Attorney General claims $80M in recovered fraud for MassHealth last year

BOSTON (State House News Service) – Attorney General Maura Healey’s Medicaid fraud division recovered more than $80 million for the MassHealth program in 2016, which her office said is the second-highest amount recovered for the program in a single year.

The total, announced by Healey Wednesday, includes nearly $68 million that the pharmaceutical manufacturer Wyeth agreed to pay to resolve claims it knowingly underpaid mandated drug rebates. The May 2016 settlement, a joint multi-state and federal agreement, was the largest Medicaid fraud recovery in Massachusetts history, Healey said. The money recovered is primarily the result of 29 civil settlements, 19 of which were multi-state agreements, according to Healey’s office.

“Medicaid is 40 percent of the state’s budget and it must be protected,” Healey said in a statement. “Each year our office recovers millions of dollars for MassHealth to ensure that taxpayer funds are used properly to benefit our residents.”

Six individuals were convicted last year on criminal charges brought by the Medicaid Fraud Division, and 14 others charged in connection with defrauding MassHealth still have cases pending, the AG’s office said. The division “prioritized cases involving prescribers, pharmacists and others who contribute to the opioid epidemic by illegally prescribing or dispensing pills,” according to Healey’s office.