Colorado to Receive Large Medicaid Fraud Settlement

The attorney general for Colorado announced a settlement for $79,208 for fraudulent Medicaid claims.

Colorado isn’t the only state to receive a settlement for fraudulent Medicaid claims. In fact, the total settlement nationwide was $19.2 million, with Colorado’s share being $79,208. Still, it’s a settlement that makes a point and puts a stop to fraud in the health care system.

The nationwide agreement was recently reached with Alpharma, Inc. (a pharmaceutical company) with the purpose of settling allegations of fraudulent Medicaid claims that were put forward for a drug called Kadian – a painkiller that was supposed to be for moderate to severe pain,” outlined Miller Leonard, a Denver federal criminal defense lawyer and state criminal defense lawyer.

Since this wound up being a class action lawsuit pursued by several states attorneys general, it was a multistate lawsuit. The drug company was supposedly offering and paying for training programs, research grants, speakers’ bureaus, consulting forums, and made false statements about the safety of Kadian and how well it was supposed to work. There was evidence this happened from January 2000 to December 2008.

Evidently, an investigation revealed that physicians wooed by Alpharma got a variety of indirect forms of kickbacks from the company, prescribed higher quantities of Kadian than doctors who were not courted. The result was the Colorado Medicaid program got billed for drugs it otherwise would not have been billed for but for the actions of Alpharma,” explained Leonard.

There are at least 700,000 recipients of Medicaid in Colorado and every year, the government pays out close to $4 billion for their medical care. The Medicaid Fraud Control Unit will respond by investigating and prosecuting any health care providers suspected of defrauding the Medicaid program.

It’s really important for any company engaged in business that involves Medicare or Medicaid to have a robust compliance training program. Many violations of the Anti-Kickback Statute happen because businesses and their employees do not properly understand the law,” advised Miller Leonard, a Denver federal criminal defense lawyer and state criminal defense lawyer.

Statutes like the Anti-Kickback Statute are in place for a reason, and that reason is to prevent instances of fraud such as this case outlines. If you don’t know what the Anti-Kickback Statute means or involves, contact me and I can give you the complete run down. It makes sense to know what you’re dealing with ‘before’ the fact of a breach, rather than later, when it’s too late,” added Leonard.

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