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April 2003
Bayer
and GalxoSmithKline Settle
Medicaid Fraud Allegations for $344 Million
On
April 16, 2003, the Department of Justice
announced that Bayer Corp. and GlaxoSmithKline
(GSK) had agreed to pay over $344 million to
settle allegations of Medicaid fraud. Bayer will
pay a total of $257,200,00 and GSK will pay
$87,600,922. This represents the largest Medicaid
fraud settlement in history. The settlement
proceeds will be shared by the Federal
Government, 49 states, the District of Columbia,
and Public Health Service entities.
The
Government alleged that Bayer and GSK, in a
scheme referred to as "lick and stick,"
sold re-labeled drugs to an HMO at deeply
discounted prices, and then concealed this
information in order to avoid their obligation to
pay millions of dollars in additional rebates to
the Medicaid program. The Medicaid Rebate program
requires drug manufacturers to report to the
Government's Center for Medicare and Medicaid
Services the best price they offer to any
commercial, for-profit customer, and to pay a
quarterly rebate based on that best price.
According to the Government, Bayer and GSK
provided discounted prices to Kaiser Permanente
Medical Care Program, a private HMO, and affixed
slightly altered labels to those products to
avoid having to report the discounts to the
Government. The drugs involved included Bayer's
Cipro, an antibiotic, and Adalat CC, an
antihypertensive, and GSK's Paxil, an
antidepressant, and Flonase, a nasal spray.
Whistleblower
George Couto, a former marketing executive at
Bayer who is now deceased, filed the qui tam
action against Bayer in 1999. That case is
captioned United States ex rel. Estate of Couto
v. Bayer Corp., No. 00-10339 (D. Mass). The
relator's share of the Bayer portion of the
settlement is $34 million, which will go to
Couto's estate. Neil Getnick and Lesley Ann
Skillen of Getnick & Getnick (New York)
represented the relator. The FBI, HHS OIG, and
FDA's Office of Criminal Investigations
investigated this matter. Susan Winkler, Deputy
Chief of the Health Care Fraud Unit of the U.S.
Attorney's Office in Boston, as well as Assistant
U.S. Attorney George Vien of the same office
handled the matter for the Government.
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