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Health Law 2022 Discusses Regulatory Risks for Health Businesses And How to Manage Them

Each year in early December, Cozen O’Connor’s Health Care & Life Sciences industry team hosts a Health Law Program to update clients on a wide range of issues that we believe will be critical for health care businesses in the upcoming year. This year’s program, held virtually from December 8-9, 2021, included a policy view…

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Kansas Recovers $27.6 Million from Pharmacy Benefit Manager for Alleged Overbilling of Medicaid

Kansas AG Derek Schmidt reached a settlement with pharmacy benefit manager Centene Corp. and its subsidiaries (collectively “Centene”) to resolve allegations that it overbilled the state’s Medicaid program. According to the AG’s office, Centene allegedly failed to represent Medicaid’s best interests in negotiations with pharmaceutical suppliers, failed to accurately report discounts it received on certain…

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Home Care Service Providers Accused of Cheating Medicaid

Massachusetts AG Maura Healey sued home health agency Prestige Health Care Services, Inc. and related individuals (collectively “Prestige Health”) over allegations that Prestige Health falsely billed the state’s Medicaid program in violation of the Massachusetts False Claims Act and the Medicaid False Claims statute.

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Private Equity Firm to Pay Almost $20 Million to Settle Allegations of Medicaid Fraud

Massachusetts AG Maura Healey reached a settlement with private equity firms H.I.G. Growth Partners, LLC and H.I.G. Capital, LLC (collectively “HIG”), and two former executives of a mental health facility operator, South Bay Mental Health Center, Inc. (“SBMHC”), to resolve allegations that they caused fraudulent claims to be submitted to the state’s Medicaid program, known as MassHealth, in violation of federal and state false claims acts.

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Pharmacy Benefit Manager Agrees to Pay $15.2 Million to Settle Allegations of Arkansas Medicaid Overbilling

Arkansas AG Leslie Rutledge reached a settlement with Pharmacy Benefit Manager (“PBM”) Envolve Pharmacy Solutions (“Envolve”), its parent company Centene Corporation, and other Centene subsidiaries (collectively “Centene”) to resolve allegations that Centene used its subsidiaries to overcharge the state for medications in its Medicaid program.

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