Medicaid fraud investigations led to the state recovering more than $53 million last year, Attorney General Roy Cooper's office announced today.
Cooper's office said Medicaid Investigations Unit activities during the 12 months from Oct. 1, 2009 to Sept. 30, 2010 - the federal fiscal year- resulted in 22 criminal convictions and 18 civil settlements that recovered $53.5 million.
The biggest amount, more than $25.5 million, was part of a national, record-breaking $2.3 billion settlement with the drug company Pfizer. The settlement was announced in early September 2009, before the last fiscal year started. Cooper's office is counting it as part of last year's take because the money was collected in November 2009.
The team that investigated claims that Pfizer paid illegal kickbacks and marketed some of its drugs for unapproved uses included representatives from New York, Ohio, Massachusetts, Texas, Arkansas, Oregon, and Virginia.
The North Carolina Medicaid investigations office negotiated the state's part of the settlement, said Cooper spokeswoman Noelle Talley.
Medicaid, a state and federal program, pays for health care for the poor and disabled.
“Medicaid cheaters rob taxpayers, hurt needy patients and push medical costs higher for all of us,” Cooper said in a statement. “We’re stopping the waste and abuse and making violators pay.”
Facing a $3.7 billion budget hole, the state is looking for ways to limit Medicaid expenses. State officials have emphasized a crackdown on fraud in recent months, with Gov. Bev Perdue announcing work with first with IBM and later, SAS, to find cheats.
UPDATE: More than $45 million of the money recovered came from national settlements with drug companies.