Corporate Compliance

Amerigroup pays $225M to settle Medicaid fraud claims

Compliance Monitor, August 20, 2008

On August 14, the Amerigroup Corporation agreed to pay $225 million to settle allegations that the company failed to offer Medicaid coverage to all citizens who were eligible for the benefit.
 
Prior to the settlement, Amerigroup was in the process of appealing an October 2006 jury decision that found the company liable under the False Claims Act and the Illinois Whistleblower and Reward Act. The district court ordered Amerigroup to pay $335 million to the state and federal governments.
 
The Virginia Beach, VA based Amerigroup operates managed healthcare plans throughout the United States. According to a Department of Justice, Amerigroup and its Illinois subsidiary avoided enrolling pregnant women and unhealthy patients in their managed care program in Illinois in order to increase profits.
 
Because of the August 14 settlement, Amerigroup agreed to drop the appeal and enter into a Corporate Integrity Agreement with the Office of Inspector General for the U.S. Department of Health and Human Services (HHS).
 
To read the DOJ press release click here.

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