Missouri Nets $3.1 Million on Medicaid Fraud Settlement with EpiPen Maker Mylan

Missouri’s Attorney General Josh Hawley has just announced a settlement with pharmaceutical giant Mylan over Missouri Medicaid fraud involving its emergency allergy treatment, EpiPen. The settlement is part of the resolution of a complaint that included allegations of fraud across the nation.

Missouri Nets $3.1 Million on Medicaid Fraud Settlement with EpiPen Maker Mylan

Mylan will pay Missouri Medicaid $3.1 million as part of a total settlement reaching $465 million.

According to allegations first raised in a whistleblower lawsuit brought by a competitor of Mylan, the company misclassified the EpiPen as a generic drug. This misclassification allowed the defendant to avoid the payment of rebates to Medicaid. Thus, the MO state healthcare program lost millions of dollars that Mylan would have had to pay if it had listed EpiPen as a branded drug.

The alleged misconduct gained public visibility when the EpiPen’s price increased by $500 in eight  years. By 2016, the drug cost $600, and Mylan’s competitors were as outraged as the families of allergic patients who needed the EpiPen on a regular basis.

As a result of Mylan’s alleged violations of the state’s rebate regulations and its failure to report a “best price” to the Centers for Medicare and Medicaid Services, the company submitted millions of dollars worth of false claims for Epipen to government healthcare programs.

In his announcement of the settlement, Missouri’s Attorney General said that there is no place in his state for Medicaid fraud. “We will not tolerate the misuse of taxpayer money. I am grateful to the agencies that worked on this case and I am pleased that this money will be returned,” he commented.

Interestingly enough, AG Hawley took advantage of the opportunity to encourage citizens to report fraud directly to his office to obtain a 10 percent share of any recoveries. It is important to emphasize that whistleblowers who secure the services of an attorney to file a False Claims Act lawsuit can receive awards of up to 30% of recoveries and no less than 15%.

Direct tips without legal counsel also has the disadvantage that the Attorney General’s office receives a vast number of tips, and it can take prosecutors many years to investigate allegations, many going uninvestigated.

During Fiscal Year 2015, the state recovered over $12 million as a result of Missouri Medicaid fraud investigations. Last year, the recoveries ascended to about $13.5 million. This has been a result of the combined efforts of the local Medicaid Fraud Control Unit and the Attorney General, in cooperation with federal agencies and whistleblowers.

If you have information about healthcare or pharmaceutical companies cheating Medicaid in Missouri or elsewhere you might be eligible for a substantial reward if you are the first to report. So act now and Call Us or Check Your Eligibility Online


Medicaid Fraud Hotline: 888.742.7248 or Report Online