HMO operator Amerigroup has been fined $144 million by a federal jury, which concluded that the company deliberately avoided enrolling pregnant and high-risk patients in its Medicaid plan in an effort to pump up profits. The jury had originally fined the company $48 million, but the judgment was tripled under the federal False Claims Act. Next, the prosecutors plan to seek an additional $200 million in fines, in compensation for the 18,000 false claims Amerigroup filed in the state.
The federal suit was filed by whistleblower Cleveland Tyson, a former Amerigroup executive, who now stands to collect an extremely hefty whistleblower's award of $26 million to $31 million. Amerigroup served as the state's Medicaid HMO contractor from 2000 through 2003, handling $243 million in Medicaid funding. Amerigroup is appealing the decision.
To learn more about the decision:
- read this article [1] in the Chicago Tribune
- check out Amerigroup's release [2] announcing its appeal
Related Article:
Two providers settle whistleblower suits. Article [3]
A good year for whistleblowers. Report [4]
Links:
[1] http://www.chicagotribune.com/features/lifestyle/health/chi-0610310171oct31,1,4123012.story?coll=chi-health-hed&ctrack=1&cset=true
[2] http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/10-30-2006/0004462877&EDATE=
[3] http://www.fiercehealthcare.com/story/two-providers-settle-whistle-blower-suits/2006-08-22
[4] http://www.fiercehealthcare.com/story/spotlight-a-good-year-for-whistleblowers/2006-10-05