, like endogenous
erythropoietin, stimulate red blood cell formation, they are referred to as erythropoiesis-
stimulating agents or ESAs.
329. In 1989, epoetin alfa was approved by the U.S. Food and Drug Administration
(FDA) as a treatment for anemia associated with chronic renal failure (CRF), including end-
stage renal disease (ESRD) patients and patients not on dialysis. Prior to the discovery of this
treatment, the treatment for severe cases of anemia in CRF patients had been whole blood or red
cell transfusions. Treatment with epoetin alfa (Epogen therapy) or darbepoetin alfa (Aranesp
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therapy) was aimed at elevating or maintaining the red blood cell level and, thus, reducing the
need for transfusions in these patients.
330. In 1985, while epoetin alfa was still in development, Amgen entered into a
product license agreement (Licensing Agreement) with a subsidiary of Johnson & Johnson
Services, Inc. (J&J Licensee or Licensee) pursuant to which Amgen gave the Licensee an
exclusive right under its patents to market in the United States recombinant human epoetin alfa
for all medical uses, called indications, except for the treatment of anemia associated with
CRF in dialysis patients. Amgen retained the right to market epoetin alfa exclusively for this
use; it did not license J&J or any other company, then or later, to market darbepoetin alfa under
any of its U.S. patents for anemia associated with CRF.
331. During the Covered Period, Amgen marketed epoetin alfa in the United States
under the brand name Epogen; the Licensee marketed epoetin alfa in the United States through
certain subsidiary companies under the brand name Procrit under the Licensing Agreement
with Amgen. Epogen and Procrit are identical chemically. At all times relevant to this
Complaint, Procrit and Epogen were manufactured by Amgen at the same manufacturing facility
in Colorado, using the same process. The FDA-approved labels listing indications, warnings and
other information for Epogen and Procrit are identical.
332. As the result of its own efforts, between 1991 and 1996, J&J succeeded in
obtaining FDA approval to market epoetin alfa for use (a) in patients with anemia as a
consequence of cancer chemotherapy treatment, (b) in patients undergoing treatment for HIV
infection with the pharmaceutical Zidovudine, (c) in treating chronic kidney diseases in pre-
dialysis patients and (d) in anemic patients scheduled to undergo elective, non-cardiac, non-
vascular surgery.
137
333. Under the Licensing Agreement, Amgen could not expand its Epogen sales and
marketing efforts to take advantage of the indications for epoetin alfa obtained by J&J. Amgen
was limited to the dialysis market for Epogen. Given this constraint on sales, Amgen sought a
way to capture a piece of the lucrative oncology market that it had ceded to the Licensee
pursuant to the 1985 Licensing Agreement by finding a work around for the field of use
restrictions in the Licensing Agreement.
334. Slightly earlier, in 1984, Amgen and Kirin Holdings Company, Limited had
organized a joint venture company, Kirin-Amgen, Inc., to conduct research into the
development, manufacture, production and sale of erythropoietin products for human therapeutic
use. That joint venture, based in Thousand Oaks, California, had, by 1997, succeeded in
producing a new ESA, darbepoetin alfa, with a slightly different molecular structure than the
molecular structure of epoetin alfa.
335. In 1997, the J&J Licensee filed suit against Amgen, claiming that darbepoetin
alfa was covered under the Licensing Agreement. Amgen responded that darbepoetin alfa,
which it marketed under the brand name Aranesp, was distinct enough chemically to be a new
product and therefore not covered by the Licensing Agreement. In December 1998, an arbitrator
ruled that Amgen had not licensed its exclusive U.S. rights to Aranesp to J&J. As a result,
Amgen was free to market Aranesp without any of the use restrictions that applied to Epogen.
As described in a 2006 Forbes article entitled Amgens Enemies, with the development of this
drug, Amgen sidestepped the 1985 Licensing Agreement to reclaim the market it had given up
to J&J.
336. Darbepoetin alfa was approved by the FDA for use in chemotherapy-induced
anemia in September 2001. Based on Aranesps longer serum half-life and claims made by
Amgen in its application for approval, the FDA approved Aranesp to be dosed on a less frequent
138
basis than Epogen and Procrit. Amgen began marketing darbepoetin alfa in the United States as
Aranesp the same year.
337. In 2002, Amgen secured a supplemental FDA approval of darbepoetin alfa as
indicated for the treatment of anemia associated with cancer chemotherapy.
B. Marketing of Aranesp to Defendant Oncology Practices.
338. After the FDA approved Aranesp for treatment of chemotherapy-induced anemia,
in 2002, Amgen undertook an aggressive marketing campaign for Aranesp, designed to take
market share away from Procrit in the treatment of chemotherapy-induced anemia. Amgen
achieved only limited success with this campaign. Oncology physicians were generally satisfied
with Procrit and saw few reasons to switch to Aranesp. In addition, because Aranesp did not, at
that time, have a J Code from CMS, which would have allowed prescriptions to be approved in
an automated fashion, bills to Medicare and Medicaid had to be submitted using a Q Code,
which required manual approval by CMS staff from a paper submission and could delay or
frustrate payment, or reimbursement, approvals. Eventually, effective on or about January 1,
2003, a J Code was approved for Aranesp (darbepoetin alfa). The designated J Code was
J1880.
339. Given Amgens inability to convince substantial numbers of oncologists to switch
from Procrit to Aranesp based on the claim that Aranesp could be dosed less frequently than
Procrit, with the same efficacy, or the pricing structure at which it offered to sell Aranesp,
Amgen decided to retool and redirect its sales effort. In 2004, Amgen initiated a new sales
strategy. The new strategy was to provide the defendant Oncology Practices and other potential
customers with a new, real and substantial reason to buy and use Aranesp rather than Procrit.
This new, real and substantial reason was money, or greater profitability, via rebates and off-
139
invoice discounts that reduced the effective price of the drugs to purchases that qualified for the
rebates and discounts, including, potentially, the defendant Oncology Practices. In addition to
the value of the rebates and discounts themselves, because Amgen did not report these price
reductions, or concessions, to Government Healthcare Programs, the defendants stood also to
gain from the potential over-reimbursement of charges by such programs, which would occur so
long as these third-party payers were not notified that the defendant Oncology Practices had
received such discounts, rebates and other price concessions from Amgen.
340. Amgen brought its new sales plan to market as the Amgen Portfolio Contract.
The Amgen Portfolio Contract not only encouraged sales of Aranesp and the other Covered
Drugs, it encouraged larger and larger purchases of these drugs by the defendants, earning them
larger and larger discounts and rebates and, so long as the Government Healthcare Programs
were not made aware of the rebates and discounts the defendants were receiving from Amgen,
more and more revenue from drug cost reimbursement, or payments, from Government
Healthcare Programs. Under the Amgen Portfolio Contract, the greater the dollar value of the
purchases made, the greater the value of the rebates, discounts and the like that could be earned
by Amgen customers. Because to the incentive structure behind the Amgen Portfolio Contract,
the defendants were encouraged to over-prescribe the Covered Drugs as a way to increase their
profits.
341. The Amgen Portfolio Contract proved successful in increasing the use of Aranesp
by the defendant Oncology Practices and others. Amgens marketing strategy was particularly
successful in introducing Aranesp in patients previously not receiving ESA treatment and with
oncologists previously skeptical of ESA treatment. The incentives offered to increase sales
were, as noted, largely in the form of rebates, discounts and other price concessions that were not
visible to Government Healthcare Programs administrators and not reported to Government
140
Healthcare Programs. As a result of the non-disclosure, these kickbacks were not taken into
account in the drug cost reimbursement calculations of such programs. The defendants were
thus able to achieve a substantial over-recovery of the cost of the Covered Drugs from
Government Healthcare Programs.
342. Amgen heavily promoted the sale of the Covered Drugs during the Covered
Period using the Amgen Portfolio Contract. Amgen succeeded in increasing sales of Aranesp by
inducing physicians and oncology practice administrators to substitute Aranesp for Procrit as a
treatment for cancer patients suffering from chemotherapy-induced anemia. The defendants, as
a group, comprise most of the largest oncology practices in the country.
343. In implementing its Portfolio Contract, Amgen segmented customers into classes
based on their total potential as buyers of the Covered Drugs: Silver members had the
potential to make annual purchases of from $0 to $700,000; Gold members, from $700,000 to
$5,000,000 and Platinum members, more than $5,000,000.
344. Amgens drug sales force was provided with PowerPoint presentations and a
Discount & Rebate Estimator computational program to aid in marketing efforts. The
Estimator, which accompanied the rollout of the 2004 Amgen Portfolio Contract, was essentially
a simple, programmable calculator. Once assumed dollar values of Aranesp, Neulasta or
Neupogen, based on quarterly purchases, were inputted into the program, the Estimator would
compute the dollar value of the off invoice discounts and rebates, displaying the dollar value
of the percentage discounts a particular medical practice could expect to earn under the Amgen
Portfolio Contract based upon an assumed level of purchases. Using the Estimator, the Amgen
sales representative could immediately show the physician or practice manager to whom the
sales pitch was directed the dollar value, in the form of rebates and discounts, the practice could
earn by achieving certain dollar levels of purchases of the Covered Drugs from Amgen.
141
345. The Amgen 2004/2005 Portfolio Contract rollout sales materials highlighted the
rebate structure for three classes of customer: the hypothetical $600,000 customer, the
hypothetical $3,000,000 customer and the hypothetical $6,000,000 total class. The tables reflect
changes in the rebate rate structure described as enhanced rebates in the case of the contract
effective September 2004 through February 2006 versus the base rebates effective under the
previous contract, effective March 2004 through August 2004. The rebates varied from a low of
3% for purchases in excess of $75,000 in a calendar quarter to a high of 25% for purchases in
excess of $1,275,000. Copies of the three pages from the Amgen 2004/2005 contract reflecting
the rebate structure described above are attached as Exhibit No. 1 to this Complaint.
346. The Amgen 2004/2005 Portfolio Contract rollout sales materials also included a
table showing the discounts, as distinguished from rebates, that could be realized by a medical
practice. These so-called off-invoice discounts varied from a low of 3% to a high of 10%
depending on the product and, in the case of Neupogen, its packaging. A copy of this page from
the Amgen 2004/2005 contract sales materials reflecting the off-invoice discount structure
described above is attached as Exhibit No. 2 to this Complaint.
347. In addition, Amgen offered customers who achieved or exceeded their Volume
Target during the first six months of the contract (March 1, 2004 to August 31, 2004) an
additional, permanent 5% off-invoice discount on the Covered Drugs for the remainder of the
contract term (September 1, 2004 to February 28, 2005). If the customer did not achieve its
volume target, the customer would lose the additional, permanent 5% discount forever.
348. Amgen set target volumes for its customers based upon a calculation of the
customers purchases of five drugs (Aranesp, Neupogen, Neulasta, Procrit and Leukine). Two of
these drugs, Procrit and Leukine, were not Amgen drugs. Amgen relied on data from the July 1,
2003 through December 31, 2003 and then annualized these figures to set the target volumes
142
using the following formula: dollar value of purchases of Aranesp + Neupogen + Neulasta
divided by dollar value of purchases Aranesp + Neupogen + Neulasta + Procrit + Leukine.
Based on this calculation, Amgen set its Amgen Portfolio Volume Target levels at the
equivalent 50%, 60%, 65%, 70%, 75%, 80% or 85% of Amgen Portfolio Market Share levels.
Historical sales levels were considered in setting the particular customers volume target, with
that level used as a baseline. Under this scheme, as the customers loyalty to Amgen products
increased, its total rebates and discounts increased.
349. During the Covered Period, Amgen revised and reissued the Amgen Portfolio
Contract several times. With each revision, as a rule, Amgen increased the required dollar value
of purchases needed simply to retain the same level of financial benefits available under the
previous contract. Thus, the defendant Oncology Practices and other Amgen customers were
constantly provided with significant monetary incentives to increase the dollar value of their
purchases of the Covered Drugs and thereby at least to maintain the same level of rebates and
other financial benefits achieved under the previous version of the contract.
350. During the period 2003 to 2006, U.S. sales of Aranesp increased by more than
300%. Total revenues achieved by Amgen from the sale of Aranesp, Neupogen and Neulasta in
the United States from 2001 to 2012 exceeded $47.8 billion. Aranesp accounted for $15.6
billion of those sales.
351. Aranesp obtained a dramatic increase in sales from nothing to almost $2.8 billion
in annual sales within approximately five (5) years (2001 to 2006). According to Amgens
Annual Reports and 10-K filings, Amgens U.S. sales of Aranesp were as follows:
2001 $27 million
2002 $284.7 million
2003 $979.9 million
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2004 $1,533 million
2005 $2,104 million
2006 $2,790 million
2007 $2,154 million
2008 $1,651 million
2009 $1,251 million
2010 $1,103 million
2011 $986 million
2012 $782 million
352. Significantly, as sales of Aranesp increased, Procrit sales did not decrease
proportionate to the growth in Aranesps sales. Although J&J Services, Inc. does not break out
U.S. sales from its international sales, its Annual Reports and Form 10-K filings detail the
growth and decline of its sales of epoetin alfa (Procrit) by J&J worldwide:
2001 $3,426 million (for epoetin alfa internationally) *
2002 $4,269 million (for epoetin alfa internationally)
144
* 2001 figure is based upon calculations due to lack of a breakdown for epoetin alfa sales in
Form 10-K filing.
353. Amgens increased promotion of Aranesp did not erode its sales of Epogen. U.S.
sales data reflected in Amgens Annual Reports and Form 10-K filings show that Epogen
enjoyed healthy sales growth from 2001 to 2006 despite Aranesps introduction and marketing
push:
2001 $2,108 million
2002 $2.261 million
2003 $2,435 million
2004 $2,601 million
2005 $2,455 million
2006 $2,511 million
2007 $2,489 million
2008 $2,456 million
2009 $2,569 million
2010 $2,524 million
2011 $2,040 million
2012 $1,941 million
354. As the data show, sales of ESAs generally have declined appreciably since their
peak combined year of 2006, amid increased scrutiny of their efficacy at high dosage levels and
patient safety, as well as the cost of these drugs to Government Healthcare Programs. In 2006,
total U.S. sales of Aranesp were $2.8 billion, the high water mark for the drug. Procrit sales that
year were $3.18 billion down some $1.12 billion from Procrits peak year of 2002. Sales of
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Epogen in 2006 were $2.511 billion, down less than $100 million from Epogens peak year of
2004.
355. Amgens marketing of Aranesp to the defendant Oncology Practices and other
customers via the Amgen Portfolio Contract did not diminish sales of other ESAs so much as
expand the market for ESAs overall.
356. According to a 2012 report prepared for the Senate Special Committee on Aging
by the Government Accountability Office (GAO) entitled Medicare: High-Expenditure Part B
Drugs,1 Medicare Part B expenditures for Aranesp in 2010 were $504 million and for Neulasta
in the same period just a single year $888 million. In 2010, Neulasta was the sixth most
expensive Medicare Part B drug; Aranesp, for non-ESRD uses, was the seventh most expensive.
These figures do not include drug costs paid by Medicaid or by state healthcare programs.
357. According to the GAO report, spending on Medicare beneficiaries for Aranesp in
chemotherapy patients in 2010 accounted for $504 million of the $755 million of total insured
spending on Aranesp in this patient population 66.7% of total expenditures. In other words,
the United States government paid for two-thirds of all Aranesp used in oncology practices in the
United States.
358. For Neupogen, Medicare patient purchases accounted for $171 million of the
$309 million in total insurance reimbursements in 2010 55.5% of all insured spending on
Neupogen.
359. For Neulasta, Medicare beneficiaries accounted for 39.4% of all total insurance
spending or $888 million of $2,254 million.
1
Part B covers certain physician, outpatient hospital, laboratory and other services.
146
360. As the above figures show, Medicare and Medicaid have been major payers
(reimbursers) of charges associated with the cost of the Covered Drugs. By not reporting the
true (reduced) cost of the Covered Drugs to them, the defendant Oncology Practices defrauded
those programs and other Government Healthcare Programs of money. On information and
belief, the combined value of the rebates, off-invoice discounts and other things of value earned
by some of the defendant Oncology Practices for prescribing and administering the Covered
Drugs (see, e.g., Complaint, Paragraphs 11, 25, 359, 365, 372, 373, 395, 396, 399 exceeded 60%
of the average wholesale price (AWP) or average selling price (ASP) of the Covered Drugs,
as reported by Amgen.
361. On information and belief, the knowing submission by Amgen of false and
fraudulent information as to the AWP and ASP of the Covered Drugs, by failing to account for
the cost of the rebates, off-invoice discounts and other things of value provided to the defendant
Oncology Practices in exchange for their purchase of the Covered Drugs, combined with the
knowing submission of false and fraudulent claims for reimbursement of the cost of the Covered
Drugs by the defendant Oncology Practices to Government Healthcare Programs, which also
failed to account for the rebates, off-invoice discounts and other things of value the defendants
received from Amgen based upon their purchase of the Covered Drugs, caused Government
Healthcare Programs to over-reimburse the defendants for cost of the Covered Drugs, thereby
diminishing the ability of these programs to provide appropriate services and benefits to U.S.
citizens entitled by law to such services and benefits, and imposing an unnecessary and
unjustified fiscal burden upon the nation.
362. On information and belief, Amgen failed to include the cost of the rebates, off-
invoice discounts and other things of value provided to the defendant Oncology Practices in
exchange for their purchase of the Covered Drugs, in its calculation of the AWP and the ASP of
147
the Covered Drugs. Likewise, on information and belief, the defendant Oncology Practices did
not report receipt of these post-sale discounts and other things of value that had the effect of
lowering their purchase costs for the Covered Drugs in their claims for reimbursement to
Government Healthcare Programs. Thus, the defendant Oncology Practices received a double
benefit. They received a reimbursement rate that was based upon a supposed cost that was
substantially higher than what they actually paid for the drug; and, second, they received post-
sale discounts, rebates and other things of value that lowered their actual cost for the drugs to a
level substantially below the cost reported to Government Healthcare programs. Thus, each and
every claim made by a defendant to a Government Healthcare Program for the cost of a Covered
Drug was false and fraudulent, causing such programs to reimburse defendants for supposed
costs that far exceeded their actual cost of the Covered Drugs. Equally venal, the scheme
resulted in the over-prescribing of the Covered Drugs, particularly Aranesp and Neulasta, by
physicians associated with the defendant Oncology Practices and the excess use, or overdosing,
of patients prescribed these drugs, with documented serious adverse health consequences in
some patient populations.
363. According to an estimate by the Institute of Medicine in 2011, Americans incur
some $800 billion in unnecessary health care costs every year. The Institute reported that since
1989 the three anti-anemia drugs (Procrit, Epogen and Aranesp) have cost the government some
$60 billion. In 2008, according to data cited by The New England Journal of Medicine, the
average annual cost to Medicare to maintain a patient with ESRD on dialysis was $77,506. 364
N Engl J Med 593-595 (Feb. 17, 2011).
364. In 2007, The New York Times reported that physicians in the United States, as of
2002-2003, used far more ESAs, including Aranesp, in treating anemia than physicians in
Europe and in other industrialized countries where physicians had no opportunity to profit from
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prescribing the drugs. See New York Times (May 5, 2007),
http://www.nytimes.com/2007/05/09/business/09anemia.html?pagewanted=all (visited Apr. 27,
2013). As noted in the Times story:
Although the safety debate has heated up only recently [as of 2007], the first sign
that the drugs might be dangerous came more than a decade ago. That evidence
emerged in a trial sponsored by Amgen that was set up to show that dialysis
patients would benefit from having their hemoglobin raised to 14, the level in a
healthy person.
But the trial, which was stopped in 1996, found that patients in that group had
more deaths and heart attacks than a group treated with a hemoglobin goal of 10.
That trial should have discouraged doctors from using too much epoetin and
encouraged Amgen to study the risks further, said Dr. Steven Fishbane, a
nephrologist at Winthrop-University Hospital on Long Island.
365. In one comparison patient population, ESRD patients generally served by dialysis
clinics, a report by The Washington Post noted that the dosages used for ESA treatment in this
patient population more than tripled from approximately 6,000 i.u. weekly of Procrit/Epogen in
1990 to more than 20,000 i.u. weekly beginning in 2004. See Washington Post (July 19, 2012),
at http://www.washingtonpost.com/wp-srv/business/amgen-anemia-drugs/index.html (visited
Apr. 28, 2013). According to the Post story, ESRD patients in the United States in 2002
received the highest average dose of ESAs of any of the twelve (12) countries studied, at 17,360
i.u. weekly, compared to the next highest country Belgium with 12,312 i.u. average weekly
doses and the lowest dose country, Japan, with an average of 5,297 i.u. weekly. Id.
366. Effective January 1, 2011, Medicare revised the way it compensated medical
services providers that administer drugs to ESRD patients. The new system is described as a
bundled reimbursement system. Providers began receiving a single payment for each patient.
This single payment was to cover almost all treatment costs associated with ESRD for the
patient. The new system was forecasted to reduce payments to ESRD facilities by 2% overall, in
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addition to reducing incentives to overuse profitable, [previously] separately billable drugs,2
particularly ESAs, because studies showed that such overuse harms patients.3 This single
bundled payment now covers all the resources used in providing outpatient dialysis treatment,
including ESA drugs, supplies and equipment used to administer dialysis at the clinic or at the
patients home. On information and belief, prescription levels for ESAs in this patient
population decreased substantially once the financial incentives to physicians to prescribe the
drugs were reduced.
367. Evidence of diminished use of ESAs in the ESRD patient population provides
powerful circumstantial evidence that ESAs in general were prescribed in the United States by
physicians at higher dosage levels and to a greater proportion of patients than medical necessary
as a consequence of the unusual opportunity to profit by prescribing increasing amounts of the
drugs. Inasmuch as the same financial incentives were present with defendant Oncology
Practices, an inference can be made that these same incentives also caused increased dosages and
use of ESAs, including Aranesp, by the defendant Oncology Practices not based upon medical
necessity or need, but upon profit motivations.
368. On information and belief, physicians affiliated with the defendant Oncology
Practices often prescribed Aranesp for use in patients when Procrit or Epogen was the medically
indicated preferred treatment option because, by using Aranesp, the practices could and did earn
higher profits as a consequence of the discount and rebate structure of the Amgen Portfolio
Contract and the higher reimbursement levels that could be obtained by submitting false and
fraudulent claims and information to Government Healthcare Programs.
2
See Fed Reg. 2010; 75:49029-49214 (Aug. 12, 2010).
3
Besarab A, et al., The Effects of Normal as Compared With Low Hematocrit Values in
Patients With Cardiac Disease Who Are Receiving Hemodialysis and Epoetin, 339 N Engl J
Med 584-590 (1998).
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369. One aspect of the Amgen Portfolio Contract relied upon the market power of
Neupogen and Neulasta, two of the Covered Drugs to improve sales of Aranesp. Neither
Neupogen nor Neulasta faced competition from other drugs for their approved indications.
Thus, Amgen had no need to encourage sales of these drugs by extending discounts for their
purchase. Under its sales strategy, Amgen nevertheless included purchases of these drugs, as
well as Aranesp, in its calculation of the level of purchases needed to advance through the
various, increasing discount and rebate tiers. On information and belief, purchases of Neupogen
and Neulasta were included in the calculation as a way to boost sales of Aranesp by tying the
sales of the weaker product to the two products for which there were no substitutes.
370. As indicated, Amgen also promoted Aranesp at higher doses and at intervals the
FDA had not approved and for off-label uses not approved by the FDA. FDA rules prohibit drug
manufacturers from promoting sales of drugs for off-label uses. On or about December 18,
2012, Amgen pleaded guilty to a criminal information in the United States District Court for the
Eastern District of New York. The information charged Amgen with a single misdemeanor
count of misbranding Aranesp by promoting it in a way that was inconsistent with the dosage
levels and frequency approved by the FDA, as described on the package insert. The plea was
accepted the next day.
371. On information and belief, the pronounced increase in the use of Aranesp and, to
some extent, Neulasta, after initiation of the Amgen Portfolio Contract program was due in
substantial part to the financial incentives Amgen provided to Oncology Practices, including the
defendants, to increase their use of the Covered Drugs by appealing to the self-interest of the
defendants and others in increasing their profits through the increased use, administration and
billing for the Covered Drugs, and not due to medical need or patient treatment concerns.
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C. Overstating Costs to Increase Reimbursements.
372. Medical services providers that participate in Government Healthcare Programs,
including the defendant Oncology Practices, are required to abide by the laws, rules and
regulations that apply to those programs, including those related to payment, or
reimbursement, of the cost of drugs used to treat eligible patients. In order to avoid
overcompensating providers for such costs, the laws, rules and regulations that apply to
Government Healthcare Programs attempt to ensure that actual costs are accurately described
and not overstated.
373. During the Covered Period, the defendants, directly or indirectly, purchased
substantial quantities of the Covered Drugs from Amgen for administration to patients eligible to
receive benefits under Government Healthcare Programs. Thereafter, the defendants sought
payment, or reimbursement, from such programs for all or a portion of the cost of the Covered
Drugs administered to such patients.
374. During the Covered Period, Amgen and the defendant Oncology Practices
knowingly engaged in a systematic and extensive course of conduct, or scheme, intended to
cause, and actually causing, false and fraudulent information and claims for payment, or
reimbursement, for all or a portion of the cost of the Covered Drugs administered to patients
eligible to receive benefits under Government Healthcare Programs to be submitted to such
programs, including Medicare and Medicaid. Thereafter, based on such false and fraudulent
information and claims, the defendant Oncology Practices were paid, or reimbursed, for all or
for a portion of the claimed cost of such drugs by such programs in amounts that exceeded the
levels of reimbursement set according to program rules.
375. As part of the scheme, the defendants knowingly submitted inaccurate data,
directly or indirectly, to Government Healthcare Programs showing prices for the Covered Drugs
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that failed properly to account for discounts, rebates and other effective price reductions that
Amgen provided to the defendant Oncology Practices under the Amgen Portfolio Contract as
well as pursuant to other purchase incentive programs. This conduct included deliberate
disregard of specific regulations concerning acceptance of rebates and other discounts related to
the purchase of the Covered Drugs, as well as conduct designed to conceal this activity from
regulatory authorities.
376. At the time the defendants engaged in these fraudulent activities, they knew that
rebates and other discounts of the nature being paid by Amgen and accepted by the defendants
would cause numerous false claims to be submitted to and paid by Government Healthcare
Programs, including Medicare and Medicaid. Had the defendant Oncology Practices not filed
false and fraudulent claims seeking reimbursement costs of the Covered Drugs, Government
Healthcare Program funds would not have been used to pay, or reimburse, the defendants for
claimed costs that were inaccurate and that overstated the actual cost of the Covered Drugs to the
defendants and that, therefore, exceeded the reimbursement levels that would have applied had
the actual cost of the drugs been accurately reported.
D. Payments for Drugs Furnished by Physicians.
377. In order to prevent fraud on Government Healthcare Programs through the use of
kickbacks, rebates and other price terms that are not disclosed to Government Healthcare
Programs administrators, and constitute cost or price reductions not shared by Government
Healthcare Programs, such programs, including Medicare and Medicaid, have strict rules
governing the manner in which drug costs are calculated and paid, or reimbursed, to
physicians and physician practice groups, such as the defendant Oncology Practices.
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378. Under Medicare reimbursement rules, drugs furnished by physicians in non-
institutional settings are reimbursable under one of two payment methodologies. Until
December 31, 2004, the amount reimbursed for a covered drug depended upon a determination
of the AWP.
379. From January 1, 2005 to the present, Medicare reimbursement was subject to a
determination of the ASP and reimbursement rates were set at the Average Sales Price plus a
six percent (6%) markup. This reimbursement method is known as the ASP methodology.
Payment under this methodology is based on the manufacturers ASP. The manufacturers ASP
is calculated by totaling all of a manufacturers sales to all purchasers in the United States. From
this amount, price concessions are supposed to be subtracted. Price concessions offered on a
lagged basis (not given at the time of sale) must be calculated on a rolling average basis and
subtracted from total sales.
380. Once the total sales amount for a quarter is calculated, that amount must be
divided by the number of units sold in that quarter to arrive at the manufacturers ASP. This
amount must be calculated for each national drug code (NDC) number. Certain sales, such as
sales to specified branches of the federal government, state pharmaceutical assistance plans and
other entities, are excluded from the manufacturers ASP calculation. Sales at nominal prices,
which are defined as less than 10% of average manufacturer price, are also excluded.
381. The manufacturers ASP is used to calculate the payment rate for both single-
source drugs and multiple-source drugs. Multiple-source drugs are drugs that are therapeutically
equivalent, pharmaceutically equivalent and bioequivalent. Multiple-source drugs are also drugs
that shared the same code on October 1, 2003. Single-source drugs are drugs that are not
multiple-source drugs, and are sold pursuant to a new drug application approved by the FDA.
All biologicals, which category includes all of the Covered Drugs, are single-source drugs.
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382. For single-source drugs, the payment rate is equal to the weighted average of the
manufacturers ASP for all NDCs assigned to the drugs HCPCS code, plus 6%. For multiple-
source drugs, the payment rate is the weighted average of the manufacturers ASP for all the
drugs assigned to the same HCPCS code, plus 6%. Payments are made to the physician
administering the drug. If a physician engages in a group practice, payments are made to the
medical practice rather than directly to the physician prescribing the drug.
383. A substantial proportion of the cost of the Covered Drugs manufactured by
Amgen are billed to and paid by the federal government and various state governments
including those states that are named as plaintiffs in this civil action under Government
Healthcare Programs. Thus, one effect of the over-prescription of the Covered Drugs has been
to impose unnecessary and unjustified costs on government-funded healthcare programs.
384. In its December 19, 2012 settlement with Amgen, the United States made a
number of allegations regarding Amgens manipulation of the ASP, knowingly designed
improperly to increase the ASP of the Covered Drugs and other drugs to the benefit of its
customers for these drugs:
5. During the period from April 30, 2004 to January 1, 2008, Amgen
knowingly reported inaccurate Average Sales Prices (ASP) for Aranesp,
Epogen, Neulasta, and Neupogen by failing to account properly for price
concessions, including group purchasing organization volume discounts,
prompt pay discounts, cash discounts, free goods that are contingent on
any purchase requirement, chargebacks, rebates, and price concessions
disguised as bonafide service fees, in the calculation of ASP. Amgen
employees and agents were directed to explain the profitability of the
inaccurate ASP.
6. During the period from April 30, 2004 to September 30, 2011, Amgen
knowingly reported inaccurate ASP for Aranesp, Epogen, Neulasta, and
Neupogen by failing to account properly for price concessions including
rebates, volume discounts and free goods that were contingent on any
purchase requirement, referred to in the Complaints as bundled pricing
and overfill. Amgen employees and agents were directed to explain the
profitability of the inaccurate ASP.
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7. During the period from January 1, 2001 to September 30, 2011, Amgen
knowingly reported inaccurate Best Prices and Average Manufacturer
Prices for Aranesp, Enbrel, Epogen, Neulasta, Neupogen and Sensipar by
failing to include remuneration, specifically in the forms outlined in the
Paragraph G.4 Conduct, that was paid to health care providers and that
was conditioned on purchase of Amgen products in violation of the
Medicaid Rebate Statute, 42 U.S.C. 1396r-8.
During the Covered Period, the defendants were buyers of the Covered Drugs and knowingly
benefitted from the manipulation of the ASP of the Covered Drugs and from the inaccurately
reported Best Prices and Average Manufacturer Prices of the Covered Drugs. As part of the
Settlement Agreement, Amgen did not admit to these allegations.
385. More broadly, the effect of Amgens drug marketing programs aided and abetted
the actions of the defendant Oncology Practices in evading the requirements of Government
Healthcare Programs to report to Government Healthcare Programs the true and accurate price
taking into account all discounts, rebates and other price concessions at which drugs,
including the Covered Drugs, were sold. Because Amgen and the defendants submitted false
and fraudulent claims and information to Government Healthcare Programs, such programs were
defrauded of hundreds of millions of dollars of unjustified drug cost reimbursements to the
defendant Oncology Practices during the Covered Period. These false and fraudulent claims
were generally submitted to Government Healthcare Programs electronically using data
management and payment systems such as the Medicare Administrative Contractor System.
Pursuant to such claims, the defendants sought and obtained reimbursement for the supposed
cost of the Covered Drugs without accounting for the discounts, rebates, kickbacks and other
valuable consideration they received from Amgen as incentives to buy the Covered Drugs,
effectively lowering their actual cost of the drugs. On information and belief, none of the
defendants ever advised any Government Healthcare Program that they had obtained discounts,
rebates, kickbacks and other valuable consideration from Amgen as incentives to buy the
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Covered Drugs. By failing to apprise Government Healthcare Programs of these payments, the
defendant Oncology Practice obtained reimbursements from such programs that were
substantially greater than their actual cost of the Covered Drugs and substantially lower than the
amount sought for reimbursement, thereby defrauding the government sponsors of such
programs, imposing unwarranted costs on such programs and diminishing the capacity of these
programs to provide drugs and medical services to persons eligible to receive such benefits.
E. Rules on Acceptance of Discounts in Healthcare Services.
386. In 1972, Congress enacted the Medicare and Medicaid Patient Protection Act,
also known as the Anti-Kickback Statute, 42 U.S.C. 1320a-7b(b), to provide penalties for
certain practices which have long been regarded by professional organizations as unethical, as
well as unlawful . . . and which contribute appreciably to the cost of the Medicare and Medicaid
programs. H.R. Rep. No. 92-231, 92d Cong., 1st Sess. 108 (1971), reprinted in 1972
U.S.C.C.A.N. 4989, 5093.
387. In 1977, Congress amended the Anti-Kickback Statute to prohibit receiving or
paying any remuneration to induce referrals and increased the crimes severity from a
misdemeanor to a felony with a penalty of $25,000 and/or five years in jail. See Social Security
Amendment of 1972, Pub. L. No. 92-603, 241(b) and (c); 42 U.S.C. 1320a-7b. In so doing,
Congress noted that the purpose of the Anti-Kickback Statute was to combat fraud and abuse in
medical settings that cheats taxpayers who must ultimately bear the financial burden of misuse
of funds . . . diverts from those most in need, the nations elderly and poor, scarce program
dollars that were intended to provide vitally needed quality health services . . . [and] erodes the
financial stability of those state and local governments whose budgets are already overextended
and who must commit an ever-increasing portion of their financial resources to fulfill the
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obligations of their medical assistance programs. H.R. Rep. No. 95-393, pt. 2, at 37, reprinted in
1977 U.S.C.C.A.N. 3039, 3047.
388. In 1987, Congress again strengthened the Anti-Kickback Statute, this time to
ensure that kickbacks masquerading as legitimate transactions did not evade its reach. See
Medicare-Medicaid Antifraud and Abuse Amendments, Pub. L. No. 95-142, Medicare and
Medicaid Patient and Program Protection Act of 1987, Pub. L. No. 100-93.
389. The Anti-Kickback Statute prohibits any person or entity from knowingly and
willfully offering to pay or paying any remuneration to another person to induce that person to
purchase, order, or recommend any good or item for which payment may be made in whole or in
part by a federal health care program, which includes any State health program or health
program funded in part by the federal government. 42 U.S.C. 1320a-7b(b), 1320a-7b(f).
390. Generally speaking, discounts for health care items and services are encouraged
under Government Healthcare Programs rules. Federal healthcare program regulations
specifically approve of discounts, so long as the programs themselves share in the discount
where appropriate, and as appropriate, to the reimbursement methodology. But arrangements in
which federal healthcare programs get less than their proportional share of cost-savings on items
or services payable by the programs are deemed seriously abusive. Such arrangements result
in overcharges to the programs and are not protected by either the statutory exception or the
regulatory safe harbor for some types of discounts. See 64 Fed. Reg. 63526 (Nov. 19, 1999).
391. In 1999, the Office of Inspector General, Department of Health and Human
Services (OIG), provided specific guidance regarding the requirements for rebates or discounts
to qualify for safe harbor treatment under the federal Anti-Kickback Statute, 41 U.S.C. 52.
In its Final Rule interpreting the statute, OIG defined certain safe harbors for certain types of
discounts. 42 C.F.R. 1001.952 (Nov. 19, 1999). This Final Rule was in force throughout the
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Covered Period and applied to all federal healthcare programs. The Final Rule also applied to
state healthcare programs in virtually all circumstances. Id. subpart (h).
392. The Anti-Kickback Statute not only prohibits outright bribes and rebate schemes,
but also prohibits any payment or other remuneration by a drug company to a physician or other
person which has as one of its purposes the inducement of the physician to write prescriptions
for the companys pharmaceutical products or the inducement of the physician to influence or
recommend the prescribing of the product.
393. Compliance with the Anti-Kickback Statute is a precondition to participation as a
health care provider under a Government Health Care Program, including Medicare and the state
Medicaid programs. Moreover, compliance with the Anti-Kickback Statute is a condition of
payment for drug claims administered by physicians for which Medicare or Medicaid
reimbursement is sought.
394. Under 42 U.S.C. 1395y(a)(1)(A), nonpayment may be made under the Medicare
statute for any expenses incurred for items or services which . . . are not reasonable and
necessary for the diagnosis or treatment of illness or injury.
395. The United States Court of Appeals for the Second Circuit has held that, [s]ince
1395y(a)(1)(A) expressly prohibits payment if a provider fails to comply with its terms,
defendants submission of the claim forms implicitly certifies compliance with its provision.
United States ex rel. Mikes v. Straus, 274 F.3d 687, 701 (2d Cir. 2001) (emphasis in original).
396. Kickbacks are, by definition, not reasonable and necessary for the diagnosis or
treatment of illness or injury.
397. FCA liability may be premised on a violation of the Anti-Kickback Statute.
398. The rebates, discounts and other incentives to purchase the Covered Drugs
offered by Amgen to certain buyers, including the defendant Oncology Practices, as described in
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this Complaint, did not qualify for safe harbor treatment under the Anti-Kickback Statute. In
particular, the rebates, discounts and other incentives paid to the defendant Oncology Practices
pursuant to the Amgen Portfolio Contract fell outside the safe harbor provisions of the Final
Rule, as they were not discounts given at the time of sale, and were, thus, required to be reported
to Government Healthcare Programs, including Medicare and Medicaid, by the buyer unless the
buyer was a cost reporter, a Health Maintenance Organization (HMO) or a Competitive
Medical Plan (CMP).
399. As provided in OIGs Commentary on the Final Rule: A rebate under our
proposal would be defined as any discount not given at the time of sale. Consequently, a rebate
transaction would not be covered by the safe harbor if it involves a buyer that is neither a cost
reporter nor a HMO or CMP, because for such buyers, all discounts must be given at the time of
sale. 42 C.F.R. 1001.952(h)(1)(ii)(C); see also 1001.952(h)(1)(iii).
400. None of the defendant Oncology Practices qualified as a cost reporter, an
HMO or a CMP under the Final Rule. Thus, 42 C.F.R. 1001.952(h) required the buyers to
report fully and accurately any discount not given at the time of sale in accordance with 42
C.F.R. 1001.952(h)(1)(ii)(C) (The buyer must fully and accurately report the discount in the
applicable cost report).
401. On information and belief, beginning in or about 2004 and continuing through in
or about 2011, consistent with the requirement of 42 C.F.R. 1001.952(h)(1)(iii)(B) as well as
other, similar provisions contained in 42 C.F.R. 1001.952(h) that sellers and other offerors of
items or services for which payment may be made in whole or in part (42 C.F.R. 1001.952(h))
under Medicare, Medicaid and other Government Healthcare Program rules (here, the Covered
Drugs), apprise buyers that they were required to report discounts and rebates not qualified for
safe harbor treatment, the Amgen Portfolio Contract contained the following provision:
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Participating Eligible Physician Practice agrees that it will properly disclose and
account for any and all discounts and/or rebates earned in connection with the
[year] Amgen Portfolio Rebate Program and through its participation under the
Group Purchasing Agreement in a way that complies with all applicable federal,
state, and local laws and regulations, including without limitation, Section
1128B(b) of the Social Security Act and its implementing regulations, and shall
provide, upon request by the U.S. Department of Health and Human Services, or
a state agency any and all information furnished, including, but not limited to
information furnished by Amgen concerning the amount or value of any such
discount and/or rebate, on products purchased under the Group Purchasing
Agreement. Participating Eligible Physician Practice Headquarters represents and
warrants that its legally affiliated physician offices and/or satellite clinics, if any,
shall comply with any discount reporting obligations they may have in connection
with any discounts and/or rebates received under the Group Purchasing
Agreement. (Emphasis added.)
402. On information and belief, during the Covered Period, each of the defendant
Oncology Practices accepted rebates, discounts, free drugs (product overfills) and other
valuable consideration from Amgen as incentives to buy the Covered Drugs, both pursuant to the
Amgen Portfolio Contract and other Amgen purchase incentive programs. On information and
belief, none of the defendants ever advised, alerted, reported or otherwise properly disclosed and
accounted for any of the rebates, discounts and other things of value they received as a part of
the purchase and sale of the Covered Drugs from Amgen. The rebates, discounts, product
overfills and other incentives earned by the defendant Oncology Practices and provided to
them by Amgen during the Covered Period substantially reduced the actual cost of the Covered
Drugs to the defendants. The rebates, discounts, product overfills and other incentives earned
by the Defendant Oncology Practices and provided to them by Amgen during the Covered
Period did not qualify for safe harbor treatment under Medicare, Medicaid and other
Government Healthcare Program rules.
403. In order to encourage purchases of the Covered Drugs by oncology practices,
including the defendants, Amgen sales representatives, including the Relator, were instructed by
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Amgen sales executives, if asked by a customer whether discounts, rebates and the like received
from Amgen needed to be reported to Medicare or Medicaid, to advise such customers that the
rebates, discounts and other incentives they earned from Amgen by buying the Covered Drugs fit
into a safe harbor afforded certain types of rebates and discounts under Medicare and
Medicaid regulations.
404. In an email message written by Mark McLaughlin, an Amgen district manager
(sales), and circulated to sales staff on May 2, 2003, Mr. McLaughlin represented that questions
had arisen as to whether Amgens rebates to customers fell within the scope of the safe harbor
rule published in the Federal Register on November 19, 1999. The subject line of the
memorandum read: FW: Federal Register Rebates are Covered by Safe Harbors. Included
with the email message of Mr. McLaughlin was an email message from Bob Bryan, an Amgen
sales official, dated April 29, 2003, attaching a copy of the Federal Register notice of November
19, 1999 stating that rebates to physician offices [were] covered by Safe Harbors.
405. At numerous Amgen national sales meetings, Amgen personnel, including some
from Amgens legal department, represented to sales personnel that Amgens Portfolio Contract
met the safe harbor provisions of the Medicare and Medicaid regulations. Among the Amgen
personnel who made that representation to Relator and others were the following: Lois
Kwasigroch, Associate General Counsel; Mary Beth Cantrell, Associate General Counsel; Nancy
Loomis, Records Manager for Corporate Records Management; and, from Amgens senior
management, Cynthia Schwalm, Vice President and General Manager for Oncology.
406. As alleged in paragraph 398, the post-sale rebates, discounts and other things of
value earned by the defendants under their Amgen Portfolio Contracts did not qualify for safe
harbor protection under OIG guidelines. Even assuming, however, that the defendants might
properly receive the post-sale rebates, discounts and other things of value from Amgen, their
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failure, on information and belief, to report to Government Healthcare Programs that their cost
of the Covered Drugs had been reduced by the value of these items earned pursuant to the
Amgen Portfolio Contract and received post-sale constituted fraud.
407. As alleged in paragraph 402, Amgen provided the defendants with overfill and/or
samples of Aranesp. This had the intended and purposeful effect of reducing the cost of Aranesp
to the defendants, thereby increasing their profits from administration of the drug. The overfill
of Aranesp and samples of the Covered Drugs provided to the defendant Oncology Practices by
Amgen amounted to discounts or rebates falling outside the OIG guidelines for safe harbor
treatment. But even if permitted under the OIG safe harbor guidelines, if their reported to
Government Healthcare Programs as post-sale rebates or discounts and their value accounted for,
on information and belief, no defendant ever made such a report to any Government Healthcare
Program.
408. The rebate and discount program defined and described by the various Amgen
Portfolio Contracts with the defendants did not qualify for safe harbor treatment under OIG
guidelines.
409. Relator has personal knowledge that each and every defendant entered into one or
more Amgen Portfolio Contracts and earned and received post-sale rebates and discounts from
Amgen pursuant to the terms of such contract or contracts. Each and every post-sale rebate or
discount, whether in the form of money, products or other things of value earned by a defendant
under an Amgen Portfolio Contract and paid to it by Amgen that was based upon the purchase of
a Covered Drug during the Covered Period, if not reported to a Government Healthcare Program
as revenue that lowered the actual cost of such drugs to a defendant violated Government
Healthcare Program rules and regulations and constituted a false and fraudulent claim.
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410. Each and every claim for reimbursement filed by a defendant with a Government
Healthcare Program for a Covered Drug administered to a person eligible to receive benefits
under any such program during the Covered Period constituted a fraud on such program and
upon the United States and the plaintiff states that sponsored for funded such programs, unless
the money, products and other things of value earned by a defendant under an Amgen Portfolio
Contract and paid to it by Amgen were reported to such programs as reductions in the cost of the
drugs administered to such persons.
411. On information and belief, during the Covered Period, each defendant submitted
claims to Government Healthcare Programs for reimbursement of the cost of the Covered Drugs
delivered to patients eligible to receive benefits under such programs. Each such claim:
(a) was improperly filed in that (i) the claim was for a medical or other item or
service, to wit, a Covered Drug, and the person making the claim knew or should have known
that the claim was false or fraudulent in that it failed to report or identify the post-sale rebates,
discounts and other things of value earned by the defendant under an Amgen Portfolio Contract
and paid to it by Amgen, and (ii) was for a pattern of medical or other items or services, to wit,
the Covered Drugs, that were known or should have been known to be not medically necessary,
or not medically necessary at the dosage levels at which administered, both in violation of 42
U.S.C. 1320a7a;
(b) (i) contained a false statement or representation of a material fact that was
made knowing and willfully in an application for a benefit or payment under a Federal health
care program (as defined in 1320a7a(f)), to wit, a claim that the defendant was entitled to
reimbursement of a portion of the cost of the Covered Drugs without accounting for the post-
sale rebates, discounts and other things of value earned by the defendant under an Amgen
Portfolio Contract and paid to it by Amgen and (ii) contained statements or representations of
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material facts for use in determining rights of the defendant to such benefit or payment under a
Federal health care program that were knowingly and willfully false, namely, by omission, that
the defendant had not received any post-sale rebates, discounts or other things of value from
Amgen based upon its purchase of the Covered Drugs during the Covered Period, the effect of
which was to reduce the cost to it of the Covered Drugs, in violation of 42 U.S.C. 1320a-
7b(a)(1) and (2), respectively; and
(c) was improper as it was generated on the basis of kickbacks, bribes, rebates
or other remuneration paid to and received by the defendant filing the claim for the purpose of
inducing such defendant to order goods, namely, the Covered Drugs, from Amgen to be
provided to persons eligible to receive benefits under a Federal health care program, in violation
of 42 U.S.C. 1320-7b(b)(1)(A) and 1320-7b(b)(2)(A).
412. Each and every claim submitted by a defendant to a Government Healthcare
Program for reimbursement of the cost of any Covered Drug during the Covered Period violated
20 C.F.R. 498, et seq. as each such claim contained false statements or representations or
omissions or otherwise withheld disclosure of a material fact, to wit: (a) the fact that the
defendant was induced to purchase the Covered Drugs on the basis of kickbacks, bribes, rebates
or other remuneration paid to and received by the defendant, (b) the fact that the claim failed to
advise the Government Healthcare Program that the defendant was receiving post-sale rebates,
discounts and other things of value from Amgen for its purchase of the Covered Drugs; and (c)
the fact that the Covered Drugs that were the subject of the claim were known to be or should
have been known to be not medically necessary or not medically necessary at the dosage levels
administered, all such claims being relevant for use in determining a right to or amount of
benefits under title II or benefits or payments under title VIII or title XVI of the Social Security
Act.
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F. Fraudulent Reporting of ASP by Defendant Oncology Practices.
413. Prior to 2005, the reimbursement rates from the Medicare Part B and Medicaid
programs for prescription drugs were based on the manufacturers average wholesale price, the
previously defined AWP of the drug. Since January 2005, Medicare reimbursements for drug
costs have been set by reference to the average sale price, the previously defined ASP of the
drug, plus 6%. Both the AWP and the ASP price averages are or were determined by reference
actual sales prices in the calendar quarter nearest in time to the quarter ended. Thus, for
example, allowable reimbursements in the first quarter of the year, beginning in January, would
be based on prices determined by reference to transactions occurring in the third quarter of the
prior year.
414. As a direct result of the actions of the defendants and Amgen, as described above,
Government Healthcare Programs paid out hundreds of millions of dollars in excess charges
based upon false and fraudulent claims and information and submitted by them, directly or
indirectly, to such programs.
415. According to CMS, the payment limit for Aranesp (J code J1880 for non-ESRD
usage) in the first quarter of 2006 was $2.989/mcg. For the same period, the payment limit for
Neulasta (J code J2505 for injection) was $2,093.436 for 6 mg. For that same period, the
payment limit for Neupogen (J code J1440 and J1441) was $176.063 for a 300 mcg injection
and $279.354 for a 480 mcg injection.
416. According to CMS, the payment limit for Aranesp was $3.327/mcg (J code
J1880 for non-ESRD usage) in the first quarter of 2013. For the same period, the payment
limit for Neulasta (J code J2505 for injection) was $2,921.116 for 6 mg. For that same period,
the payment limit for Neupogen (J code J1440 and J1441 for injection) was $275.685 for a
300 mcg injection and $435.921 for a 480 mcg injection.
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417. According to CMS, the payment limit for Aranesp was $3.334/mcg (J code
J1880 for non-ESRD usage) in the second quarter of 2013. For the same period, the payment
limit for Neulasta (J code J2505 for injection) was $2,940.196 for 6 mg. For the same period,
the payment limit for Neupogen (J code J1440 and J1441 for injection) was $277.248 for a
300 mcg injection and $439.903 for a 480 mcg injection.
418. In the seven-year period between January 1, 2006 and January 1, 2013, the
maximum reimbursement by CMS for Aranesp increased by 11.3 % (from $2.989 to $3.327).
During the same period, the maximum reimbursement by CMS for Neulasta increased by 39.5%
(from 2,093.436 to $2,921.116) and by 56% for Neupogen (from $176.063 to $275.685 for the
300 mcg injection and from $279.354 to $435.921 for the 480 mcg injection). As is apparent,
the maximum reimbursement rate for Aranesp did not increase as rapidly did the maximum
reimbursement rate for Neulasta and Neupogen. Nevertheless, by prescribing Aranesp to be
administered at dosing levels that exceeded the levels described in the package insert, oncology
practices, including the defendant Oncology Practices, could increase the revenue they received
from Government Healthcare Programs, as reimbursements were not limited to a fixed dosage.
On information and belief, physicians affiliated with the defendant Oncology Practices
prescribed Aranesp at levels that exceeded the recommended levels in order to maintain the high
level of discounts they were receiving from Amgen and to continue receiving reimbursements
of drug costs from Government Healthcare Programs in excess of the those they would have
been entitled to receive had transaction prices included the value of the rebates, discounts and
other monetary and non-monetary inducements the defendants received to over-prescribe the
Covered Drugs.
419. Some physicians were surprisingly candid in speaking to Amgen representatives
about the purchase incentive programs Amgen sponsored and their motivation for buying and
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administering large quantities of the Covered Drugs. The following are examples culled from
statements that Relator heard directly or from notes made by Amgen executives and sales
representatives who called upon the physicians identified:
Dr. Danielle Montgomery and Jack Montgomery (ICON, Jacksonville, FL) (from
Relators direct knowledge): We are using our Amgen rebates to build our new
beach house.
Dr. Abe Cheung (Southeast Georgia Hematology & Oncology, Brunswick, GA):
These rebates are like crack cocaine.
Dr. Antonio Moran (Southeast Georgia Hematology & Oncology, Brunswick,

GA): Amgen rebates keep my Porsche running.
Dr. Wayne Keiser (Redwood Regional Oncology in Santa Rosa, CA) (Jim Daly
Notes): They dont count rebates in deciding if a drug is viable.
Dr. Graydon Harker (Utah Cancer Specialists, Salt Lake City, UT) (Jim Daly
Notes): Financial support through rebates is critical next year.
Dr. Lon Smith (South Texas Oncology Hematology, San Antonio, TX) (Jim Daly
Notes): Will need to float any drug loss until rebates are paid 6-9 months later.
Anything Amgen can do to accelerate rebate payments would be well received.
Dr. Tom Marsland (ICON, Orange Park, FL) (Jim Daly Notes): My rebates go
to my account in the Caymans.
Dr. Bruce Feinburg (Georgia Cancer Specialists, Atlanta, GA) (Jim Daly Notes):
Dont anticipate big changes in first two quarters of 2005. Overall, dont
anticipate a huge change in practices since, docs can still make a great living at a
20% reduction in income, as long as this new level is sustainable.
420. Amgen also provided incentives directly to physicians to encourage them to
prescribe these Covered Drugs for their Medicare- and Medicaid-eligible patients, effectively
lowering the price that they paid for these drugs. These incentives included the same sort of off-
invoice discounts, price protection, provision of free goods including product samples, drug
overfill in vials and an extensive rebate program as described throughout this Complaint.
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G. Overprescribing of the Covered Drugs.
421. Physicians affiliated with the defendant Oncology Practices, for the reasons
described, over-prescribed the Covered Drugs. The result of such over-prescribing was not
always benign. Strokes and death could and did occur. These costs, unlike the financial costs
imposed on the nations healthcare systems, cannot be measured in dollars and cents. They may,
however, be measured in negative patient outcomes, which were not uncommon. While
individual physicians were making literally millions of dollars from overprescribing and
overusing the Covered Drugs to climb higher and higher into the Amgen Portfolio Contract tier
structure to earn greater rebates, desperate and vulnerable patients were harmed. At best,
patients did not receive a medical benefit justifying the use of these Covered Drugs at the doses
patients often received.
422. At least as early as 2005, physicians knew or should have known that Aranesp
was a very dangerous drug and that it performed less well in important treatment criteria than
Procrit. In that year, a study by Dr. Roger Waltzman, St. Vincents Comprehensive Cancer
Center (New York), and others, comparing the efficacy of epoetin alfa to darbepoetin alfa in
anemic patients with cancer receiving chemotherapy, concluded that epoetin alfa was preferable
to darbepoetin alfa for two reasons: first, epoetin alfa (Procrit) showed an earlier hemotologic
response than darbepoetin alfa (Aranesp) and, second, blood transfusion intensity, although not
frequency, was significantly lower for patients being treated with epoetin alfa (Procrit) at the
dosage levels tested, which were consistent with those most commonly used in clinical practice
and with recommendations in published guidelines regarding use of these agents. In other
words, with respect to the first measure, Procrit worked faster in increasing red blood cells
circulating in the patients blood stream than Aranesp, the median time for Procrit to get a
significant response being 35 days to Aranesps 46 days; and, with respect to the second
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measure, Procrit patients did not need as much blood to be transfused, on average, as patients on
Aranesp in the study period: only 2.6 units vs. 3.9 units for patients on Aranesp.
423. On or about December 16, 2006, Amgen advised the FDA of the results of the so-
called DAHANCA 10 clinical trial. The trial had been stopped prematurely in approximately
October 2006 two months before Amgens letter. The preliminary data released to the FDA
from this study showed a significantly greater number of adverse events, up to and including
death, for those on Aranesp versus the control placebo group.
424. On January 26, 2007, Amgen sent a dear physician letter to the oncology
medical community advising that a large, multicenter, randomized, placebo-controlled study
showed that Aranesp was ineffective in reducing red blood cell transfusions or fatigue in patients
with cancer who had anemia not due to concurrent chemotherapy. The letter also stated that the
study showed higher mortality in patients receiving Aranesp than the placebo group.
425. On February 16, 2007, the FDA notified healthcare professionals of the results
from a large clinical trial evaluating use of darbepoetin alfa to treat anemia in cancer patients not
receiving chemotherapy. In this study, patients received either Aranesp (darbepoetin alfa),
according to the approved dosing regimen or a placebo. Patients treated with Aranesp had a
higher death rate and no reduction in the need for transfusions compared to those treated with the
placebo. The FDA announcement also noted that the findings in the Aranesp study may apply to
other ESAs. Additionally, the findings showed that treating anemic cancer patients not currently
on chemotherapy with an ESA may offer no benefit and may cause serious harm.
426. In an update to its February 16 warning, on March 9, 2007, the FDA notified
healthcare professionals of new safety information for Aranesp (darbepoetin alfa), Epogen
(epoetin alfa) and Procrit (epoetin alfa). The FDA advised that four new studies in patients with
cancer found a higher chance of serious and life-threatening side effects or death with the use of
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ESAs. The research studies were evaluating an unapproved dosing regimen, a patient population
for which ESAs were not approved, or a new unapproved ESA. FDA advised that it had
required changes in the full prescribing information for Aranesp, Epogen and Procrit to include a
new boxed warning, updated warnings and a change to the dosage and administration sections
for all ESAs.
427. The March 2007 FDA advisory recommended caution in using ESAs in cancer
patients whether or not they were receiving chemotherapy; it also indicated a lack of clinical
evidence to support improvements in quality of life or transfusion requirements in patients being
administered these drugs claims that had been made by Amgen for Aranesp and Epogen.
428. The March 2007 FDA advisory further cautioned physicians that ESAs should be
administered at the lowest possible dose needed to bring red blood cell counts up to a level just
within the limit necessary to avoid transfusions. As previously alleged (see paragraphs 362, 364,
above), ESAs in general were prescribed in the United States by physicians at higher dosage
levels and to a greater proportion of patients than medical necessary as a consequence of the
unusual opportunity to profit by prescribing increasing amounts of the drugs. Amgens tiered
rewards system encouraged physicians to dose patients at the highest levels they could tolerate.
429. In November 2007, additional black box warnings were included on the label
for Aranesp at the request of the FDA. The FDAs black box warning was prompted by linkages
between Aranesp and cardiovascular incidents and between Aranesp and faster tumor growth.
The new labeling emphasized that there are no data from controlled trials demonstrating that
ESAs improve symptoms of anemia, quality of life, fatigue, or patient well-being for patients
with cancer or for patients with HIV undergoing AZT therapy.
430. In December 2008, the FDA posted on its Web site, an advisory notice as a
medication guide regarding the use of ESAs. The advisory noted that use of ESAs can lead to
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serious side effects which may result in death and that some of these side effects are more
likely to happen if the patient has cancer or CRF. In patients with all types of cancer for which
ESA use is approved, the advisory warned (a) that the tumor may grow faster and the patient
may die sooner when ESA treatment is used, (b) that ESAs have not been shown to improve
the symptoms of anemia, quality of life, fatigue, or well-being for patients with cancer, and, for
that reason, should be used only to reduce the chance that a patient with low red blood counts
(anemia) will get a blood transfusion and, finally, (c) that [t]reatment with an ESA should be
stopped when chemotherapy treatment is finished.
431. A physician has an ethical duty not to prescribe a drug for a patient unless use of
the drug is warranted by medical necessity. Under Medicare and Medicaid definitions, medical
necessity means reasonable and necessary for the diagnosis or treatment of illness or injury or
to improve the functioning of a malformed body member . . . . 42 U.S.C. 1395y.
Practices as agents, employees or owners prescribed Aranesp and Neulasta at levels that
exceeded medical necessity. Relator recalls hearing Dr. Abe Cheung of Southeast Georgia
Hematology & Oncology, Brunswick, GA telling another physician at American Society of
Clinical Oncologists (ASCO) meeting in approximately 2004: All my patients get Aranesp and
Neulasta and some of them actually need it.
Practices often prescribed Aranesp and Neulasta not because of the medical needs or comfort of
their patients, but for business and financial reasons, i.e., to earn increased revenues and higher
profits from the discounts, rebates and other monetary and non-monetary benefits they could
obtain from Amgen, as well as the higher reimbursement levels they could receive for
prescribing these drugs to patients entitled to receive benefits under Government Healthcare
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Programs and then failing to report the discounts, rebates and other monetary and non-monetary
benefits they received from Amgen to Medicare, Medicaid and other Government Healthcare
Programs so as to avoid having the reimbursement levels of these drugs reduced.
434. Aranesp had potentially serious side effects. At too high a dosage, Aranesp could
lead to serious adverse consequences, including stroke and even death. Because oncology
patients treated with the Covered Drugs are often considered to be terminal, on information and
belief, the true effects of administration of the Covered Drugs at the off-label doses prescribed
by some physicians was masked because of an expectation of high mortality rates in such
patients.
435. On information and belief, the defendant Oncology Practices have information in
their possession, custody or control that would show that increased dosing of some patients with
Aranesp and Neulasta was not done for reasons of medical necessity, but to improve the
financial bottom lines of the defendant Oncology Practices, i.e., to increase their profits. On
information and belief, each of the defendants has in its possession, custody or control records
and other information that would show that it switched patients who were being treated for
chemotherapy-induced anemia from Procrit to Aranesp virtually overnight, i.e., shortly after the
defendant entered into an agreement with Amgen to prescribe these drugs as part of an incentive
buying program.
436. On information and belief, each of the defendants has in its possession, custody
or control records and other information that would show that, shortly after patients being treated
for chemotherapy-induced anemia were converted from Procrit to Aranesp, they were placed on
larger equivalent doses of Aranesp, with the result that the defendants revenues and profits from
its treatment of such patients increased. The increase in revenues and profits was largely
accounted for by three interrelated factors: (a) higher sales revenues from increased dosing, (b)
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lower purchase costs due to the rebates, discounts and other consideration received from Amgen
and (c) higher reimbursement rates from Government Healthcare Programs due to the failure to
report the rebates, discounts and other consideration received from Amgen.
437. As an example of the kind of change described above, Relator is familiar with the
case of Dr. Joel Stone, a principal in defendant ICON. As of approximately 2001, ICON spent
about $1 million per year to buy Procrit and Neupogen. By 2006, having entered into the
Amgen Portfolio Contract, ICON spent about $32 million annually for Aranesp and Neupogen.
This 32-fold increase in purchases came at a time when cancer death rates were decreasing,
according to the American Cancer Society,4 and at a time when ICON had realized no significant
change in its patient population.
438. Relator is also familiar with the case of Dr. William Harwin, a Florida oncologist
and principal of Florida Cancer Specialists. In or about 2006, Dr. Harwin, responding to the
profit incentive provided by Amgens purchase incentive scheme, began to administer Neupogen
to his Medicare patients because the Neupogen vials contained a large amount of overfill which
could be administered to additional patients, thus allowing his oncology practice the opportunity
for greater cost recoupment. The recoupment was greater for two reasons: (a) the vials of
Neupogen contained overfill that could be recovered, administered to patients and billed to
Government Healthcare Programs or other third-party payers and (b) because Neupogen had a
higher reimbursement rate than Neulasta. At the same time, Dr. Harwin kept his private
4
Cancer deaths were falling: Cancer death rates decreased by 1.8% per year in males and by
1.5% per year in females during the most recent 5 years of data (2005-2009). These declines
have been consistent since 2001 and 2002 in men and women, respectively, and are larger in
magnitude than those occurring in the previous decade (Table 5). Death rates peaked in men in
1990 (279.8 per 100,000), in women in 1991 (175.3 per 100,000), and overall in 1991 (215.1 per
100,000). Between 1990/1991 and 2009, cancer death rates decreased 24% in men, 16% in
women, and 20% overall. See Trends in Cancer Mortality, American Cancer Society (2013),
http://onlinelibrary.wiley.com/doi/10.3322/caac.21166/pdf (visited Aug. 26, 2013).
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insurance patients on Neulasta, rather than Neupogen, because of Neulastas greater efficacy and
the typically lower private insurance company reimbursement rates for Neupogen.
H. Other Illegal Practices.
1. Tying the Purchase of Aranesp to the Purchase of Neupogen and

Neulasta.
439. Under the Amgen Portfolio Contract, purchases of Neupogen and Neulasta, in
addition to purchases of Aranesp, counted toward the dollar total of a customers qualified
purchases necessary to achieve a higher tier in the Amgen discount and rebate structure. By
including Neupogen and Neulasta in the discount and rebate scheme, Amgen extended its power
in one the market the market for white blood cell stimulation agents, which it had because of
Neupogen and Neulasta to an ESA, Aranesp, known to be inferior to Procrit in the treatment of
chemotherapy-induced anemia, contrary to U.S. antitrust law. 15 U.S.C. 1. See Ortho Biotech
Products, LP. v. Amgen, Inc., Case No. 2:05-cv-04850-SRC-MAS (D.N.J. filed Oct. 11, 2005).
In this case, the plaintiff, Ortho Biotech Products, LP (Ortho), a J&J subsidiary, sought a
preliminary injunction enjoining Amgen from offering discounts to oncology clinics on
Neupogen, Neulasta and Aranesp based on the volume of these products purchased. Ortho also
sought a permanent injunction against such discounts, as well as money damages. The case was
finally settled by a $200 million payment from Amgen to Ortho, as announced by Amgen in a
press release issued on or about July 11, 2008.
2. Off-Invoice Discounts.
440. Beginning in or about 2003, Amgen offered customers, including the defendant
Oncology Practices, lower bottom-line prices for the Covered Drugs and, by reducing the cost of
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these drugs through the use of a post-sale, off-invoice discount, which provided a way for the
defendants to increase their revenues and profits simply by failing to account for these discounts
in their submission of claims for payment, or reimbursement, of the cost of the Covered Drugs
used to treat patients eligible for benefits under Government Healthcare Programs.
441. By providing the defendants with invoices that did not represent the actual cost of
the Covered Drugs, Amgen facilitated, and intended to facilitate, their submission of claims for
payment, or reimbursement, to Government Healthcare Programs that were based upon the
invoice amount, even though the invoice price did not represent the actual cost of the drugs to
the defendants. Because the scheme included the presentation by Amgen of a physical invoice
that misstated the actual cost of the Covered Drugs to the defendants, or to their GPOs, the
scheme provided defendants with a false indicator of the price they paid for the drugs in the
event of an audit.
442. On information and belief, the defendant Oncology Practices filed false and
fraudulent claims for reimbursement to Government Healthcare Programs based upon invoices
supplied by Amgen for the Covered Drugs that overstated the actual cost of these drugs to them
and, based on these false and fraudulent claims, the defendants obtained excess reimbursement
of the actual cost of the Covered Drugs used to treat eligible patients from Government
Healthcare Programs.
443. In March 2008, Amgen and number of other drug companies settled litigation
brought against them by a variety of consumers and insurance companies. The lawsuits accused
the drug companies of fraudulently inflating published average wholesale drug prices. See In re:
Pharmaceutical Industry Average Wholesale Price Litigation, M.D.L. No. 1456, No. 01-12257
(D. Mass). In the litigation, consumers and insurance companies accused the companies of
fraudulently inflating published average wholesale drug prices. Those wholesale prices led to
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higher consumer and insurance company payments for branded and generic drugs used to treat
serious illnesses like cancer and HIV.
3. Use and marketing of overfill.
444. Overfill means the provision of extra product to the customer. When a product
is delivered in a vial, as was true in the case of the Covered Drugs, the vial is filled beyond the
amount shown on the invoice. The significance of having an extra amount of the drug to a
physician, a medical services provider or other buyer that administers the drug is that the extra,
unaccounted-for amount of the drug can be administered to a patient and the patient or a third-
party payer, including a Government Healthcare Program, charged for the amount of the drug
administered, even if the drug was provided to the medical services provider free of charge.
445. Beginning with the approval of Aranesp for treatment of CRF in 2001, Amgen, to
increase physician preferences for the Covered Drugs, and thereby to increase sales of these
drugs, began providing customers with extra quantities of Aranesp at no charge. This practice of
providing extra quantities of Aranesp in vials for no charge continued with the approval of
Aranesp for chemotherapy-induced anemia for the oncology market in 2002. This practice of
overfilling vials was also used by Amgen for Neupogen, beginning with its launch in February
1991.
446. By providing customers with amounts of the Covered Drugs greater than reflected
on invoices, Amgen intended to encourage customers to prefer Amgen products over potential
substitute products, in the case of Aranesp, and to increase the quantities of the Covered Drugs
sold to customers.
447. The overfill program benefitted the defendant Oncology Practices by reducing
the effective cost of the Covered Drugs to them in a way that could not readily be detected by
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Government Healthcare Program administrators. This facilitated their ability to avoid reporting
this financially valuable but non-monetary discount to government-funded healthcare programs,
yet provided them with the opportunity to earn greater profits from the purchase of the Covered
Drugs.
448. The overfill program was intended to, and did, allow the defendants to administer
the Covered Drugs they received for free to patients. The patients or, more frequently, third-
party payers, principally Government Healthcare Programs and insurance companies, were then
billed for the drugs based on the volume of the drug administered, not its cost, as there was no
cost for the extra, overfill amount. The claims filed by the defendant Oncology Practices to
Government Healthcare Programs for the Covered Drugs exceeded the actual cost of the drugs to
them, inasmuch as delivering extra, unaccounted-for drugs with a drug order effectively lowered
the cost of the drugs on a per-unit basis.
449. On information and belief, defendant Oncology Practices benefitted substantially
from the overfill program, while costing Government Healthcare Programs additional money.
For example, assume the case of a hypothetical 500mcg vial of Aranesp in 2006 the size of vial
which accounted for a substantial percentage of Aranesp sales. Assuming a 20% overfill, which
is consistent with marketing materials the Relator received from Amgens marketing department
as to the average amount of overfill in Amgen-supplied vials of the Covered Drugs, the vial
would contain approximately 100mcg of overfill. This 100mcg of Aranesp would then be
available to a defendant to administer to patients, providing the defendant with an opportunity to
earn an extra $298.90, the amount a practice would earn in Medicare-billable profit from a single
administration of the drug to a single patient, according to the CMS advisory on the maximum
billing allowed in the first quarter of 2006. Further, of course, as the maximum reimbursement
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rate for Aranesp increased over time, so did the profit a defendant could earn in billing
Medicare, Medicaid or other Government Healthcare Programs for the overfill.
450. By way of further explanation, assuming the same 500mcg vial and that each of
five patients was administered a single 100mcg dose of Aranesp, each patient or her third-party
payer, such as a Government Healthcare Program, would be billed for one-fifth of the cost of the
vial. But since, in this example, the vial actually contained 600mcg, a sixth 100mcg dose could
be administered to a sixth patient and billed to that patient or his third-party payer. Since the
medical services provider would have paid nothing for the extra 100mcg dose, the income
collected on the sixth dose would be pure profit.
451. Similarly, with respect to Neupogen, in a hypothetical case, a physician might
dose an average size person (70kg or 154 lbs) with a 350mcg dose, but, because of the limited
number of dispenser sizes, would need to draw this dose from a 480mcg vial. Since a 480mcg
vial would actually contain 530mcg of Neupogen, however, after administering the 350mcg
dose, the physician or the medical services provider would still have 180mcg (480 350 + 50) of
the drug left. That 180mcg could then be administered to another patient and billed to a third-
party payer without any additional cost.
4. Price protection.
452. During the Covered Period, Amgen generally initiated one or two price increases
per year on most products. These increases were usually in the range of 5%. But, in order to
increase sales, Amgen allowed current customers, including the defendant Oncology Practices,
to continue purchasing the Covered Drugs and other products at the old price until the date of
next price increase.
453. Price protection had at least two specific benefits for Amgen customers who had
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entered in to the Amgen Portfolio Contract. First, it allowed customers, including the defendant
Oncology Practices, to purchase certain drugs, including the Covered Drugs, at the old price
longer after a price increase had been announced and implemented. Second, it increased the size
and value of drug cost reimbursements defendants could realize from Government Healthcare
Programs. This effect stemmed from the fact that, as Amgens ASP increased, the
reimbursement rates of Government Healthcare Programs also increased, to adjust for the higher
supposed higher ASP, whereas the actual cost of the Covered Drugs to the defendants did not
increase.
454. Amgen took steps to ensure that its price increase announcement would be
published in industry publications, such as the Red Book which tracked all drug industry price
changes and which Amgen knew was relied on by Government Healthcare Programs for drug
pricing data. Through the Red Book, and via other means, Amgen began reporting a new, higher
ASP for the Covered Drugs to Government Healthcare Programs, based on the price increase,
even though only a small fraction, if any, of its drug sales were made at that price. Knowing that
Amgens reported ASP did not accurately reflect the actual selling price of the Covered Drugs,
the defendants nevertheless submitted claims for payment, or reimbursement, of their drug
costs, to Government Healthcare Programs that failed to account for the fact that Amgens
claimed ASP did not accurately reflect the price paid and, therefore, were false and fraudulent.
5. Free goods.
455. Amgen supplied free goods and samples to the defendant Oncology Practices and
other customers as a way to drive sales and to reduce the effective cost of the Covered Drugs to
the defendants. Each Amgen sales representative had $50,000 in free goods to use to promote
the sale of each drug within his/her portfolio. More than that amount of money was usually
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readily available to the sales representative from Amgen, upon request. The sales force was
encouraged by Amgen to dole out free samples of Amgen drugs to customers. Physicians and
practice groups that received these gifts were then free to administer the drugs to patients,
charging the patient or a third-party payer, such as a Government Healthcare Program, the full,
ordinary (claimed) cost of the drug, with the revenue derived from such sales being pure profit.
456. These free goods, or spoils, reduced the effective price of the Covered Drugs and
other drugs to the defendants. On information and belief, the defendants did not, in submitting
claims for payment, or reimbursement, of drug costs to Government Healthcare Programs,
report that these drugs had been supplied to them at no cost or accounted for the fact that they
had paid nothing for the drugs to reduce their average cost of that drug during a calendar quarter
or any other relevant period of time.
6. Marketing the spread.
457. As reflected earlier in this Complaint, the defendant Oncology Practices signed
Amgen Portfolio Contracts based upon the promise of profits per patient, or spread. The
spread was the difference between what Amgen would charge the defendants for the Covered
Drugs and what Government Healthcare Programs would pay the defendant Oncology Practices
for these same drugs once purchased by a defendant and administered to an eligible patient.
458. Relator and other Amgen sales representatives deliberately marketed the Covered
Drugs to specific defendants on the basis of the profits per patient, or spread, such defendants
could earn, as these defendants were particularly highly motivated to purchase the Covered
Drugs based not upon their efficacy for a specific patient, but based upon the revenue that could
be earned from administering the drug to a patient.
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459. Based on personal knowledge, the drug purchasing decisions of the following
defendant Oncology Practices were heavily influenced by Amgens practice of marketing the
spread, as well as their desire for profit: Florida Cancer Specialists, Gulfcoast Oncology
Associates, North Florida Hematology and Oncology, Regional Consultants in Hematology and
Oncology, Georgia Cancer Specialists, Tennessee Oncology, the West Clinic, Montgomery
Cancer Specialists and Florida Oncology Associates/ICON. The defendants named in this
paragraph, recognizing the profit potential that could be achieved by buying on the spread,
including profits that could be achieved from administration of the Covered Drugs so long as
they failed to report the rebates, discounts, kickbacks and other remuneration received as
incentives to buy the Covered Drugs to Government Healthcare Programs dramatically
increased their purchases of these drugs in response to Amgens sales campaign. On information
and belief, the defendant Oncology Practices generally and the defendants specifically named in
this paragraph would not have increased their purchases of the Covered Drugs in so dramatic a
fashion as they did had the physicians who made the prescribing and dosing decisions not
understood the profit-making rationale for making such decisions.
460. On information and belief, the defendant Oncology Practices knew that, at the
levels ordered and administered, Aranesp was not medically necessary, and was indeed
potentially harmful, to the majority of their patients.
461. The free goods, drug overfills, sham honoraria, fraudulent roundtable
discussions at which relevant medical topics were not discussed, fraudulent reimbursement
roundtables at which issues related to reimbursement were not discussed, rebates, discounts,
price protection and things of value provided by Amgen to the defendants, and that were tied to
their purchase of the Covered Drugs during the Covered Period, constituted improper and
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fraudulent kickbacks to induce the defendants to purchase the Covered Drugs, in violation of the
federal anti-kickback statute. 42 U.S.C. 1320a-7b.
462. The practice of marketing the spread, coupled with the false and fraudulent
claims filed by the defendants, caused Government Healthcare Programs to pay out substantial
sums of money to the defendants as drug cost reimbursements that exceeded the amounts that
should properly have been paid out pursuant to laws, rules and regulations covering
reimbursement rates for Government Healthcare Programs.
7. Other improper financial incentives provided to oncology practices.
463. During the Covered Period, Amgen provided the defendant Oncology Practices
with numerous additional financial incentives to influence the defendants selection and
utilization of the Covered Drugs regardless of medical necessity. These incentives included, but
were not limited to, sham honoraria constituting improper and fraudulent kickbacks to the
defendants or to their owners, employees or agents.
464. One incentive Amgen offered was a free dinner for the physician and his/her
family, plus an honorarium to the physician for attending the event. Although billed as
roundtable discussions at which medical issues were discussed, it was often the case that no
medical discussions took place. In that event, Relator or another Amgen sales representative
would deliver a check of up to $1,000 to the physician for simply showing up. Physicians
affiliated with defendants Florida Cancer Specialists, Gulfcoast Oncology Associates and ICON
all accepted sham honoraria, specifically Dr. Jeffrey Paonessa, Dr. Joel Stone and Dr. Thomas
Marsland, respectively. In addition, on information and belief, physicians affiliated with other
defendant Oncology Practices accepted sham honoraria from Amgen.
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465. Amgen also marketed the Covered Drugs by arranging for employees of medical
services providers, including employees of the defendant Oncology Practices, to attend
reimbursement roundtables. Often, these events did not involve discussion of
reimbursement procedures. Instead, their sole purpose was for members of Amgens sales
staff to ingratiate themselves with the staff of a medical services provider. These roundtables
often featured meals with minimal discussion, if any at all, of how to bill for Amgen products.
466. The defendant Oncology Practices failed to disclose these improper financial
incentives to Government Healthcare Programs that provided payment, or reimbursement, of
the cost of the Covered Drugs administered to eligible patients, even though the effect of the
honoraria was to decrease the effective prices these Oncology Practices paid for the Covered
Products.
467. The defendant Oncology Practices had an obligation not to allow financial
inducements to affect patient treatment decisions. On information and belief, the honoraria and
other financial inducements did just so: Patients who relied on their physicians to exercise their
best medical judgment regarding treatments to improve their health were not treated as human
beings to whom the physicians owed an ethical duty of care, but as objects through which the
defendant Oncology Practices could fatten their financial bottom lines.
8. Use for off-label indications due to marketing and promotion.
468. During the Covered Period, in order to increase sales, Amgen promoted the off-
label sale and use of Aranesp to the defendant Oncology Practices. For oncology purposes,
Aranesp was approved by the FDA only for the treatment of chemotherapy-induced anemia.
Other ESAs, including Procrit and Epogen, had other FDA-approved non-oncology indications.
The fact that Aranesp had only the one approved indication for oncology limited its potential
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markets. To overcome this limitation, Amgen management directed and supported the off-label
use of Aranesp, including for treatment of anemia in Zidovudine-treated HIV patients, reduction
of allogeneic blood transfusions in surgery patients, anemia of cancer and myelodysplastic
syndromes. Amgen provided oncology sales representatives a proof source book that included
extensive off label marketing materials for a range of different uses. Although numerous
warnings stated that the book was for information purposes only, the purpose of the book was
to enable Amgens sales representatives to market Aranesp off label and encourage doctors to
prescribe and use Aranesp for a host of medical indications where FDA approval had not been
given.
469. On information and belief, the defendant Oncology Practices, based, in part, on
Amgens illegal and fraudulent off-label promotion of Aranesp, purchased and administered
Aranesp for non-approved uses based, not on appropriate treatment concerns and medical
efficacy, but based principally on the increased profits they could earn from higher Government
Healthcare Program payments and higher Amgen rebates, discounts and the like under the
Amgen Portfolio Contract.
9. Defendants fraudulent activities have threatened public health and

safety.
470. As alleged elsewhere in this Complaint (see paragraphs 401 and 402), studies
have linked the use of anti-anemia drugs, such as Aranesp and Epogen to cardiovascular
incidents, including death and faster tumor growth. This Complaint also alleges (see paragraphs
404-405) that, in 2007, the FDA added a black box warning cautioning about the use of
erythropoeisis-stimulating agents in cancer patients receiving chemotherapy or not receiving
chemotherapy and advising that the medications should be administered at the lowest dose
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possible in order to bring red blood cell counts to a level just below the level at which blood
transfusions would not be recommended.
471. During the Covered Period, the defendant Oncology Practices accepted rebates,
discounts and other incentives, including kickbacks, from Amgen to purchase the Covered
Drugs. On information and belief, acceptance of those incentives caused the defendants to
search for and find reasons to buy these drugs and to administer them to patients, despite their
being medically unnecessary and even dangerous to patient health.
472. As previously alleged (see paragraph 429), one physician affiliated with
defendant Southeast Georgia Hematology & Oncology who regularly accepted financial
incentives from Amgen in return for purchasing the Covered Drugs, Dr. Abe Cheung, stated in a
conversation overheard by Relator: Yes, we use Aranesp and Neulasta and some of our patients
actually need it. Another physician affiliated with defendant ICON who routinely accepted
financial incentives from Amgen in return for purchasing the Covered Drugs, Dr. Joel Stone,
stated in a conversation overheard by Relator: Yes, the patient only has six more months to
live, and thats six more months we can bill Medicare.
473. In 2012, The Washington Post detailed the story of Jim Lenox, a 54-year-old
cancer patient who allegedly died as the result of unnecessary ESA injections. Washington Post
(July 19, 2012), at http://www.washingtonpost.com/wp-srv/business/amgen-anemia-
drugs/index.html (visited Apr. 28, 2013). The Post also reported that, from 2006 to 2011,
Amgen spent more than $10 million a year on lobbying efforts in Washington. Id.
474. Amgens political influence is well known in Washington. The New York Times
reported in an article from January 2013 that Amgen has 74 lobbyists on staff. As an example of
Amgens political influence, press reports have noted that buried in the fiscal cliff negotiations
that were concluded in early January 2013, Amgen was able to obtain a two-year delay a set of
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Medicare price restraints for a class of drugs, including its Sensipar drug, used by kidney dialysis
patients. This two-year delay achieved on top of a previous two-year delay is expected to
cost Medicare $500 million. New York Times Jan. 28, 2013) at
http://www.nytimes.com/2013/01/20/us/medicare-pricing-delay-is-political-win-for-amgen-
drug-maker.html (visited Apr. 30, 2013) (Just two weeks after pleading guilty in a major federal
fraud case, Amgen, the worlds largest biotechnology firm, scored a largely unnoticed coup on
Capitol Hill: Lawmakers inserted a paragraph into the fiscal cliff bill that did not mention the
company by name but strongly favored one of its drugs.)
I. Hub and Spoke Conspiracy to Commit Fraud.
475. With the FDA approval of Aranesp for chemotherapy-induced anemia in 2002,
Amgen, began a process of seeking to persuade the Defendant Oncology Practices to use
Aranesp. This sales effort accelerated with the introduction of the Amgen Portfolio Contracts in
approximately March, 2004.
476. Although some of Amgens focus in its marketing efforts for Aranesp was to
induce medical providers to replace Procrit with Aranesp, Amgens basic marketing strategy was
to increase the sales of Aranesp by expanding the market, both in terms of increased dosing of
Aranesp and the use of Aranesp in a broader patient population. In particular, Amgen offered its
rebates to customers based upon the growth in sales rather than a straightforward rebate based
upon the volume of total purchases. Instead of providing the highest rebates to its largest
volume customers, Amgen structured its rebate program to emphasize sales growth, with the
highest level of rebates going to customers that showed the greatest increase in purchases of
Amgen products.
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477. Upon information and belief, Amgen entered into agreements with each of the
Defendant Oncology Practices. One of the agreements that Relator is best informed about is the
agreement that Amgen and Gulf Coast Oncology Associates of St. Petersburg, Florida entered
into, known as an Amgen Portfolio Rebate Program Letter Agreement that offered the following
rebate schedule from March 1, 2004 through August 31, 2004:
VOLUME Participating Eligible Physician Aranesp NEUPOGEN
TIERS Practices Aggregate Combined Rebate and
Gross Purchases of Aranesp, Percent Neulasta
NEUPOGEN and Neulasta Rebate
during he applicable Quarterly Percent
Measurement Period
Tier 1 $1,051,771 - $1,262,124 5.0% 5.0%
Tier 2 $1,262,125 - $1,367,301 11.5% 7.5%
Tier 3 $1,367,302 - $1,472,478 13.5% 10.5%
Tier 4 $1,472,479 - $1,577,655 14.5% 11.5%
Tier 5 $1,577,656 - $1,682,832 18.5% 13.5%
Tier 6 $1,682,833 - $1,788,009 20.0% 20.0%
Tier 7 > $1,788,010 25.0% 25.0%
478. Another example is the agreement between Amgen and Florida Oncology
Associates of Jacksonville, Florida entitled Amgen Portfolio Rebate Program Letter Agreement,
that offered the following rebate schedule from March 1, 2004 through August 31, 2004:
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Measurement Period
Tier 1 $2,025,630 - $2,430,755 5.0% 5.0%
Tier 2 $2,430,756 - $2,633,318 11.5% 7.5%
Tier 3 $2,633,319 - $2,835,881 13.5% 10.5%
Tier 4 $2,835,882 - $3,038, 444 14.5% 11.5%
Tier 5 $3,038,445 - $3,241,007 18.5% 13.5%
Tier 6 $3,241,008 - $3,443,570 20.0% 20.0%
Tier 7 > $3,443,571 25.0% 25.0%
A comparison of these two contracts clearly shows that Florida Oncology Associates had to
purchase almost twice the volume of Covered Drugs to get the same percentage rebate as Gulf
Coast Oncology Associates.
479. Another example is theAmgen Portfolio Rebate Program Letter Agreement
beginning in March 1, 2004, entered into by Southeast Georgia Hematology Oncology and
Amgen. This agreement offered Southeast Georgia Hematology Oncology the following base
rebate schedule from March 1, 2004 through August 31, 2004:
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Measurement Period
Tier 1 $446,493 - $535,791 4.0% 4.0%
Tier 2 $535,792 - $580,440 10.5% 6.5%
Tier 3 $580,441 - $625,090 12.5% 9.5%
Tier 4 $625,091 - $669,739 13.5% 10.5%
Tier 5 $669,740 - $714,388 16.5% 12.5%
Tier 6 $714,389-$759,037 18.0% 16.0%
Tier 7 > $759,038 20.0% 21.0%
Southeast Georgia Hematology Oncology was able to obtain a 20 percent Aranesp discount by
purchasing approximately one-third as much of the Covered Drugs as Florida Oncology
Associates.
480. For Southeast Georgia Hematology Oncology, the 2006 Amgen Portfolio
Contract increased the amount of purchases of Covered Drugs required to obtain any rebate at
all:
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LEVEL Participating Eligible Physician Aranesp Neulasta NEUPOGEN
Practices aggregate combined Rebate Rebate Rebate
Gross Purchases of the Products Percent Percent Percent
plus Retail Prescriptions during
the applicable Quarterly
Measurement Period
Base $897,059 - $941,911 18.0% 14.0% 10.0%

Five $941,912 - $986,764 18.5% 14.5% 11.0%
Ten $986,765 - $1,076,470 19.0% 15.0% 12.0%
Twenty $1,076,471 - $1,166,175 19.5% 15.5% 13.0%
Thirty $1,166,176 - $1,255,881 20.0% 16.0% 14.0%
Forty $1,255,882 - $1,345,587 20.5% 16.5% 15.0%
Fifty > $1,345,588 21.0% 17.0% 16.0%
In order to obtain any rebate at all from Amgen, Southeast Georgia Hematology Oncology had to
more than double its purchases of the Covered Drugs from 2004 to and 2006. Amgen, in fact,
provided substantial economic incentives for the Defendant Oncology Practices to increase their
purchases of the Covered Drugs as with successive Amgen Portfolio Contracts, each of the
Defendant Oncology Practices had to increase Covered Drug purchases to obtain rebates at the
same level or even any rebate at all. This, in turn, resulted, in a dramatic increase in the use of
these Covered Drugs in oncology patients and in the billing for this use to Government
Healthcare Programs by the Defendant Oncology Practices. This dramatic increase in billings
for the Covered Drugs to Government Healthcare Programs cannot be explained by medical
necessity. Instead, this increase in the use of the Covered Drugs was the result of the economic
incentives that were offered by Amgen and accepted by the Defendant Oncology Practices.
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481. Amgen falsely claimed in promotional materials that it provided its best prices
to its best customers in the form of the higher rebates. Amgen sought to portray these Amgen
Portfolio Contracts as a way for Amgen to reward its biggest volume purchasers with the lowest
prices for the Covered Drugs. But, this was not the case. On information and belief, Amgen
sought to mislead the public, government officials, and even its customers as to the true intention
behind these Amgen Portfolio Contracts. The true purpose of these contracts was to increase
sales of the Covered Drugs during the Covered Period without regard to clinical efficacy or
medical necessity. The Defendant Oncology Practices were provided with individually tailored
rebate programs designed to encourage, in exchange for money, as much use of the Covered
Drugs as each practice could, theoretically, prescribe in specific patient populations, whether
these patient populations would benefit from the use of these Covered Drugs or not.
482. The Settlement Agreement entered into by Amgen and the United States in
December 2012 specifically excluded from the release provided to Amgen:Claims that Amgen
unlawfully marketed the spread for its products; that is, that Amgen promoted the profit margins
between the prices at which its products were sold to Amgens customers and the higher
Medicare and/or Medicaid reimbursement prices for those products, knowing that the prices it
reported to drug pricing compendia (such as First Data Bank) specifically, AWP and
Wholesale Acquisition Costs (WAC) were higher than they should have been, that those
reported higher prices would be used and/or relied upon by state Medicaid programs to set
reimbursement rates, and that the difference between Amgens reported prices and the actual
sales prices to its customers created substantial profit margins for pharmacists and medical
providers as a result of state Medicaid programs reimbursement methodologies. Settlement
Agreement, Preamble (G)(8)(b). Relator seeks to hold Amgen liable for marketing the spread
and all other conduct directed toward the sale of the Covered Drugs to the Defendant Oncology
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Practices that resulted in reimbursements by Government Healthcare Programs, to the extent not
precluded by the Settlement Agreement.
483. Amgens sales forces office visits with the Defendant Oncology Practices
reflected its sales goals. First, Amgen, in direct contravention of FDA guidelines and
regulations, marketed the Covered Drugs to the Defendant Oncology Practices by marketing to
spread. Amgen sought to convince the Defendant Oncology Practices to purchase the Covered
Drugs by emphasizing how much money the Defendant Oncology Practices could make per
patient by prescribing and administering the Covered Drugs. As described herein, the term
spread means the difference between what the Government Healthcare Programs paid the
Defendant Oncology Practices what defendants were actually charged for the Covered Drugs,
after taking account of the rebates, other discounts, overfill, and free product samples Amgen
provided to the Defendant Oncology Practices in exchange for their purchases of the Covered
Drugs. The Defendant Oncology Practices that qualified for the highest rebates could receive
from Amgen a rebate of up to half of the reimbursement amounts that the practices received
from the Government Healthcare Programs.
484. Amgens sales force touted this spread as an advantage that the Covered Drugs
had over Procrit and competing therapies. By marketing the spread, Amgen demonstrated to the
Defendant Oncology Practices the large sums of money that could be made by prescribing and
administering the Covered Drugs to patients regardless of the clinical benefit to the patient.
Given that many of cancer patients were terminal and desperate for any and all medical
interventions, this patient population was uniquely vulnerable to receiving unnecessary medical
care with no clinical benefit from Defendant Oncology Practices.
485. Over time, Amgen increased the level of purchases required of the Defendant
Oncology Practices to receive a constant level of discounts, rebates, and other inducements to
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buy the Covered Drugs from Amgen. Amgen based the rebates it paid to the Defendant
Oncology Practices not on the total amount of Covered Drugs these practices purchases, but.
rather, on the potential for increased purchases from each practice. The Defendant Oncology
Practices with the highest percentage increase in purchases received the highest rebate rates from
Amgen, up to 50% of the costs of the drugs that the practice billed to the Government Healthcare
Programs. Over time, Amgen raise the purchase level increases that the practices had to meet to
receive the highest rebates. These increases in the amount of the Covered Drugs that had to be
purchased to obtain the same level of rebate were significantly greater than the actual growth in
the oncology patient population. Because the patient population was increasing at a much
slower rate, the Defendant Oncology Practices that desired to continue to receive these
significant rebates had to find some means to increase their use of the Covered Drugs. In short,
Amgen provided financial inducements to Defendant Oncology Practices to increase the amount
of Covered Drugs particularly Aranesp used in by the Defendant Oncology Practices. How
this specific increase was achieved by each Defendant Oncology Practice was different for each
practice. Patients of the Defendant Oncology Practices experiencing anemia associated with
chemotherapy treatment for cancer were provided higher doses of Aranesp. Other Covered
Drugs were also used at a higher rate for those patients for whom there was an FDA-approved
indication. Also, the Defendant Oncology Practices expanded the patient population for using
these Covered Drugs including non-FDA approved uses or off-label uses of the Covered
Drugs.
486. Amgen stood at the center of this scheme, providing billions of dollars in rebates
to the Defendant Oncology Practices and other community oncology practices wherein these
practices had already received full reimbursement for these Covered Drugs through Government
Healthcare Programs. The Defendant Oncology Practices did their part to further the scheme by
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prescribing more and more Aranesp and other Covered Drugs to more and more patients, not on
the basis of clinical benefit or medical necessity, but based upon the profits that were being made
by the Defendant Oncology Practices in using these Covered Drugs. As alleged elsewhere in
this Complaint, the Defendant Oncology Practices did not report these rebates, discounts and
other things of value received from Amgen to the Government Healthcare Programs and did not
reimburse the Government Healthcare Programs for the double reimbursement the Defendant
Oncology Practices received for prescribing and administering the Covered Drugs.
487. Amgen initiated the conspiracy and was at its center, serving as the hub. Each
of the Defendant Oncology Practice was connected to the conspiracy through Amgen, as a
spoke. Amgens primary goal for the conspiracy was to increase its sales of the Covered
Drugs, and, hence, its revenues and profits.
488. In undertaking the actions described herein, Amgen and the Defendant Oncology
Practices became participants in and the primary beneficiaries of the conspiracy to defraud
Government Healthcare Programs of money.
489. Amgens actions, as alleged, in combination with those of the Defendant
Oncology Practices, constituted a conspiracy to defraud third-party payers, including
Government Healthcare Programs of money by failing to disclose the discounted, actual charge
for the Covered Drugs paid by the Defendant Oncology Practices. By failing to disclose to
Government Healthcare Program the rebates, discounts and other things of value the Defendant
Oncology Practices received as an agreed term governing their purchases of the Covered Drugs
under their Amgen Portfolio Contracts, the defendants caused Government Healthcare Programs
to over-reimburse the Defendant Oncology Practices, hence defrauding them of money.
491. The rebates and other inducements by Amgen to the Defendant Oncology
Practices to generate greater and greater purchases of the Covered Drugs made the
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reimbursements obtained by the Defendant Oncology Practices from Government Healthcare
Programs fraudulent wherein these reimbursements were for a higher dosing of the Covered
Drugs in patients without clinical benefit and/or the use of these Covered Drugs was in patients
without any clinical benefit or medical need.
492. The primary goal the Defendant Oncology Practices sought from their
participation in the conspiracy was increased revenues and profits. The Defendant Oncology
Practices achieved that goal, in part, by obtaining rebates, discounts, overfill, and samples from
Amgen, thereby reducing the cost of the Covered Drugs.
493. Under the Amgen Portfolio Contract, to the extent the Defendant Oncology
Practices were able to achieve higher levels of use of the Covered Drugs, their cost to purchase
these drugs from Amgen decreased, providing them with increased revenues and increase per-
unit profits; the Defendant Oncology Practices were also able to increase their revenues and
profits from prescriptions they wrote and drugs they administered for patients receiving benefits
under Government Healthcare Programs by failing to disclose to program administrators the
rebates, discounts and other things of value they were being paid by Amgen for writing
prescriptions and administering the Covered Drugs, all of which lowered the effective cost of the
Covered Drugs to them, such disclosure being required by program rules and by provisions in
their Amgen Portfolio Contracts as described in this complaint herein. The Defendant Oncology
Practices therefore received far more in reimbursements for the Covered Drugs from
Government Healthcare Programs than they in fact had paid for the Covered Drugs and were
lawfully entitled to receive.
494. The rapid growth in purchases and administration of the Covered Drugs during
the Covered Period by the Defendant Oncology Practices cannot be justified based upon clinical
benefit or medical need. The administration of the Covered Drugs by the Defendant Oncology
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Practices during the Covered Period increased at a rate far higher than any increase in the
incidence of applicable cancer or the treatment of cancer by the Defendant Oncology Practices
495. Amgen and the defendant Oncology Practices worked together to effectuate
Amgens scheme of increasing its profits on the Covered Drugs and increasing the practices
profits by obtaining excess payments for the drugs they administered to their patients. Amgen
sold the Covered Drugs to the defendant Oncology Practices for a price listed on an invoice. The
Defendant Oncology Practices administered the drugs to their patients and submitted the
invoices to the Government Healthcare Programs to obtain reimbursement. When the Defendant
Oncology Practices presented these claims to the Government, they knew they were false. They
knew the claims for reimbursement were false because they knew that Amgen would soon pay
them a rebate of as much as 50% of the fake price listed on the invoice. The Defendant
Oncology Practices also knew that Amgen wanted to increase it sales of Aranesp, especially at
the expense of Procrit. They knew that to continue to receive the highest rebates, they had to
increase the growth of the amount of Aranesp they prescribed at ever increasing rates. They
knew that they had to prescribe Aranesp to more and more patients for more and more reasons at
higher and higher doses. By encouraging the Defendant Oncology Practices to submit false
claims to Government Healthcare Programs, Amgen recruited the Defendant Oncology Practices
into an overarching, massive, billion-dollar scheme to defraud federal- and state-sponsored
healthcare programs. Although the scheme had hundreds of participants, there was a single,
overarching goal: increasing Amgens revenues and profits and increasing the revenues and
profits of the Defendant Oncology Practices by fraudulently causing payments to be made by
Government Healthcare Programs to Defendant Oncology Practices. Amgen could not have
achieved its objectives without the participation of hundreds of the Defendant Oncology
Practices, and the Defendant Oncology Practices could not have achieved their goals without
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Amgen. Amgen was therefore at the center of a massive conspiracy to defraud the Federal
Government and each of the Defendant Oncology Practices were part of that conspiracy.
Therefore Amgen is jointly and severally liable for the damages caused by the scheme.
Similarly, each of the Defendant Oncology Practices is jointly and severally liable for the losses
the Government Healthcare Programs suffered as a result of the scheme.
496. Amgen and the Defendant Oncology Practice engaged in a scheme to defraud the
Government Healthcare Programs, the United States Government, and the governments of
several States, as herein described. The actions that Amgen and the Defendant Oncology
Practices took in furtherance of that scheme, as described with particularity above, were both
legal and illegal, and included:
a. Violating the False Claims Act by knowingly presenting false claims for
reimbursement to Government Healthcare Programs in violation of 31
U.S.C. 3729 et seq.;
b. Defrauding the US Government in violation of 18 U.S.C. 371;
c. Using mail and interstate wire communication to commit a fraud, in
violation of 18 U.S.C. 1341 & 1343;
d. Prescribing and administering medications that were not medically
indicated at all or at doses that were higher than medically indicated, in
violation of various state statutes and state standards of medical ethics;
e. Falsely reporting its prices for Aranesp and other drugs to drug pricing
compendia (such as First Data Bank) specifically, AWP and Wholesale
Acquisition Costs (WAC);
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f. Running a criminal enterprise in violation of 15 U.S.C. 1961 by
engaging in a pattern of illegal activities included major fraud, mail fraud,
and wire fraud
497. The hub and spoke conspiracy between Amgen on the one hand and the
Defendant Oncology Practices on the other resulting in the defrauding of Government
Healthcare Programs by the submission of false claims for payment and knowledge that these
claims were false.
498. Because of Amgens conduct described herein, Amgen is jointly and severally
liable for all acts committed by all of the Defendant Oncology Practices as to Counts One
through Twenty-One. All of the Defendant Oncology Practices who participated in the scheme
are also jointly and severally with each other and with Amgen for the full amount of the fraud
J. Affected federal and state health care programs.
499. The United States provides medical insurance for indigent or poor persons
through Title XIX of the Social Security Act, 42 U.S.C. 13961, et seq., a program commonly
referred to as Medicaid. Medicaid is a program funded by the federal government and various
state governments. The various states named as plaintiffs in this Complaint have, as a result of
the activities described throughout this Complaint, been required to pay reimbursements to the
defendant Oncology Practices in excess of the amounts they were eligible to receive under
governing regulations. Therefore, these state governments are properly named as plaintiffs in
this lawsuit by virtue of their respective state fraud recovery statutes.
500. Although Medicaid is administered at the state level, each state is required to
adhere to federal guidelines. Federal statutes and regulations limit the drugs that the federal
government will pay for through its funding of state Medicaid programs. Federal statutes and
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regulations restrict the uses for which the federal government will pay for approved drugs: even
an approved drug is not eligible for cost reimbursement if the use for which it was prescribed is
not a proper indication.
501. Generally, a medically accepted indication, or use, must be present before
Medicaid will reimburse a medical services provider, such as the defendants in this case, or a
pharmacy for a drug that is prescribed or administered to an individual covered by Medicaid. In
knowingly submitting false fraudulent information and claims for reimbursement under the
Medicaid program, Amgen and the defendant Oncology Practices defrauded Government
Healthcare Programs of money.
502. The federal government provides medical insurance for retirees and persons who
are disabled through Title XVIII of the Social Security Act, 42 U.S.C. 1395h, et seq., a
program commonly referred to as Medicare. Medicare is a health insurance program also
administered by the federal government by the Department of Health and Human Services,
Centers for Medicare & Medicaid Services, Center for Medicare.
503. Medicare has, since the implementation of the Medicare Prescription Drug
Improvement and Modernization Act of 2003 paid for a substantial portion of outpatient
prescription drugs for covered individuals. Medicare Part D, which provides beneficiaries with a
level of coverage for the cost of prescription drugs, requires providers to adhere to the same laws
and regulations as apply to providers under the Medicaid program.
504. In knowingly submitting false and fraudulent information and claims for
reimbursement to Medicare, Amgen and the defendant Oncology Practices defrauded the United
States of money, in violation of laws and regulations applicable to such claims. In addition to
defrauding Medicaid and Medicare, the defendant Oncology Practices also defrauded other
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healthcare programs funded by the federal government. The programs identified in succeeding
paragraphs of this subpart of the Complaint.
505. The Federal Employees Health Benefits (FEHB) Program, a program that
provides medical benefits to United States government employees. It is administered by the
Office of Personnel Management. This program and federal healthcare programs generally are
administered pursuant to 5 U.S.C. 8901, et seq.
506. The Civilian Health and Medical Program of the Department of Veterans Affairs,
a program that provides medical benefits to eligible veterans.
507. TRICARE, a program that provides medical benefits to eligible uniformed
military personnel and related individuals through civilian facilities. TRICARE is managed by
TRICARE Management Activity, a field activity under the policy guidance and direction of the
Assistant Secretary of Defense (Health Affairs), Department of Defense.
508. The Indian Health Service (IHS), an agency of the Department of Health and
Human Services that provides comprehensive medical care to eligible American Indians and
Alaska Natives. The IHS is administered pursuant to 42 U.S.C. 2002, et seq.
509. The Railroad Retirement Medicare, a program is authorized by the Railroad
Retirement Act of 1974. 45 U.S.C. 231, et seq. The program is administered though the
United States Railroad Retirement Board.
510. For each of these programs named herein, the fraud perpetrated upon them by
Amgen and the defendant Oncology Practices resulted in improper and fraudulent payments or
overpayments for drugs. The fraudulent submission for reimbursement for non-approved or
medically unnecessary uses and other purposes as described herein caused direct harm to the
United States government and to the governments of the affected states by the payment or
overpayment to the requested entities that should not have been reimbursed, or paid. In
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addition, the failure by the defendant Oncology Practices to identify the rebates and other things
of value received by the defendant Oncology Practices resulted in overpayment of
reimbursements to these entities.
COUNT ONE
Violation of False Claims Act, 31 U.S.C. 3729(a)
as to Defendant Oncology Practices as Specified Herein
511. Relator realleges and incorporates by reference the allegations of paragraphs 1-
510 of this Complaint.
512. This count sets forth claims for treble damages and forfeitures under the federal
False Claims Act, 31 U.S.C. 3729-3732, as amended.
513. As described above, the defendant Oncology Practices, and each of them named
and specified herein, have engaged in fraudulent activities including but not limited to
purchasing the Covered Drugs and submitting claims to Government Healthcare Programs for
payment, or reimbursement, for these drugs in order to receive rebates, discounts and other
financial incentives to purchase the Covered Drugs from Amgen. The defendant Oncology
Practices have, furthermore, prescribed and submitted claims payment, or reimbursement, of
the cost of the Covered Drugs purchased from Amgen to Government Healthcare Programs that
failed to account for the rebates, discounts, drug overfills, kickbacks and other financial
incentives received from Amgen under various purchase incentive programs that were tied to the
level, or volume, of such purchases. The defendant Oncology Practices have, furthermore,
prescribed and submitted claims payment, or reimbursement, of the cost of the Covered Drugs
purchased from Amgen to Government Healthcare Programs for the Covered Drugs that were
administered to patients when not medically necessary or, while medically necessary, were
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administered in an amount greater than medically necessary for the patient or in an amount
greater than necessary to obtain the medical benefit for the patient.
514. The defendants have knowingly violated:
a. 31 U.S.C. 3729(a)(1) by knowingly presenting, or causing to be
presented, to an officer or employee of the United States Government or a member of the Armed
Forces of the United States a false or fraudulent claim for payment or approval;
b. 31 U.S.C. 3729(a)(2) by knowingly making, using or causing to be made
or used, a false record or statement to get a false or fraudulent claim paid or approved by the
United States Government; and/or
c. 31 U.S.C. 3729(a)(3) by conspiring to defraud the United States
Government by getting a false or fraudulent claim allowed or paid.
515. By reason of the defendants false and fraudulent activities, the United States has
been damaged, and may continue to be damaged.
COUNT TWO
Violation of California False Claims Act, Cal. Gov. Code 12650 et seq.
as to Defendants Redwood Regional Oncology, Tower Hematology Oncology Medical
Group, Cancer Associates of Fresno Medical Group, Inc., Pacific Oncology Hematology
Associates, Inc., Pacific Shores Medical Group, Inc. Santa Barbara Hematology-Oncology
Medical Group, Inc., Santa Barbara Hematology-Oncology Medical Group, Inc., The
Breast Care Center Oncology Center; East Bay Medical Oncology Hematology
Associates, Orange Coast Oncology, Cancer Care Associates Medical Group, Inc., Ventura
County Hematology-Oncology Specialists, Inc., Valley Medical Oncology Consultants,
Wilshire Oncology Medical Group, North County Oncology, Stockton Hematology
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Oncology, Medical Group of North County, Southbay Oncology Hematology Partners,
Cancer Care Consultants, Medical Oncology Associates of San Diego, Hematology
Oncology Medical Group of Orange County, St. Joseph Medical Plaza-Buildin, Valley
Tumor Medical Group, d/b/a Antelope Valley Cancer Center, The Angeles Clinic and
Research Institute, Los Palos Oncology and Hematology, Capitol Hematology/Oncology,
North Valley Hematology Oncology Medical
Group, Pacific Hematology and Oncology Associates, and Palo Alto Medical Foundation
(California Oncology Practices)
517. This is a claim for treble damages and penalties under the California False Claims
Act.
518. At all relevant times herein, defendants Redwood Regional Oncology, Tower
Hematology Oncology Medical Group, Cancer Associates of Fresno Medical Group, Inc.,
Pacific Oncology Hematology Associates, Inc., Pacific Shores Medical Group, Inc. Santa
Barbara Hematology-Oncology Medical Group, Inc., Santa Barbara Hematology-Oncology
Medical Group, Inc., The Breast Care Center Oncology Center; East Bay Medical Oncology
Hematology Associates, Orange Coast Oncology, Cancer Care Associates Medical Group, Inc.,
Ventura County Hematology-Oncology Specialists, Inc., Valley Medical Oncology Consultants,
Wilshire Oncology Medical Group, and North County Oncology, Stockton Hematology
Oncology, Medical Group of North County, Southbay Oncology Hematology Partners, Cancer
Care Consultants, Medical Oncology Associates of San Diego, Hematology Oncology Medical
Group of Orange County, St. Joseph Medical Plaza-Buildin, Valley Tumor Medical Group, d/b/a
Antelope Valley Cancer Center, The Angeles Clinic and Research Institute, Los Palos Oncology
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and Hematology, Capitol Hematology/Oncology, North Valley Hematology Oncology Medical
Group, Pacific Hematology and Oncology Associates, and Palo Alto Medical Foundation
(California Oncology Practices) did business in the State of California.
519. As described above, the defendant California Oncology Practices have engaged in
false and fraudulent activities including but not limited to purchasing the Covered Drugs and
submitting to the State of California claims for reimbursement of the cost of these drugs that did
not disclose to the State of California the fact that the defendant California Oncology Practices
received discounts, rebates, drug overfills, kickbacks and other things of value from Amgen
for buying the Covered Drugs that were not properly disclosed to the State of California nor was
the State of California provided its proportionate share of the discounts, rebates, kickbacks and
other things of value received from Amgen.
520. As described above, the defendant California Oncology Practices have engaged in
false and fraudulent activities, including but not limited to, purchasing the Covered Drugs and
submitting claims to the State of California for reimbursement, or payment, for the cost of
these drugs. The defendant California Oncology Practices prescribed and administered the
Covered Drugs to patients without medical necessity or in amount greater than medically
necessary for a patient or in an amount greater than necessary to obtain the medical benefit for
the patient. Despite administering these drugs without medical benefit or necessity or in excess
of what would be required to obtain the medical benefit or necessity, defendant California
Oncology Practices then sought reimbursement from the State of California for these improperly
and fraudulently prescribed and administered drugs.
521. As described herein, defendants have knowingly violated Californias False
Claims Act by submitting these false claims and omitting material information such that the
State of California, not knowing that these claims were false and not aware of the omitted
205
information, paid these claims that would not have been paid but for the illegal acts of defendant
California Oncology Practices.
522. By reason of the acts described herein, the State of California has been damaged
and continues to be damaged in an amount to be fully calculated and stated at trial.
523. The State of California is, furthermore, entitled to the maximum penalty for each
and every false or fraudulent claim, record or statement made, used, presented or caused to be
made, used or presented by the defendant California Oncology Practices.
COUNT THREE
Violation of Delaware False Claims Act, 6 Del. Code 1201 et seq.
as to Defendant Medical Oncology Hematology Consultants, P.A.
(Delaware Oncology Practice)
525. This is a claim for treble damages and penalties under the Delaware False Claims
and Reporting Act.
526. At all relevant times herein, defendant Medical Oncology Hematology
Consultants, P.A. (Delaware Oncology Practice) did business in the State of Delaware.
527. As described above, the defendant Delaware Oncology Practice has engaged in
fraudulent activities including but not limited to selling and purchasing the Covered Drugs and
submitting claims to the State of Delaware for reimbursement for these drugs. Defendant
Delaware Oncology Practice received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Delaware nor was the State of Delaware provided its
proportionate share of any discount received.
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528. As described above, defendant Delaware Oncology Practice has engaged in
submitting claims to the State of Delaware for reimbursement for these drugs. The defendant
Delaware Oncology Practice prescribed and administered these drugs to patients without medical
necessity or in amount greater than medically necessary for a patient or in an amount greater
than necessary to obtain the medical benefit for the patient. Despite administering these drugs
without medical benefit or necessity or in excess of what would be required to obtain the
medical benefit or necessity, the defendant Delaware Oncology Practice then sought
reimbursement from the State of Delaware for these improperly and fraudulently prescribed and
administered drugs.
529. As described herein, defendants have knowingly violated Delawares False
Claims and Reporting Act by submitting these false claims and omitting material information
such that the State of Delaware, not knowing that these claims were false and not aware of the
omitted information, paid these claims that would not be paid but for the illegal acts of defendant
Delaware Oncology Practices.
530. By reason of the acts described herein, the State of Delaware has been damaged
531. The State of Delaware is, furthermore, entitled to the maximum penalty for each
and every false or fraudulent claim, record or statement made, used, presented, or caused to be
made, used, or presented by the defendant Delaware Oncology Practice.
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COUNT FOUR
Violation of the District of Columbia Procurement Reform Amendment Act, D.C. Code
Ann. 2-308.13 et seq. as to Defendant George Washington University Medical Faculty
Associates
(District of Columbia Oncology Practice)
533. This is a claim for treble damages and penalties under the District of Columbia
Procurement Reform Amendment Act.
534. At all relevant times herein, defendant George Washington University Medical
Faculty Associates (District of Columbia Oncology Practices) did business in the District of
Columbia.
535. As described above, the defendant District of Columbia Oncology Practice has
engaged in fraudulent activities including but not limited to selling and purchasing the Covered
Drugs and submitting claims to the District of Columbia for reimbursement for these drugs. The
defendant District of Columbia Oncology Practice received financial incentives and kickbacks
from Amgen that were not properly disclosed to the District of Columbia nor was the District of
Columbia provided its proportionate share of any discount received.
536. As described above, the defendant District of Columbia Oncology Practice has
engaged in fraudulent activities including but not limited to selling and purchasing the Covered
Drugs and submitting claims to the District of Columbia for reimbursement for these drugs. The
defendant District of Columbia Oncology Practice prescribed and administered these drugs to
patients without medical necessity or in amount greater than medically necessary for a patient or
in an amount greater than necessary to obtain the medical benefit for the patient. Despite
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administering these drugs without medical benefit or necessity or in excess of what would be
required to obtain the medical benefit or necessity, the defendant District of Columbia Oncology
Practice then sought reimbursement from the District of Columbia for these improperly and
fraudulently prescribed and administered drugs.
537. As described herein, defendant has knowingly violated the District of Columbia
Procurement Reform Amendment Act by submitting these false claims and omitting material
information such that the District of Columbia, not knowing that these claims were false and not
aware of the omitted information, paid these claims that would not be paid but for the illegal acts
of the defendant District of Columbia Oncology Practice.
538. By reason of the acts described herein, the District of Columbia has been
damaged and continues to be damaged in an amount to be fully calculated and stated at trial.
539. The District of Columbia, is, furthermore, entitled to the maximum penalty for
each and every false or fraudulent claim, record or statement made, used, presented, or caused to
be made, used, or presented by the defendant District of Columbia Oncology Practice.
COUNT FIVE
Violation of Florida False Claims Act, Fl. Stat. 66.081 et seq.
as to Defendants Florida Cancer Specialists, Gulfcoast Oncology Associates, Integrated
Community Oncology Network, LLC, Oncology Hematology Radiation Care, LLC d/b/a
Advance Medical Specialists, Palm Beach Cancer Institute, Hematology and Oncology
Consultants, Florida Hematology Oncology Specialists, Hematology and Oncology
Associates of the Treasure Coast, Mid Florida Hematology and Oncology Centers, Pasco
Hernando Oncology Associates, P.A., Regional Consultants in Hematology and Oncology,
Boca Raton Community Hospital, Inc., Cancer Institute of Florida, P.A., South Florida
209
Oncology Hematology, Coastal Oncology, PL, Oncology Physicians, Stuart Oncology, Neil
Finkler and Robert Holloway, M.D.S., Ayub, Sokoi, Matzkowitz and Sennabaum, d/b/a
New Hope Cancer Center, Hematology and Medical Oncology of Southern Palm Beach
County, and David Dresdner, M.D.
(Florida Oncology Practices)
541. This is a claim for treble damages and penalties under the Florida False Claims
Act.
542. At all relevant times herein, defendants Florida Cancer Specialists, Gulfcoast
Oncology Associates, Integrated Community Oncology Network, LLC, Oncology Hematology
Radiation Care, LLC d/b/a Advance Medical Specialists, Palm Beach Cancer Institute,
Hematology and Oncology Consultants, Florida Hematology Oncology Specialists, Hematology
and Oncology Associates of the Treasure Coast, Mid Florida Hematology and Oncology Centers,
Pasco Hernando Oncology Associates, P.A., Regional Consultants in Hematology and Oncology,
Boca Raton Community Hospital, Inc., Cancer Institute of Florida, P.A., South Florida Oncology
Hematology , Coastal Oncology, PL, Oncology Physicians, Stuart Oncology, Neil Finkler and
Robert Holloway, M.D.S., Ayub, Sokoi, Matzkowitz and Sennabaum, d/b/a New Hope Cancer
Center, Hematology and Medical Oncology of Southern Palm Beach County, and David
Dresdner, M.D. (Florida Oncology Practices) did business in the State of Florida.
543. As described above, the defendant Florida Oncology Practices have engaged in
submitting claims to the State of Florida for reimbursement for these drugs. The defendant
Florida Oncology Practices received financial incentives and kickbacks from Amgen that were
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not properly disclosed to the State of Florida nor was the State of Florida provided its
544. As described above, the defendant Florida Oncology Practices have engaged in
submitting claims to the State of Florida for reimbursement for these drugs. The defendant
Florida Oncology Practices prescribed and administered these drugs to patients without medical
medical benefit or necessity, the defendant Florida Oncology Practices then sought
reimbursement from the State of Florida for these improperly and fraudulently prescribed and
administered drugs.
545. As described herein, defendants have knowingly violated Floridas False Claims
Act by submitting these false claims and omitting material information such that the State of
Florida, not knowing that these claims were false and not aware of the omitted information, paid
these claims that would not be paid but for the illegal acts of the defendant Florida Oncology
Practices.
546. By reason of the acts described herein, the State of Florida has been damaged and
continues to be damaged in an amount to be fully calculated and stated at trial.
547. The State of Florida, is, furthermore, entitled to the maximum penalty for each
made, used, or presented by the defendant Florida Oncology Practices.
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COUNT SIX
Violation of Georgia False Medicaid Claims Act, O.C.G.A. 49-4-168 et seq.
as to Defendants Georgia Cancer Specialists, Northwest Georgia Oncology Centers,
Augusta Oncology Associates, Central Georgia Cancer Care, Northeast Georgia Cancer
Care, Southeast Georgia Hematology/Oncology, Southeastern Gynecologic Oncology, and
The Longstreet Clinic, P.C.
(Georgia Oncology Practices)
549. This is a claim for damages and penalties under the Georgia False Medicaid
Claims Act.
550. At all relevant times herein, defendants Georgia Cancer Specialists, Northwest
Georgia Oncology Centers, Augusta Oncology Associates, Central Georgia Cancer Care,
Northeast Georgia Cancer Care, Southeast Georgia Hematology/Oncology, Southeastern
Gynecologic Oncology, and The Longstreet Clinic, P.C. (Georgia Oncology Practices) did
business in the State of Georgia.
551. As described above, the defendant Georgia Oncology Practices have engaged in
submitting claims to the State of Geogia for reimbursement for these drugs. The defendant
Georgia Oncology Practices received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Georgia nor was the State of Georgia provided its
552. As described above, the defendant Georgia Oncology Practices have engaged in
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submitting claims to the State of Georgia for reimbursement for these drugs. The defendant
Georgia Oncology Practices prescribed and administered these drugs to patients without medical
medical benefit or necessity, the defendant Georgia Oncology Practices then sought
reimbursement from the State of Georgia for these improperly and fraudulently prescribed and
administered drugs.
553. As described herein, defendants have knowingly violated Georgia False Medicaid
State of Georgia, not knowing that these claims were false and not aware of the omitted
information, paid these claims that would not be paid but for the illegal acts of defendant
Georgia Oncology Practices.
554. By reason of the acts described herein, the State of Georgia has been damaged
555. The State of Georgia, is, furthermore, entitled to the maximum penalty for each
made, used, or presented by the defendant Georgia Oncology Practices.
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COUNT SEVEN
Violation of Hawaii False Claims Act, Haw. Rev. Stat. 661-21 et seq.
as to Defendant Oncare Hawaii, Inc.
(Hawaii Oncology Practice)
557. This is a claim for treble damages and penalties under the Hawaii False Claims
Act.
558. At all relevant times herein, defendant Oncare Hawaii, Inc. (Hawaii Oncology
Practices) did business in the State of Hawaii.
559. As described above, the defendant Hawaii Oncology Practice has engaged in
submitting claims to the State of Hawaii for reimbursement for these drugs. The defendant
Hawaii Oncology Practice received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Hawaii nor was the State of Hawaii provided its
560. As described above, the defendant Hawaii Oncology Practice has engaged in
submitting claims to the State of Hawaii for reimbursement for these drugs. The defendant
Hawaii Oncology Practice prescribed and administered these drugs to patients without medical
medical benefit or necessity, the defendant Hawaii Oncology Practice then sought
214
reimbursement from the State of Hawaii for these improperly and fraudulently prescribed and
administered drugs.
561. As described herein, defendants have knowingly violated Hawaiis False Claims
Act by submitting these false claims and omitting material information such that the State of
Hawaii , not knowing that these claims were false and not aware of the omitted information,
paid these claims that would not be paid but for the illegal acts of the defendant Hawaii
Oncology Practice.
562. By reason of the acts described herein, the State of Hawaii has been damaged
563. The State of Hawaii is, furthermore, entitled to the maximum penalty for each
made, used, or presented by the defendant Hawaii Oncology Practice.
COUNT EIGHT
Violation of Illinois Whistleblower Reward and Protection Act,
740 Ill. Comp. Stat. 173/1 et seq. as to Defendants Oncology-Hematology Associates of
Central Illinois, Prairie Oncology Management Services, LLC, Intermed Oncology,
Northwest Oncology and Hematology, Northwestern Medical Faculty Foundation, Joliet
Oncology Hematology Associates, Inc., Fox Valley Hematology and Oncology, Ltd.,
Medical Arts Associates, Ltd., North Shore Oncology-Hematology Associates, Ltd.,
Edward Cancer Center, and Associates in Medical Oncology
(Illinois Oncology Practices)
215
565. This is a claim for treble damages and penalties under the Illinois Whistleblower
Reward and Protection Act.
566. At all relevant times herein, defendants Oncology-Hematology Associates of
Central Illinois, Prairie Oncology Management Services, LLC, Intermed Oncology, Northwest
Oncology and Hematology, Northwestern Medical Faculty Foundation, Joliet Oncology
Hematology Associates, Inc., Fox Valley Hematology and Oncology, Ltd., Medical Arts
Associates, Ltd., North Shore Oncology-Hematology Associates, Ltd., Edward Cancer Center,
and Associates in Medical Oncology (Illinois Oncology Practices) did business in the State of
Illinois.
567. As described above, the defendant Illinois Oncology Practices have engaged in
submitting claims to the State of Illinois for reimbursement for these drugs. The defendant
Illinois Oncology Practices received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Illinois nor was the State of Illinois provided its
568. As described above, the defendant Illinois Oncology Practices have engaged in
Illinois Oncology Practices prescribed and administered these drugs to patients without medical
medical benefit or necessity, the defendant Illinois Oncology Practices then sought
216
reimbursement from the State of Illinois for these improperly and fraudulently prescribed and
administered drugs.
569. As described herein, defendants have knowingly violated Illinois Whistleblower
Reward and Protection Act by submitting these false claims and omitting material information
such that the State of Illinois, not knowing that these claims were false and not aware of the
omitted information, paid these claims that would not be paid but for the illegal acts of the
defendant Illinois Oncology Practices.
570. By reason of the acts described herein, the State of Illinois has been damaged and
571. The State of Illinois, furthermore, entitled to the maximum penalty for each and
every false or fraudulent claim, record or statement made, used, presented, or caused to be made,
used, or presented by the defendant Illinois Oncology Practices.
COUNT NINE
Violation of Indiana False Claims and Whistleblower Act, In. Code 5-11-5.5 et seq.
as to Defendants Michiana Hematology-Oncology, Inc., Hematology-Oncology of Indiana,
P.C., Oncology Hematology Associates of South West Indiana, Cancer Health Treatment
Centers, P.C., Fort Wayne Medical Oncology and Hematology, American Health Network
Hematology Associates, Cancer Care Center, Inc., Arnett Cancer Care, A P. and S. Clinic,
LLC, Medical Consultants, American Health Network, and Internal Medicine Associates
(Indiana Oncology Practices)
217
573. This is a claim for treble damages and penalties under the Indiana False Claims
and Whistleblower Act.
574. At all relevant times herein, defendants Michiana Hematology-Oncology, Inc.,
Hematology-Oncology of Indiana, P.C., Oncology Hematology Associates of South West
Indiana, Cancer Health Treatment Centers, P.C., Fort Wayne Medical Oncology and
Hematology, American Health Network Hematology Associates, Cancer Care Center, Inc.,
Arnett Cancer Care, A P. and S. Clinic, LLC, Medical Consultants, American Health Network,
and Internal Medicine Associates (Indiana Oncology Practices) did business in the State of
Indiana.
575. As described above, the defendant Indiana Oncology Practices have engaged in
Indiana Oncology Practices received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Indiana nor was the State of Indiana provided its
576. As described above, the defendant Indiana Oncology Practices have engaged in
submitting claims to the State of Indiana for reimbursement for these drugs. The defendant
Indiana Oncology Practices prescribed and administered these drugs to patients without medical
medical benefit or necessity, the defendant Indiana Oncology Practices then sought
218
reimbursement from the State of Indiana for these improperly and fraudulently prescribed and
administered drugs.
577. As described herein, defendants have knowingly violated Indiana False Claims
and Whistleblower Act by submitting these false claims and omitting material information such
that the State of Indiana, not knowing that these claims were false and not aware of the omitted
information, paid these claims that would not be paid but for the illegal acts of defendant Indiana
Oncology Practices.
578. By reason of the acts described herein, the State of Indiana has been damaged and
579. The State of Indiana, furthermore, entitled to the maximum penalty for each and
used, or presented by the defendant Indiana Oncology Practices.
COUNT TEN
Violation of Louisiana Medical Assistance Programs Integrity Law,
La. Rev. Stat. 46: 437 et seq. as to Defendants Oncology RX, Louisiana Oncology
Associates, and Louisiana Hematology Oncology Associates
(Louisiana Oncology Practices)
581. This is a claim for damages and penalties under the Louisiana Medical Assistance
Programs Integrity Law.
219
582. At all relevant times herein, defendants Oncology RX, Louisiana Oncology
Associates, and Louisiana Hematology Oncology Associates (Louisiana Oncology Practices)
did business in the State of Louisiana.
583. As described above, the defendant Louisiana Oncology Practices have engaged in
submitting claims to the State of Louisiana for reimbursement for these drugs. The defendant
Louisiana Oncology Practices received financial incentives and kickbacks from Amgen that
were not properly disclosed to the State of Louisiana nor was the State of Louisiana provided its
584. As described above, the defendant Louisiana Oncology Practices have engaged in
submitting claims to the State of Louisiana for reimbursement for these drugs. The defendant
Louisiana Oncology Practices prescribed and administered these drugs to patients without
medical necessity or in amount greater than medically necessary for a patient or in an amount
greater than necessary to obtain the medical benefit for the patient. Despite administering these
drugs without medical benefit or necessity or in excess of what would be required to obtain the
medical benefit or necessity, the defendant Louisiana Oncology Practices then sought
reimbursement from the State of Louisiana for these improperly and fraudulently prescribed and
administered drugs.
585. As described herein, defendants have knowingly violated Louisianas Medical
Assistance Programs Integrity Law by submitting these false claims and omitting material
information such that the State of Louisiana, not knowing that these claims were false and not
of defendant Louisiana Oncology Practices.
220
586. By reason of the acts described herein, the State of Louisiana has been damaged
587. The State of Louisiana, furthermore, entitled to the maximum penalty for each
made, used, or presented by the defendant Louisiana Oncology Practices.
COUNT ELEVEN
Violation of Massachusetts False Claims Law, Mass. Gen. Laws Ch. 12 5(B) et seq.
as to Defendants Berkshire Hematology Oncology, P.C.
(Massachusetts Oncology Practice)
589. This is a claim for treble damages and penalties under the Massachusetts False
Claims Law.
590. At all relevant times herein, defendant Berkshire Hematology Oncology, P.C.
(Massachusetts Oncology Practice) did business in the Commonwealth of Massachusetts.
591. As described above, the defendant Massachusetts Oncology Practice has engaged
in fraudulent activities including but not limited to selling and purchasing the Covered Drugs
and submitting claims to the State of Massachusetts for reimbursement for these drugs. The
defendant Massachusetts Oncology Practice received financial incentives and kickbacks from
Amgen that were not properly disclosed to the Commonwealth of Massachusetts nor was the
Commonwealth of Massachusetts provided its proportionate share of any discount received.
592. As described above, the defendant Massachusetts Oncology Practice has engaged
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and submitting claims to the Commonwealth of Massachusetts for reimbursement for these
drugs. The defendant Massachusetts Oncology Practice prescribed and administered these drugs
to patients without medical necessity or in amount greater than medically necessary for a patient
or in an amount greater than necessary to obtain the medical benefit for the patient. Despite
required to obtain the medical benefit or necessity, the defendant Massachusetts Oncology
Practices then sought reimbursement from the Commonwealth of Massachusetts for these
improperly and fraudulently prescribed and administered drugs.
593. As described herein, defendants have knowingly violated the Massachusetts False
Claims Law by submitting these false claims and omitting material information such that the
Commonwealth of Massachusetts, not knowing that these claims were false and not aware of the
Massachusetts Oncology Practices.
594. By reason of the acts described herein, the Commonwealth of Massachusetts has
been damaged and continues to be damaged in an amount to be fully calculated and stated at
trial.
595. The Commonwealth of Massachusetts, furthermore, is entitled to the maximum
penalty for each and every false or fraudulent claim, record or statement made, used, presented,
or caused to be made, used, or presented by the defendant Massachusetts Oncology Practice.
222
COUNT TWELVE
Violation of Michigan Medicaid False Claims Act, M.C.L. 400.601 et seq.
as to Defendants Cancer and Hematology Centers of Western Michigan, Cancer Care
Associates, the Oakland Medical Group, Great Lakes Cancer Management Specialists,
Singh and Arora Oncology Hematology, P.C., Genessee Cancer and Blood Disease
Treatment Center, Inc., Oncology Care Associates, West Michigan Cancer Center,
Michigan Hematology Oncology, P.C., Hematology Oncology Consultants, Newland
Medical Associates, Ann Arbor Hematology Oncology Associates, P.C., and Genesee
Hematology-Oncology, P.C.
(Michigan Oncology Practices)
597. This is a claim for treble damages and penalties under the Michigan Medicaid
False Claims Act.
598. At all relevant times herein, defendants Cancer and Hematology Centers of
Western Michigan, Cancer Care Associates, the Oakland Medical Group, Great Lakes Cancer
Management Specialists, Singh and Arora Oncology Hematology, P.C., Genessee Cancer and
Blood Disease Treatment Center, Inc., Oncology Care Associates, West Michigan Cancer
Center, Michigan Hematology Oncology, P.C., Hematology Oncology Consultants, Newland
Medical Associates, Ann Arbor Hematology Oncology Associates, P.C., and Genesee
Hematology-Oncology, P.C. (Michigan Oncology Practices) did business in the State of
Michigan.
599. As described above, the defendant Michigan Oncology Practices have engaged in
223
submitting claims to the State of Michigan for reimbursement for these drugs. The defendant
Michigan Oncology Practices received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Michigan nor was the State of Michigan provided its
600. As described above, the defendant Michigan Oncology Practices have engaged in
submitting claims to the State of Michigan for reimbursement for these drugs. The defendant
Michigan Oncology Practices prescribed and administered these drugs to patients without
medical benefit or necessity, the defendant Michigan Oncology Practices then sought
reimbursement from the State of Michigan for these improperly and fraudulently prescribed and
administered drugs.
601. As described herein, defendants have knowingly violated the Michigan Medicaid
False Claims Act by submitting these false claims and omitting material information such that
the State of Michigan, not knowing that these claims were false and not aware of the omitted
Michigan Oncology Practices.
602. By reason of the acts described herein, the State of Michigan has been damaged
603. The State of Michigan, furthermore, is entitled to the maximum penalty for each
made, used, or presented by the defendant Michigan Oncology Practices.
224
COUNT THIRTEEN
Violation of New Mexico Medicaid False Claims Act, N.M. Stat. 27-2F-1 et seq.
as to Defendants New Mexico Oncology Hematology Consultants
(New Mexico Oncology Practice)
605. This is a claim for treble damages and penalties under the New Mexico Medicaid
False Claims Act.
606. At all relevant times herein, defendant New Mexico Oncology Hematology
Consultants (New Mexico Oncology Practices) did business in the State of New Mexico.
608. As described above, the defendant New Mexico Oncology Practice has engaged
and submitting claims to the State of New Mexico for reimbursement for these drugs. The
defendant New Mexico Oncology Practice received financial incentives and kickbacks from
Amgen that were not properly disclosed to the State of New Mexico nor was the State of New
Mexico provided its proportionate share of any discount received.
608. As described above, the defendant New Mexico Oncology Practice has engaged
and submitting claims to the State of New Mexico for reimbursement for these drugs. The
defendant New Mexico Oncology Practice prescribed and administered these drugs to patients
without medical necessity or in amount greater than medically necessary for a patient or in an
amount greater than necessary to obtain the medical benefit for the patient. Despite
required to obtain the medical benefit or necessity, the defendant New Mexico Oncology
225
Practice then sought reimbursement from the State of New Mexico for these improperly and
609. As described herein, the defendant has knowingly violated the New Mexico
Medicaid False Claims Act by submitting these false claims and omitting material information
such that the State of New Mexico, not knowing that these claims were false and not aware of
the omitted information, paid these claims that would not be paid but for the illegal acts of the
defendant New Mexico Oncology Practice.
610. By reason of the acts described herein, the State of New Mexico has been
611. The State of New Mexico, furthermore, is entitled to the maximum penalty for
be made, used, or presented by the defendant New Mexico Oncology Practice.
226
COUNT FOURTEEN
Violation of New Jersey False Claims Act, N.J. Stat. 2A:32C-1 et seq.
as to Defendants Medical Oncology-Hematology Specialists, Hematology-Oncology
Associates of Northern New Jersey, Hematology-Oncology of Central New Jersey, Cooper
Cancer Institute, Southern Oncology-Hematology Associates, P.A., Medical Diagnostic
Associates, Kenneth D. Hahum, M.D., Hunterdon Hematology Oncology Group, Princeton
Medical Group, Central Jersey Oncology Center, P.A., Atlantic Hematology Oncology
Associates, Hope Community Cancer Center, The Center for Hematology / Oncology, and
Hematology Oncology Associates of New Jersey
(New Jersey Oncology Practices)
613. This is a claim for treble damages and penalties under the New Jersey False
Claims Act.
614. At all relevant times herein, defendants Medical Oncology-Hematology
Specialists, Hematology-Oncology Associates of Northern New Jersey, Hematology-Oncology
of Central New Jersey, Cooper Cancer Institute, Southern Oncology-Hematology Associates,
P.A., Medical Diagnostic Associates, Kenneth D. Hahum, M.D., Hunterdon Hematology
Oncology Group, Princeton Medical Group, Central Jersey Oncology Center, P.A., Atlantic
Hematology Oncology Associates, Hope Community Cancer Center, The Center for
Hematology/Oncology, and Hematology Oncology Associates of New Jersey(New Jersey
Oncology Practices) did business in the State of New Jersey.
615. As described above, the defendant New Jersey Oncology Practices have engaged
227
and submitting claims to the State of New Jersey for reimbursement for these drugs. The
defendant New Jersey Oncology Practices received financial incentives and kickbacks from
Amgen that were not properly disclosed to the State of New Jersey nor was the State of New
Jersey provided its proportionate share of any discount received.
616. As described above, the defendant New Jersey Oncology Practices have engaged
and submitting claims to the State of New Jersey for reimbursement for these drugs. Defendant
New Jersey Oncology Practices prescribed and administered these drugs to patients without
medical benefit or necessity, the defendant New Jersey Oncology Practices then sought
reimbursement from the State of New Jersey for these improperly and fraudulently prescribed
and administered drugs.
617. As described herein, defendants have knowingly violated the New Jersey False
State of New Jersey, not knowing that these claims were false and not aware of the omitted
information, paid these claims that would not be paid but for the illegal acts of defendant New
Jersey Oncology Practices.
618. By reason of the acts described herein, the State of New Jersey has been damaged
619. The State of New Jersey, furthermore, is entitled to the maximum penalty for
be made, used, or presented by the defendant New Jersey Oncology Practices.
228
COUNT FIFTEEN
Violation of New York False Claims Act, N.Y. Stat. Fin. 187 et seq.
as to Defendants North Shore Hematology Oncology Associates, P.C., Broome Oncology,
Hematology Oncology Associates of Central New York, P.C., Hudson Valley Hematology
Oncology, Queens Long Island Medical Group, P.C., Park Slope Medicine, Buffalo Medical
Group, Century Medical Associates, South Shore Hematology Oncology Associates,
Tomao, Marino and McNelis, M.D.S.,Department of Medicine Medical Services Group At
SUNY HSC d/b/a University Physicians, Hematology Oncology Associates of Western
Suffolk, P.C., Hematology and Medical Oncology, and Hematology-Oncology Associates of
Rockland, P.C.
(New York Oncology Practices)
621. This is a claim for treble damages and penalties under the New York False Claims
Act.
622. At all relevant times herein, defendants North Shore Hematology Oncology
Associates, P.C., Broome Oncology, Hematology Oncology Associates of Central New York,
P.C., Hudson Valley Hematology Oncology, Queens Long Island Medical Group, P.C., Park
Slope Medicine, Buffalo Medical Group, Century Medical Associates, South Shore Hematology
Oncology Associates, Tomao, Marino and McNelis, M.D.S.,Department of Medicine Medical
Services Group At SUNY HSC d/b/a University Physicians, Hematology Oncology Associates
of Western Suffolk, P.C., Hematology and Medical Oncology, and Hematology-Oncology
Associates of Rockland, P.C. (New York Oncology Practices) did business in the State of New
York.
229
623. As described above, the defendant New York Oncology Practices have engaged
and submitting claims to the State of New York for reimbursement for these drugs. The
defendant New York Oncology Practices received financial incentives and kickbacks from
Amgen that were not properly disclosed to the State of New York nor was the State of New York
provided its proportionate share of any discount received.
624. As described above, the defendant New York Oncology Practices have engaged
and submitting claims to the State of New York for reimbursement for these drugs. The
defendant New York Oncology Practices prescribed and administered these drugs to patients
required to obtain the medical benefit or necessity, the defendant New York Oncology Practices
then sought reimbursement from the State of New York for these improperly and fraudulently
prescribed and administered drugs.
625. As described herein, defendants have knowingly violated the New York False
State of New York, not knowing that these claims were false and not aware of the omitted
information, paid these claims that would not be paid but for the illegal acts of the defendant
New York Oncology Practices.
626. By reason of the acts described herein, the State of New York has been damaged
230
627. The State of New York, furthermore, is entitled to the maximum penalty for each
made, used, or presented by the defendant New York Oncology Practices.
COUNT SIXTEEN
Violation of Nevada False Claims Act, Nev. Rev. Stat. 357.040 et seq.
as to Defendants Nevada Cancer Center and Cancer and Blood Specialists of Nevada
(Nevada Oncology Practices)
629. This is a claim for treble damages and penalties under the Nevada False Claims
Act.
630. At all relevant times herein, defendanst Nevada Cancer Center and Cancer and
Blood Specialists of Nevada (Nevada Oncology Practices) did business in the State of Nevada.
631. As described above, the defendant Nevada Oncology Practices have engaged in
submitting claims to the State of Nevada for reimbursement for these drugs. The defendant
Nevada Oncology Practices received financial incentives and kickbacks from Amgen that were
not properly disclosed to the State of Nevada nor was the State of Nevada provided its
632. As described above, the defendant Nevada Oncology Practices have engaged in
submitting claims to the State of Nevada for reimbursement for these drugs. The defendant
Nevada Oncology Practices prescribed and administered these drugs to patients without medical
231
medical benefit or necessity, the defendant Nevada Oncology Practices then sought
reimbursement from the State of Nevada for these improperly and fraudulently prescribed and
administered drugs.
633. As described herein, defendants have knowingly violated the Nevada False
State of Nevada, not knowing that these claims were false and not aware of the omitted
Nevada Oncology Practices.
634. By reason of the acts described herein, the State of Nevada has been damaged and
635. The State of Nevada, furthermore, is entitled to the maximum penalty for each
made, used, or presented by the defendant Nevada Oncology Practices.
COUNT SEVENTEEN
Violation of Oklahoma Medicaid False Claims Act, 63 OK. Stat. 5053, et seq.
as to Defendants Oklahoma Oncology and Hematology Associates, Inc. d/b/a/ Cancer Care
Associates, Oklahoma Oncology Incorporated
(Oklahoma Oncology Practices)
232
637. This is a claim for treble damages and penalties under the Oklahoma Medicaid
False Claims Act.
638. At all relevant times herein, defendants Oklahoma Oncology and Hematology
Associates, Inc. d/b/a/ Cancer Care Associates, Oklahoma Oncology Incorporated (Oklahoma
Oncology Practices) did business in the State of Oklahoma.
639. As described above, the defendant Oklahoma Oncology Practices have engaged
and submitting claims to the State of Oklahoma for reimbursement for these drugs. The
defendant Oklahoma Oncology Practices received financial incentives and kickbacks from
Amgen that were not properly disclosed to the State of Oklahoma nor was the State of Oklahoma
640. As described above, the defendant Oklahoma Oncology Practices have engaged
and submitting claims to the State of Oklahoma for reimbursement for these drugs. The
defendant Oklahoma Oncology Practices prescribed and administered these drugs to patients
required to obtain the medical benefit or necessity, the defendant Oklahoma Oncology Practices
then sought reimbursement from the State of Oklahoma for these improperly and fraudulently
641. As described herein, defendants have knowingly violated the Oklahoma Medicaid
the State of Oklahoma, not knowing that these claims were false and not aware of the omitted
233
Oklahoma Oncology Practices.
642. By reason of the acts described herein, the State of Oklahoma has been damaged
643. The State of Oklahoma furthermore, is entitled to the maximum penalty for each
made, used, or presented by the defendant Oklahoma Oncology Practices.
COUNT EIGHTEEN
Violation of Tennessee Medicaid False Claims Act, Tenn. Stat. 75-1-181 et seq.
as to Defendants Tennessee Oncology PLLC, The West Clinic, Tennessee Cancer
Specialists, Boston Baskin Cancer Group, Kingsport Hematology-Oncology Associates,
Thompson Oncology Group, Chattanooga Oncology Hematology Associates, East
Tennessee Hematology Oncology Associates, Timothy Panella, M.D., d/b/a University
Cancer Specialists, and Wahid T. Hanna, M.D.
(Tennessee Oncology Practices)
645. This is a claim for treble damages and penalties under the Tennessee Medicaid
False Claims Act.
646. At all relevant times herein, defendants Tennessee Oncology PLLC, The West
Clinic, Tennessee Cancer Specialists, Boston Baskin Cancer Group, Kingsport Hematology-
Oncology Associates, Thompson Oncology Group, Chattanooga Oncology Hematology
Associates, East Tennessee Hematology Oncology Associates, Timothy Panella, M.D., d/b/a
234
University Cancer Specialists, and Wahid T. Hanna, M.D. (Tennessee Oncology Practices) did
business in the State of Tennessee.
647. As described above, the defendant Tennessee Oncology Practices have engaged
and submitting claims to the State of Tennessee for reimbursement for these drugs. The
defendant Tennessee Oncology Practices received financial incentives and kickbacks from
Amgen that were not properly disclosed to the State of Tennessee nor was the State of Tennessee
648. As described above, the defendant Tennessee Oncology Practices have engaged
and submitting claims to the State of Tennessee for reimbursement for these drugs. The
defendant Tennessee Oncology Practices prescribed and administered these drugs to patients
required to obtain the medical benefit or necessity, the defendant Tennessee Oncology Practices
then sought reimbursement from the State of Tennessee for these improperly and fraudulently
649. As described herein, defendants have knowingly violated the Tennessee Medicaid
the State of Tennessee, not knowing that these claims were false and not aware of the omitted
Tennessee Oncology Practices.
235
650. By reason of the acts described herein, the State of Tennessee has been damaged
651. The State of Tennessee, furthermore, is entitled to the maximum penalty for each
made, used, or presented by the defendant Tennessee Oncology Practices.
COUNT NINETEEN
Violation of Texas Medicaid Fraud Prevention Law, Tex. Hum. Res. Code 36.002 et seq.
as to Defendants South Texas Oncology and Hematology Associates, Houston Cancer
Clinic, Oncology Consultants, Tyler Hematology Oncology, Metroplex
Hematology/Oncology Associates d/b/a Arlington Cancer Center, Southeast Texas
Oncology Partners, Northwest Cancer Center, Rohit Kappor, M.D., P.A., Texas Cancer
Associates, University of Texas At Southwestern Simmons Cancer Center, Abilene
Hematology-Oncology Group, P.A., Lone Star Oncology Consultants, P.A., Kelsey Seybold
Clinic, Blood and Cancer Center of East Texas, Coastal Bend Cancer Center, and South
Texas Institute of Cancer and Blood Disorders
(Texas Oncology Practices)
653. This is a claim for treble damages and penalties under the Texas Medicaid Fraud
Prevention Law.
654. At all relevant times herein, defendants South Texas Oncology and Hematology
Associates, Houston Cancer Clinic, Oncology Consultants, Tyler Hematology Oncology,
Metroplex Hematology/Oncology Associates d/b/a Arlington Cancer Center, Southeast Texas
236
Oncology Partners, Northwest Cancer Center, Rohit Kappor, M.D., P.A., Texas Cancer
Associates, University of Texas At Southwestern Simmons Cancer Center, Abilene Hematology-
Oncology Group, P.A., Lone Star Oncology Consultants, P.A., Kelsey Seybold Clinic, Blood
and Cancer Center of East Texas, Coastal Bend Cancer Center, and South Texas Institute of
Cancer and Blood Disorders (Texas Oncology Practices) did business in the State of Texas.
655. As described above, the defendant Texas Oncology Practices have engaged in
submitting claims to the State of Texas for reimbursement for these drugs. Defendant Texas
Oncology Practices received financial incentives and kickbacks from Amgen that were not
properly disclosed to the State of Texas nor was the State of Texas provided its proportionate
share of any discount received.
656. As described above, the defendant Texas Oncology Practices have engaged in
submitting claims to the State of Texas for reimbursement for these drugs. The defendant Texas
Oncology Practices prescribed and administered these drugs to patients without medical
medical benefit or necessity, the defendant Texas Oncology Practices then sought
reimbursement from the State of Texas for these improperly and fraudulently prescribed and
administered drugs.
657. As described herein, defendants have knowingly violated the Texas Medicaid
the State of Texas, not knowing that these claims were false and not aware of the omitted
237
information, paid these claims that would not be paid but for the illegal acts of defendant Texas
Oncology Practices.
658. By reason of the acts described herein, the State of Texas has been damaged and
659. The State of Texas, furthermore, is entitled to the maximum penalty for each and
used, or presented by the defendant Texas Oncology Practices.
COUNT TWENTY
Violation of Virginia False Claims Act, Va. Code Ann. 8.01-216.3(a) et seq.
as to Defendants Virginia Cancer Institute, Hematology Oncology Patient Enterprises
(HOPE), Lynchberg Hematology Oncology Clinic, Peninsula Cancer Institute, Cancer
Outreach Associates, Danville Hematology-Oncology Clinic, Shenandoah Oncology
Associates, and Delta Hematology/Oncology Associates
(Virginia Oncology Practices)
661. This is a claim for treble damages and penalties under the Virginia False Claims
Act.
662. At all relevant times herein, defendants Virginia Cancer Institute, Hematology
Oncology Patient Enterprises (HOPE), Lynchberg Hematology Oncology Clinic, Peninsula
Cancer Institute, Cancer Outreach Associates, Danville Hematology-Oncology Clinic,
Shenandoah Oncology Associates, and Delta Hematology/Oncology Associates (Virginia
Oncology Practices) did business in the Commonwealth of Virginia.
238
663. As described above, the defendant Virginia Oncology Practices have engaged in
submitting claims to the Commonwealth of Virginia for reimbursement for these drugs.
Defendant Virginia Oncology Practices received financial incentives and kickbacks from Amgen
that were not properly disclosed to the Commonwealth of Virginia nor was the Commonwealth
of Virginia its proportionate share of any discount received.
664. As described above, the defendant Virginia Oncology Practices have engaged in
submitting claims to the Commonwealth of Virginia for reimbursement for these drugs. The
defendant Virginia Oncology Practices prescribed and administered these drugs to patients
required to obtain the medical benefit or necessity, the defendant Virginia Oncology Practices
then sought reimbursement from the Commonwealth of Virginia for these improperly and
665. As described herein, defendants have knowingly violated the Virginia False
Commonwealth of Virginia, not knowing that these claims were false and not aware of the
Virginia Oncology Practices.
666. By reason of the acts described herein, the Commonwealth of Virginia has been
239
667. The Commonwealth of Virginia, furthermore, is entitled to the maximum penalty
for each and every false or fraudulent claim, record or statement made, used, presented, or
caused to be made, used, or presented by the defendant Virginia Oncology Practices.
COUNT TWENTY-ONE
Violation of Wisconsin False Claims for Medical Assistance Act , Wis. Stat. 20.931, et seq.
as to Defendants Oncology Alliance, Marshfield Clinic, Fox Valley Hematology and
Oncology, Auroa Sheboygan Clinic, Green Bay Oncology Limited, and Medical
Consultants Limited
(Wisconsin Oncology Practices)
669. This is a claim for treble damages and penalties under the Wisconsin False
Claims for Medical Assistance Act.
670. At all relevant times herein, defendants Oncology Alliance, Marshfield Clinic,
Fox Valley Hematology and Oncology, Auroa Sheboygan Clinic, Green Bay Oncology Limited,
and Medical Consultants Limited (Wisconsin Oncology Practices) did business in the State of
Wisconsin.
671. As described above, the defendant Wisconsin Oncology Practices have engaged
and submitting claims to the State of Wisconsin for reimbursement for these drugs. The
defendant Wisconsin Oncology Practices received financial incentives and kickbacks from
Amgen that were not properly disclosed to the State of Wisconsin nor was the State of
Wisconsin provided its proportionate share of any discount received.
240
672. As described above, the defendant Wisconsin Oncology Practices have engaged
and submitting claims to the State of Wisconsin for reimbursement for these drugs. The
defendant Wisconsin Oncology Practices prescribed and administered these drugs to patients
required to obtain the medical benefit or necessity, the defendant Wisconsin Oncology Practices
then sought reimbursement from the State of Wisconsin for these improperly and fraudulently
673. As described herein, defendants have knowingly violated the Wisconsin False
Claims for Medical Assistance Act by submitting these false claims and omitting material
information such that the State of Wisconsin, not knowing that these claims were false and not
of the defendant Wisconsin Oncology Practices.
674. By reason of the acts described herein, the State of Wisconsin has been damaged
675. The State of Wisconsin, furthermore, is entitled to the maximum penalty for each
made, used, or presented by the defendant Wisconsin Oncology Practices.
241
COUNT TWENTY-TWO
Violation of 31 U.S.C. 3730(h)
as to Defendant Amgen
677. In violation of the False Claims Act 31 U.S.C. 3730(h), defendant Amgen took
negative employment actions against Relator, including terminating Relators employment,
because of lawful acts taken by Relator in furtherance of an action under 31 U.S.C. 3730,
including investigating and reporting defendants fraudulent activities.
678. As a result of defendant Amgens conduct, Relator has suffered damages.
PRAYER FOR RELIEF
WHEREFORE, Relator requests that judgment be entered against defendants, ordering that:
a. Defendants pay an amount equal to three times the amount of damages the
United States has sustained because of defendants actions, plus a civil penalty against
defendants of not less than $5,500, and not more than $11,000 for each violation of 31 U.S.C.
729;
b. Defendants pay an amount equal to three times the amount of damages the
State of California has sustained because of defendants actions, plus all applicable civil
penalties for each violation of California Government Code 12650(a);
c. Defendants pay an amount equal to three times the amount of damages the
State of Delaware has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Delaware Code 1201(a);
242
d. Defendants pay an amount equal to three times the amount of damages the
District of Columbia has sustained because of defendants actions, plus all applicable civil
penalties for each violation of D.C. Code Ann. 2-308.13, et seq.;
e. Defendants pay an amount equal to three times the amount of damages the
State of Florida has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Florida Statute 66.082;
f. Defendants pay an amount equal to three times the amount of damages the
State of Georgia has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Georgia Statute 49-4-168, et seq.;
g. Defendants pay an amount equal to three times the amount of damages the
State of Hawaii has sustained because of defendants actions, plus all applicable civil penalties
for each violation of California Revised Statute 661-21(a), et seq.;
h. Defendants pay an amount equal to three times the amount of damages the
State of Illinois has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Illinois Comp. Statute 175/3(a);
i. Defendants pay an amount equal to three times the amount of damages the
State of Indiana has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Indiana Code 5-11-5.5, et seq.;
j. Defendants pay an amount equal to three times the amount of damages the
State of Louisiana has sustained because of defendants actions, plus all applicable civil
penalties for each violation of Louisiana Revised Statute 437, et seq.;
k. Defendants pay an amount equal to three times the amount of damages the
State of Massachusetts has sustained because of defendants actions, plus all applicable civil
penalties for each violation of Massachusetts General Laws Chapter 12 5B;
243
l. Defendants pay an amount equal to three times the amount of damages the
State of Michigan has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Michigan C.L. 400.601, et seq.;
m. Defendants pay an amount equal to three times the amount of damages the
State of New Mexico has sustained because of defendants actions, plus all applicable civil
penalties for each violation of New Mexico Statute 27-2F-1, et seq.;
n. Defendants pay an amount equal to three times the amount of damages the
State of New York has sustained because of defendants actions, plus all applicable civil
penalties for each violation of New York State Fin. 187, et seq.;
o. Defendants pay an amount equal to three times the amount of damages the
State of Nevada has sustained because of defendants actions, plus all applicable civil penalties
for each violation of Nevada Revised Statute 357.040, et seq.;
p. Defendants pay an amount equal to three times the amount of damages the
State of New Jersey has sustained because of defendants actions, plus all applicable civil
penalties for each violation of N.J. Sat. 2A:32C-1, et seq.;
q. Defendants pay an amount equal to three times the amount of damages the
State of Oklahoma has sustained because of defendants actions, plus all applicable civil
penalties for each violation of 63 Oklahoma Statute 5053, et seq.;
r. Defendants pay an amount equal to three times the amount of damages the
State of Tennessee has sustained because of defendants actions, plus all applicable civil
penalties for each violation of Tennessee Statute 75-1-181, et seq.;
244
s. Defendants pay an amount equal to three times the amount of damages the
State of Texas has sustained because of defendants actions, plus all applicable civil penalties for
each violation of Texas Hum. Res. Code 36.002;
t. Defendants pay an amount equal to three times the amount of damages the
Commonwealth of Virginia has sustained because of defendants actions, plus all applicable civil
penalties for each violation of Va. Code Ann. 8.01-216.3(a), et seq.;
u. Defendants pay an amount equal to three times the amount of damages the
State of Wisconsin has sustained because of defendants actions, plus all applicable civil
penalties for each violation of Wisc. Stat. 20.932, et seq.;
v. Relator be awarded the maximum amount allowed pursuant to 31 U.S.C.
730(d);
w. Defendants cease and desist from violating the False Claims Act, 31
U.S.C. 3729, et seq.
x. Relator be awarded all damages available pursuant to 1 U.S.C. 3730(h)
as a result of defendant Amgens retaliation against Relator, including but not limited to 2 times
the amount of back pay, interest on the back pay, and compensation for any special damages as a
result of the discrimination, including damages for emotional distress;
y. Relator be awarded all costs of this action, including attorneys fees,
expenses, and costs pursuant to 31 U.S.C. 3730(d) and (h) and all other applicable statutes
including the False Claims Acts of the various states identified herein; and
z. The United States and Relator be granted all such other relief as the Court
deems just and proper.
245
Dated: December 31, 2013
/s/
__________________________________________
Rob Hennig
California Bar No. 174646
Law Offices of Rob Hennig
1875 Century Park E., Suite 1770
Los Angeles, CA 90067
rob@robhennig.com
(310) 843-0020 Phone
(310) 843-9150 Fax
Admitted Pro Hac Vice
Attorney for Plaintiff/Qui Tam Relator
/s/
__________________________________________
Hays Gorey, Jr.
D.C. Bar No. 330415
GeyerGorey LLP
1776 Eye Street, N.W., Suite 900
Washington, DC 20006
hays.gorey@geyergorey.com
(202) 644-8732 Phone
(703) 255-3848 Fax
246
DEMAND FOR JURY TRIAL
A trial by jury is requested in this case.
Dated: December 31, 2013
/s/
__________________________________________
Rob Hennig
California Bar No. 174646
Law Offices of Rob Hennig
1875 Century Park E., Suite 1770
Los Angeles, CA 90067
rob@robhennig.com
(310) 843-0020 Phone
(310) 843-9150 Fax
/s/
__________________________________________
Hays Gorey, Jr.
D.C. Bar No. 330415
GeyerGorey LLP
1776 Eye Street, N.W., Suite 900
Washington, DC 20006
hays.gorey@geyergorey.com
(202) 644-8732 Phone
(703) 255-3848 Fax
247
EXHIBIT 1
EXHIBIT 2

USA, Hanks Vs Amgen, US Oncology Et Al

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UNITED STATES DISTRICT COURT

FOR THE EASTERN DISTRICT OF NEW YORK

UNITED STATES OF AMERICA )

FILED IN CAMERA AND UNDER SEAL PURSUANT TO COURT ORDER

FOR THE EASTERN DISTRICT OF NEW YORK

UNITED STATES OF AMERICA )

FILED IN CAMERA AND UNDER SEAL PURSUANT TO COURT ORDER

FOR THE EASTERN DISTRICT OF NEW YORK

UNITED STATES OF AMERICA )

II. JURISDICTION AND VENUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

III. THE PARTIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

IV. FACTUAL ALLEGATIONS RELATED TO SPECIFIC DEFENDANTS . . . . . . . . . . .10

A. Amgen, Inc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

B. US Oncology Specialty, LP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

C. Defendant Oncology Practices by Individual States of Practice . . . . . . . . . . . . . .14

Alabama Oncology Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Arizona Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Arkansas Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

California Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Colorado Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Connecticut Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Delaware Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

District of Columbia Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Florida Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Georgia Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Hawaii Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Illinois Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Indiana Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54

Iowa Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Kansas Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Kentucky Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Louisiana Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Maine Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Maryland Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Massachusetts Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Michigan Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67

Minnesota Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

Mississippi Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

Missouri Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

Montana Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

Nebraska Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78

New Jersey Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

New Mexico Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85

New York Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Nevada Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

North Carolina Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

North Dakota Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96

Ohio Oncology Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Oklahoma Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

Oregon Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102

Pennsylvania Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103

South Carolina Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113

South Dakota Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Tennessee Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

Texas Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120

Utah Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126

Virginia Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127

Washington Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

Wisconsin Oncology Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

IV. FACTUAL ALLEGATIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136

B. Marketing Aranesp to Defendant Oncology Practices. . . . . . . . . . . . . . . . . . . . .139

C. Payments for Drugs Furnished by Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . .152

D. Overstating Costs to Increase Reimbursements. . . . . . . . . . . . . . . . . . . . . . . . . .153