Utah Recovers $11m Per Year From Medicaid Fraud Prosecutions

by Michael Spencer | Sep 22nd, 2017

Utah’s Medicaid Fraud Control Unit has recovered and average of $11M per year for the time period 2007 – 2011.

Other states with similarly sized recovery programs recouped an average of $3M annually for that time period.

Why does this matter?

Because Medicaid fraud affects all of us — individually as consumers of Medicaid services and as a community that collectively pays the Medicaid bills.

Medicaid Fraud Costs the U.S. Billions of Dollars a Year

Each year, U.S. consumers, businesses, and governments spend more than $2 trillion on healthcare. At least 3% of that spending ($68 billion) is lost to fraud.

Given that state governments alone spend many billions of dollars a year on Medicaid programs, it’s reasonable to assume that there are billions of dollars in Medicaid fraud.

Medicaid fraud takes many forms. The most common are —

  • Billing for services not provided
  • Double billing
  • Billing for phantom visits
  • Billing for more hours than there are in a day
  • Falsifying credentials
  • Substitution of generic drugs
  • Billing for unnecessary services or tests
  • Billing for more expensive procedures than were performed
  • Kickbacks
  • False cost reports

Each state has a Medicaid Fraud Control Unit whose mission is to protect the integrity of the Medicaid Program by investigating and prosecuting fraud cases.

Utah Stands Up To the Big Guys

Utah’s Unit has been more successful that its peers because of its aggressive approach in going after the big guys — the drug companies who hide important safety information from physicians and patients and who engage in illegal marketing.

A list of pharmaceutical companies who’ve been held accountable includes Abbot Laboratories, Novartis, Bristol-Myers, Aventis, Merk, Eli Lilly, and GlaxoSmithKline.

Siegfried & Jensen is proud to have been a partner with the Attorney General’s Office in helping to recover $24M from Eli Lilly for its “off-label” marketing and withholding of information about the anti-psychotic drug Zyprexa®.

Our attorneys are no strangers to going after bad corporate citizens. For years we’ve been committed to holding big corporations accountable for the harm they do when they put profits before safety.

If you’ve been hurt because a corporation put their profits before your safety –whether it was because of a medicationa vehicle, or something else entirely– you need someone who can help you use the legal system the way it was intended. Contact us today for a free, no pressure consultation. We’re here to help.


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