Through investigations into fraud within public assistance programs in Massachusetts, more than $80 million was recovered for the state's Medicaid program last year, the office of Attorney General Maura Healey announced this week.
Through investigations into fraud within public assistance programs in Massachusetts, more than $80 million was recovered for the state's Medicaid program last year, the office of Attorney General Maura Healey announced this week.
"Medicaid is 40 percent of the state's budget and it must be protected," Healey said. "Each year our office recovers millions of dollars for MassHealth to ensure that taxpayer funds are used properly to benefit our residents."
The state attorney general's office has a division dedicated to investigating Medicaid fraud. For every dollar allocated during the 2016 fiscal year, nearly $20 was recovered as the result of 29 settlements - including multi-state agreements.
In May, Pfizer agreed to pay $784.6 million to resolve allegations that subsidiary Wyeth overcharged the federal government for prescription drugs in a multi-state settlement.
Seeking to incentivize the purchase of certain drugs, Wyeth gave hospitals across the nation steep discounts on their medication, according to the government's complaint. After patients were prescribed the medication in hospitals, the discounted price was not made available to individual patients, including those on Medicaid.
The allegations were brought to federal prosecutors by two employees.
Of that agreement, nearly $68 million was paid to MassHealth.
Four months later, the attorney general's office also reached a $795,000 settlement with CVS Pharmacy regarding the pharmacy staff working in Massachusetts locations filling prescriptions for opioids. Employees are mandated to check the state's Prescription Monitoring Program before filling such prescriptions, in an effort to prevent drug misuse.
Other settlements include a Boston dentist paying $700,000 to settle claims of improper billing in her three offices, a psychiatrist practicing in Attleboro and Sharon paying more than $300,000 after patients with MassHealth were required to pay out-of-pocket for a drug that should have been free.