(Boise) The National Association of Medicaid Fraud Control Units has announced that the 50 states and the federal government have reached a $102 million settlement with Warner Chilcott PLC (“Warner Chilcott”), a pharmaceutical company alleged to have falsified health program coverage paperwork to ensure federal and state reimbursement.
As part of the settlement, the State of Idaho will receive $6,673 in restitution and other recovery.
This investigation resulted from an action filed in the United States District Court of the District of Massachusetts against Warner Chilcott, which is based in Ireland with U.S. headquarters in New Jersey. In the complaint, two former Warner Chilcott managers alleged that from January 1, 2009 through March 31, 2013, the company paid illegal kickbacks to doctors in the form of promotional speaking fees, honoraria, and meals to induce them to prescribe: Actonel, Asacol, Asacol HD, Atelvia, Doryx, Enablex, Estrace, Loestrin 24 Fe, and Lo Loestrin. The complaint also alleged that Warner Chilcott falsified prior authorization requests, non-formulary exception requests, and coverage determination requests, to ensure Medicaid and federal healthcare program coverage and reimbursement for the drug Atelvia in all states.
Warner Chilcott has agreed to pay the states and federal government $102 million in civil damages and penalties to resolve the civil kickback and false documentation allegations. The total Medicaid portion of the settlement, state and federal, is $10.6 million. The states’ share of the Medicaid recovery is more than $5 million. Warner Chilcott will be permanently excluded from Medicaid, Medicare and other Federal health care programs. Additionally, Warner Chilcott has pled guilty to one felony count that alleged violation of 18 U.S.C. § 1347 [health care fraud].
A team from the National Association of Medicaid Fraud Control Units represented the interests of the states during negotiations with Warner Chilcott.
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