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TRENTON
– Attorney General Anne Milgram announced
today that New Jersey will receive more
than $1 million as its share of a national
settlement of a civil Medicaid fraud lawsuit
filed against the Walgreens pharmacy chain.
The basis of the federal
false claims suit was that between 2001
and 2005, Walgreens improperly switched
the dosage forms called for in prescriptions
of different strengths of Rantindine (the
generic form of Zantac), Fluoxetine (the
generic form of Prozac), and Selegiline
(the generic form of Eldepyl) in order to
avoid payment limits set by the federal
government for certain dosage forms of those
drugs. This resulted in overcharges to the
Medicaid program.
Walgreens is a national
pharmacy chain which operates retail pharmacies
in many states. Walgreens agreed to pay
a total national settlement of $35 million
to resolve allegations of improper billing
of the Medicaid program and other federally
funded health insurance programs.
The Medicaid program is
jointly funded by the state and federal
governments. The combined federal and state
share of the settlement for the New Jersey
Medicaid program is $2.4 million, of which
New Jersey will receive $1.08 million, including
restitution and penalties. Walgreens also
was required to enter into a corporate integrity
agreement with the U.S. Department of Health
and Human Services Office of Inspector General
so its business practices can be monitored.
“Through this civil
settlement, we have recovered more than
$1 million for the Medicaid program in New
Jersey that can be used to provide vital
health care services and medicines for residents
who otherwise couldn’t afford them,”
said Attorney General Milgram.
The Office of the Insurance
Fraud Prosecutor’s Medicaid Fraud
Control Unit routinely participates in civil
false claims settlements brought on a national
level. Gregory A. Paw, Director of the Division
of Criminal Justice, credited Assistant
Attorney General John Krayniak of the Medicaid
Fraud Control Unit for representing New
Jersey in this settlement along with representatives
of the U.S. Department of Justice and other
state Medicaid Fraud Control Units.
“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
health care fraud and returning much needed
dollars to victims of insurance fraud, including
the Medicaid program.”
Attorney General Milgram
noted that New Jersey has a new tool to
combat Medicaid fraud. She explained that
on Jan. 14, Governor Corzine signed the
New Jersey False Claims Act, which took
effect on March 14 and which contains a
whistleblower provision to provide rewards
to people, often corporate insiders, who
blow the whistle on fraud.
The State of New Jersey
administers the Medicaid program through
the Division of Medical Assistance and Health
Services and through the Office of Insurance
Fraud Prosecutor’s Medicaid Fraud
Control Unit, which investigates both criminal
and civil Medicaid fraud and abuse in that
program.
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