July 12, 2016

Illinois claimed its share of a $784.6 million settlement reached with drug companies Wyeth and Pfizer earlier this year, part of billions being recovered by state and local government cracking down on purported health care fraud. 

What is less clear is how much of such alleged fraud is actually being uncovered  in Illinois and nationwide.

In May, attorneys general in 35 states, including Illinois, along with the District of Columbia, announced their shares of the large settlement. The settlement resolved allegations Wyeth didn't provide the same discounts to the government that it provides to private purchasers, despite being required to do so by Medicaid.

“This significant settlement illustrates that the government will not permit drug companies to dodge their obligations to the Medicaid program or create elaborate pricing schemes to deceive Medicaid into paying more than it should for drugs,” Carmen Milagros Ortiz, the U.S. Attorney for the District of Massachusetts, was quoted in a press release. “This settlement, after years of hard-fought litigation, shows our commitment to ensuring that healthcare businesses do not take advantage of the federal health insurance programs which serve those who need assistance most.”

The settlement also resolved allegations from two whistleblowers, Lauren Kieff and William St. John LaCorte, who sued the drug companies in United States ex rel. Kieff and LaCorte v. Wyeth and Pfizer in Massachusetts federal court under the False Claims Act. The False Claims Act allows private parties, such as the whistleblowers, to sue on the government's behalf for false claims on government funds and to receive a share of any settlement or other recovery.

The full article can be read here