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Attorney General Announces Record $46.7 In Medicaid Recoveries In 2008

02:32PM / Thursday, January 15, 2009
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BOSTON, Mass. - Attorney General Martha Coakley’s Office announced that recoveries by the office’s Medicaid Fraud Division totaled more than $46.7 million during 2008, breaking the previous recovery record, set in 2007, by over $20 million. Approximately $73.2 million has been returned to the state Medicaid program by the Medicaid Fraud Division during Attorney General Coakley’s two years in office. The Medicaid Fraud Division is responsible for the investigation and prosecution of fraud against the state Medicaid program.

The $46.7 million recovered in 2008 is primarily the result of 13 civil settlements, nine of which were multi-state agreements. Representatives from the Attorney General’s Medicaid Fraud Division serve on national multi-state fraud teams that negotiate the resolution of these cases, which in 2008 resulted in the return of over $1.4 billion to the federal government and state Medicaid programs across the country.

“We have built strong partnerships with other state and federal agencies,” Attorney General Coakley said. “This broad based approach has allowed us to aggressively pursue both local and national providers whose fraudulent practices cause great harm to this vital program which provides the most fundamental services to the Commonwealth’s most vulnerable citizens. While we are extremely proud of these results, we are troubled that this fraudulent behavior seems to be increasing at a time when health care costs are rising. Our office will continue to be a leader in the efforts to combat this growing epidemic and to assist the Medicaid program in operating as efficiently and cost effectively as possible.”

During 2008, the Attorney General reached multi-million dollar agreements with three generic drug manufacturers to settle a False Claims Act case pending in the United States District Court in Boston. Most recently, in December 2008, Teva Pharmaceuticals USA, Inc., and its wholly-owned subsidiary, Ivax Corporation, agreed to pay a combined $7 million to settle allegations against them. Boehringer Ingelheim Roxane, Inc. similarly agreed to pay $1.8 million in September 2008.  

In March 2008, as a result of a seven-year investigation initiated and led by the Massachusetts Medicaid Fraud Division, the National Association of Medicaid Fraud Control Units reached a settlement with CVS/Caremark to resolve allegations that the retail pharmacy chain violated various state and federal statutes and regulations. The settlement recovered a total of $36.7 million for 23 states Medicaid programs and returned $3.7 million to the Massachusetts Medicaid program.

In one of the largest healthcare fraud settlements ever reached, Massachusetts received $10.5 million in February 2008 as part of two separate global settlements with the pharmaceutical giant Merck & Co., Inc, totaling $649 million dollars. An Assistant Attorney General in the Medicaid Fraud Division served as a member of the four-person national Medicaid fraud team that negotiated on behalf of the 49 states that participated in the settlements.

In another multistate settlement, Massachusetts received $9.2 million from international pharmaceutical manufacturer Bristol-Myers Squibb Company in July 2008. The joint investigation was conducted by the U.S. Department of Justice, the U.S. Attorney’s Office for the District of Massachusetts, and a five-person national Medicaid fraud team which included an Assistant Attorney General from Attorney General Coakley’s Medicaid Fraud Division.

Medicaid is a multi-billion dollar joint state and federal program that provides health insurance for the economically disadvantaged. The monies recovered by the Medicaid Fraud Division are returned to the Medicaid program.
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