Pennsylvania Receives More Than $500,000 in Settlement of National Medicaid Fraud Case

Pennsylvania received more than half a million dollars on May 17 as part of a $44.3 million multi-state settlement with a Massachusetts based pharmaceutical company accused of submitting false/fraudulent claims to the Medicaid program.

The pharmaceutical company's alleged actions caused thousands of false/fraudulent claims to be submitted to Medicaid and Medicare. Medicaid programs nationwide will receive approximately $19 million of the total settlement.

Acting Attorney General Bill Ryan said the multi-state agreement was reached between 50 states, the District of Columbia, the federal government and EMD Serono, Inc. Serono developed, manufactured, distributed, marketed and sold the drug Rebif throughout the country.

Ryan explained that Rebif is an interferon beta-1a drug injected subcutaneously to treat relapsing forms of multiple sclerosis (MS) in order to reduce the number of flare-ups and slow down the development of physical disability associated with the disease.

From January 2002 through December 2009, Serono allegedly offered and paid "inducements" to medical professionals to encourage them to prescribe the drug Rebif. These incentives were in the form of payments for attending speaker training, advisory, and consultant meetings, many of which were held at lavish resorts and other upscale locations.

Under the agreement, Serono agrees to pay the participating states and the United States $44.3 million, plus interest. Pennsylvania will receive $552,792 in state and federal funds. Medicaid is funded jointly by the federal and state governments.

The investigation was initiated by a lawsuit filed under the qui tam provisions of the Federal False Claims Act. This action was filed in the United States District Court for the District of Maryland.

Ryan said the investigation was led by a four state group including, South Carolina, New York, North Carolina, Texas and the National Association of Medicaid Fraud Control Units.


 

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