TRENTON
- Acting Attorney General Anne Milgram announced
that New Jersey has received a check for
nearly half a million dollars as a result
of a national settlement which required
pharmaceutical company Glaxo SmithKline
to pay over $145 million in damages and
penalties to federal and state Medicaid
programs across the country.
“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 Acting Attorney General Milgram. “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.”
New
Jersey was reimbursed $472,382. More specifically,
the New Jersey Medicaid program, which is
funded by the state and federal governments,
received $900,919, of which the state received
$408,178, including $204,089 as restitution
and $204,089 as a penalty. This recovery
was increased by $64,204 in post-agreement
interest.
According
to Division of Criminal Justice Director
Gregory A. Paw, the Medicaid Fraud Control
Unit of the Office of the Insurance Fraud
Prosecutor participated in a national investigation
of Glaxo SmithKline. The investigation was
initiated when a federal false claims lawsuit
was filed alleging that Glaxo SmithKline
inflated the average wholesale price for
Zofran and Kytril, which are used to prevent
or treat nausea.
It
was alleged that Glaxo SmithKline set, reported
and maintained fraudulent and inflated average
wholesale price information for these drugs.
The average wholesale price for drugs is
used by government sponsored health care
plans such as Medicaid and Medicare to determine
theamount drug purchasers will be reimbursed.
The
New Jersey Medicaid program would reimburse
hospital and other pharmacies for Medicaid
claims. By inflating the average wholesale
price, the Medicaid program paid more when
reimbursing claims for the drugs. Glaxo
SmithKline was able to increase its market
share through this scheme, earning more
money for itself.
In
total, Glaxo SmithKline agreed to pay national
damages for inflated Medicare and Medicaid
claims in the amount of $149 million.
The Medicaid program 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.
www.NJInsuranceFraud.org.
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