Miami Herald: Medicaid-fraud informants to be rewarded with Pfizer settlement

Sep 4, 2009

This story was published in the Miami Herald on Sept. 4, 2009


Florida will use part of its $58 million share of a federal settlement from pharmaceutical giant Pfizer as reward money for tipsters who report Medicaid fraud.

The state will reward informants whose tips lead to fines, civil or criminal charges or forfeitures of property. The state is putting about $1 million from the Pfizer settlement into the reward program.

Some of the remaining money from the settlement will reimburse the federal Medicaid program for Florida and the state Medicaid program, and nearly $10 million will go into the state’s general fund.

Pfizer agreed Wednesday to pay a total of $2.3 billion to settle allegations about the marketing of 13 drugs, including pain reliever Bextra.

Federal authorities said Pfizer paid doctors’ expenses to attend meetings at resort locations, where some were treated to massages, golf and other activities — at the same time the company was negotiating deals on past misconduct.

The government said Pfizer pushed four prescription drugs as treatments for medical conditions different from those the drugs had been approved for.

Using drugs in these scenarios isn’t uncommon, but drug manufacturers are not allowed to market products for uses that have not been approved by the Food and Drug Administration.

Florida’s Medicaid fraud program, including the tips portion, was created by the Legislature in the spring.

Tipsters can call the attorney general’s fraud hot line at 866-966-7226 or 850-414-3990.

The Medicaid Fraud Control Unit can protect the identities of informants. Rewards will only be paid out after a case has been resolved.

The amount of the reward may be up to 25 percent of the amount recovered, with a maximum of $500,000 per case. The law also requires that Medicaid recipients receive information annually on the reward program and how to report criminal Medicaid fraud.

“Every dollar saved from Medicaid fraud is a dollar we can spend providing care to those who need it the most,” Attorney General Bill McCollum said.

The settlement is the largest a drug company has paid for violating federal drug rules, the Justice Department said.

This was Pfizer’s fourth settlement over illegal marketing since 2002.