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Tuesday, December 10, 2019

R.I. AG's medicaid fraud unit recovered $8.1M in 2013

By Bryan Cohen | Jan 29, 2014


PROVIDENCE, R.I. (Legal Newsline) - Rhode Island Attorney General Peter Kilmartin announced on Monday that his Medicaid Fraud and Control Unit recovered more than $8.1 million for the state's Medicaid budget in 2013.

Last year, the MFCU entered into 16 settlement agreements with major pharmaceutical companies that allegedly overbilled the state for drugs and/or engaged in off-label billing. The settlements resulted in the recovery of $6.8 million in funds returned to the Medicaid budget. The MFCU also recovered $1,276,530 in civil penalties from physician practices for alleged coding and overbilling errors and $81,365 from individuals convicted of patient abuse or Medicaid fraud.

"Medicaid is one of Rhode Island's most expensive programs and cannot afford to be plagued with fraud, waste and abuse," Kilmartin said. "From big pharma looking to pocket tens of millions of dollars in profits through the off-label marketing of drugs to individual caregivers who defraud the system a few hundred dollars at a time, each must be held accountable."

In November, the MFCU recovered $5.6 million as part of a multi-state and federal settlement with Johnson & Johnson and its subsidiary, Janssen Pharmaceuticals Inc. One of the unit's largest settlements with an individual physician was a $244,923 settlement with Hafeez Kahn, a former Rhode Island physician.

The MFCU enforces laws that pertain to fraud in the Rhode Island Medicaid program and prosecutes cases of neglect, abuse or mistreatment of patients in all state healthcare facilities. The MFCU also works with federal and state authorities to look into pharmaceutical companies who defraud and overbill the state's Medicaid program.

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