Pharma price "scam has cost Missouri $19M+"

A scheme by several pharmaceutical companies to inflate the reimbursement for Medicaid-covered prescriptions has cost the US state of Missouri at least $19.0 million since 1994, says state Attorney General Jay Nixon, who has filed law suits against the firms and is asking for penalties and treble damages to reimburse Medicaid for the over-payments.

The suits claim the firms sold drugs to Medicaid providers such as pharmacies at one price but then greatly inflated the reported price used by the program to reimburse providers. In one case, a drug was sold to a provider for about seven cents a unit but the price reported for Medicaid reimbursement was more than $1.42 per unit, they state.

"A pharmacy that knew it would receive greater reimbursement from Medicaid if it dispensed a generic drug from one of these companies would be more likely to dispense drugs from those companies," said AG Nixon, adding: "by reporting inflated prices that were then used to calculate Medicaid reimbursement, the companies were defrauding taxpayers in order to increase their market shares. This is a significant example of waste, fraud and abuse in the Medicaid system."