TRENTON
- Attorney General Zulima V. Farber announced
that New Jersey’s Medicaid program
will receive almost $2 million as a result
of a national settlement which requires
Schering-Plough Corp. to pay over $203 million
in civil damages and penalties to the federal
government and state Medicaid programs across
the country.
As
part of the settlement, which is subject
to court approval, New Jersey’s Medicaid
program will be reimbursed approximately
$3.5 million to be split by the state and
federal government, with the state receiving
$1,967,790.
“This
settlement returns a sizable amount of money
to the State of New Jersey and to the Medicaid
program, which assists and benefits those
citizens who need the aid the most,”
said Attorney General Farber. “We
have dedicated significant resources to
investigating and prosecuting Medicaid fraud
in New Jersey.”
“Every
dollar lost to fraud or abuse is one less
dollar available to help the most needy
citizens of our state,” said Insurance
Fraud Prosecutor Greta Gooden Brown. “The
Office of the Insurance Fraud Prosecutor
is committed to fighting healthcare fraud
and returning much needed dollars to victims
of insurance fraud including Medicaid, insurance
companies and taxpayers.”
According
to Division of Criminal Justice Director
Gregory A. Paw and Insurance Fraud Prosecutor
Brown, the Medicaid Fraud Control Unit of
the Office of the Insurance Fraud Prosecutor
participated in a national investigation
as well as the negotiations with Schering-Plough.
OIFP’s
Medicaid Fraud Control Unit routinely participates
in national settlements with the Department
of Justice through the National Association
of Medicaid Fraud Control Units (NAMFCU).
Following
the filing of a federal false claims action,
NAMFCU’s investigation revealed that
Schering-Plough concealed its “best
price” for purposes of rebating the
Medicaid program for certain drugs. These
drugs included an allergy medication known
as Claritin; a potassium supplement known
as K-Dur; and a drug used in connection
with the treatment of brain cancer known
as Temodar. The investigation also revealed
that Schering Plough allegedly paid kickbacks
to doctors in connection with prescribing
Intron-A, PEG-Intron, and Rebetron which
were used to treat hepatitis infections.
As the result of NAMFCU’s negotiation,
Schering-Plough agreed to pay $203 million
dollars to settle these allegations. The
total settlement also includes payment of
a $180 million criminal fine to the federal
government by a subsidiary of Schering-Plough,
as well as roughly $50 million in payments
not related to Medicaid.
As
the result of OIFP’s Medicaid Fraud
Control Unit participating in the investigation
and negotiations, the New Jersey and federal
share of the settlement in connection with
payments made by the New Jersey Medicaid
program will amount to $3,535,903.
The
Medicaid program, which is funded by the
state and federal governments, provides
health care services and prescription drugs
to persons who may not otherwise be able
to afford such services and medicines. The
State of New Jersey administers the Medicaid
program through the Division of Medical
Assistance and Health Services. The Office
of the Insurance Fraud Prosecutor’s
Medicaid Fraud Control Unit investigates
both criminal and civil Medicaid fraud and
abuse in that program.
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