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Amgen to pay NC nearly $1.2 million for false Medicaid claims

Release date: 12/20/2012

Drug maker illegally marketed drugs, manipulated prices, AG Cooper alleges

:  Pharmaceutical company Amgen, Inc. will pay nearly $1.2 million to North Carolina for illegally marketing its drugs, manipulating prices, and causing false Medicaid claims to be submitted, Attorney General Roy Cooper announced Thursday.
 
“Causing Medicaid to overpay for drugs wastes tax dollars, prevents patients from getting needed care, and drives up health care costs for all of us,” Cooper said. “We are continuing to crack down on Medicaid fraud to protect patients and save money.”
 
The agreement is part of a $612 million national settlement that Amgen reached this week with state and federal authorities to compensate Medicaid, Medicare, and other taxpayer funded health care programs for its illegal conduct. As part of the settlement, North Carolina will receive $1,183,577 in restitution and other recovery.
 
Cooper and the other parties contend that Amgen engaged in several improper practices including:
 
  • Illegally marketing the drugs Aranesp, Enbrel and Neulasta;

  • Illegally offering or paying kickbacks to influence health care providers to prescribe Aranesp, Enbrel, Epogen, Neulasta, Neupogen, and Sensipar for Medicaid recipients; and

  • Knowingly reporting inaccurate Best Prices and/or Average Sales Prices for Aranesp, Enbrel, Epogen, Neulasta, Neupogen and Sensipar, which caused Medicaid to pay too much for the drugs.
     
Amgen will also agree to close monitoring of its future sales and marketing practices by the United States Department of Health and Human Services, Office of the Inspector General.
 
This settlement is based on ten whistleblower cases that were filed in the United States District Court for the District of Massachusetts, the United States District Court for the Eastern District of New York and the United States District Court for the Western District of Washington by private individuals under state and federal false claims statutes.  
 
In addition, Amgen has agreed to plead guilty in the United States District Court for the Eastern District of New York for introducing a drug that was misbranded, Aranesp, in violation of the Food, Drug and Cosmetic Act.
 
The North Carolina settlement agreement was reached by Cooper’s Medicaid Investigations Division and the North Carolina Division of Medical Assistance. 
 
North Carolina’s MID has recouped more than $500 million over the past decade and helped to convict hundreds of individuals on criminal charges including patient abuse and neglect as well as financial fraud. During the federal fiscal year that ended September 30, 2012, the MID won 33 criminal convictions and 14 civil settlements that recovered $94,390,397.85 from Medicaid abusers. In the latest bust, State Bureau of Investigation agents arrested nine individuals across North Carolina for Medicaid Fraud this week.
 
The Attorney General’s MID investigates fraud and abuse of Medicaid benefits by hospitals, doctors, pharmaceutical companies, medical equipment companies, mental health and personal care providers, ambulance services and others. The MID also investigates patient abuse and neglect in nursing homes and other Medicaid-funded facilities, and works closely with United States Attorneys, District Attorneys, and other state and federal law enforcement agencies.



Media contact:Noelle Talley (919) 716-6413