Attorney General Ken Paxton has announced a settlement that secures $40 million for Texas following an investigation into Medicaid fraud involving Molina Healthcare. The enforcement action was brought under the Texas Health Care Program Fraud Prevention Act (THFPA) against Molina Healthcare of Texas, Inc. and Molina Healthcare, Inc.
Molina is a publicly traded Fortune 500 healthcare organization serving Texans in the Medicaid STAR+PLUS program, which supports individuals who are disabled, blind, or aged 65 and older.
The settlement addresses allegations that Molina did not timely assess Medicaid beneficiaries for required services and concealed its non-compliance from the state. These alleged violations were reported in a lawsuit filed by a whistleblower under the qui tam provisions of the THFPA.
Attorney General Paxton stated, “This $40 million payment to Texas helps ensure that managed care organizations who contract with Texas Medicaid are held to the highest standards.” He further emphasized his commitment to defending health programs against fraud and taking action against those attempting to exploit the state's health system.