For Immediate Release - January 03, 2013

AG’s Office Announces Record $85.6 Million in Recoveries for Massachusetts Medicaid Program in 2012

BOSTON – Recoveries by the Attorney General’s Medicaid Fraud Division totaled more than $85.6 million during 2012, breaking the previous recovery record set in 2010 by more than $19 million, Attorney General Martha Coakley announced today.

More than $321 million has been recovered for the state Medicaid program by the Medicaid Fraud Division during AG Coakley’s six years in office. The Medicaid Fraud Division is responsible for the investigation and prosecution of fraud against the state Medicaid program. The total amount recovered during 2012 alone represents more than the amount recovered during a 10 year period from 1996 – 2006, approximately $67.9 million, before AG Coakley took office.

“Our office has recovered a record amount of taxpayer money this past year through our continuing effort to stop Medicaid fraud and abuse,” said AG Coakley. “This program provides important health services to more than a million Massachusetts residents and our ongoing effort to target fraud will ensure that these services reach the people who need them the most.”

The AG’s Office has established itself nationally as a leader in the fight against fraud, waste and abuse in the Medicaid program. In 2012, in recognition of the Medicaid Fraud Division’s role as a national leader, the division was awarded the State Medicaid Fraud Control Unit Award by the Office of the Inspector General of the United States Department of Health and Human Services for efforts to combat fraud and recover taxpayer funds.

Representatives from the Medicaid Fraud Division served as the lead negotiators for multi-state litigation teams that worked with the federal government to secure a settlement with GlaxoSmithKline, returning more than $35 million to the Medicaid program and approximately $1 billion to Medicaid programs nationwide, making it the largest health care fraud settlement of 2012. In May 2012, representatives from the Medicaid Fraud Division served as members of the national team that resulted in Abbott Laboratories agreeing to pay more than $17 million to the Medicaid Program for allegations that the pharmaceutical company illegally marketed the drug Depakote over a 10-year period. 

In addition to the settlements above, representatives of AG Coakley’s Medicaid Fraud Division negotiated a variety of cases for the Commonwealth that achieved substantial settlements from various entities including a long-term care pharmacy, pharmaceutical manufacturers, independent clinical labs and dental practices. In March 2012, Calloway Laboratories paid $20 million in restitution to resolve allegations of an elaborate kickback scheme. Three defendants in the Calloway case also pleaded guilty to criminal charges, which resulted in their exclusion from participating in the Massachusetts Medicaid Program.

Medicaid is a multi-billion dollar joint state and federal program that provides health insurance for the economically disadvantaged.  The Medicaid Fraud Division works cooperatively with MassHealth and other state and federal agencies to prosecute fraud against the Massachusetts Medicaid program.

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