Office of the Attorney General’s Civil Medicaid Fraud Division Recovers $42.7 Million in Taxpayer Funds

Attorney General Ken Paxton

The Office of the Attorney General’s (“OAG”) Civil Medicaid Fraud Division settled an enforcement action brought under the Texas Medicaid Fraud Prevention Act (“TMFPA”) against pharmaceutical drug manufacturers Shire PLC, Baxter International Inc., Baxalta Inc., Viropharma Inc., Takeda Pharmaceuticals U.S.A., Inc., and Takeda Pharmaceuticals America.

The settlement resolves allegations that the drug manufacturers violated the TMFPA by providing, directly or indirectly, nursing and reimbursement services to Texas Medicaid providers for certain pharmaceutical drugs, as well as by paying clinical nurse educators to refer or recommend the drug Vyvanse to providers from January 2014 to December 2015. Under the agreement, the drug manufacturers will pay more than $42 million to settle the claims against the companies.

The alleged TMFPA violations were originally brought in a lawsuit filed by a whistleblower under the qui tam provisions of the TMFPA, which allow a whistleblower to bring a lawsuit on Texas’s behalf for violations of the TMFPA.

Identifying and preventing Medicaid fraud continues to be a top priority for the Texas Attorney General. Medicaid fraud schemes undermine the integrity of Texas’s Medicaid program resulting in a misuse of taxpayer funds. Since 2000, the Texas Attorney General’s Civil Medicaid Fraud Division has recovered approximately $2.5 billion for taxpayers under the Texas Medicaid Fraud Prevention Act.

For more information about the Texas Attorney General’s efforts to fight Medicaid fraud, please visit the OAG’s website.

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