Pharmaceutical drugs sales, qui tam lawsuits
and the False Claims Act -- Part III
Medicaid fraud involving "best price" for pharmaceuticals
In exchange for having their drugs approved for use in the Medicaid program, pharmaceutical companies are required by law to report to the government their "best prices" for those drugs to retail, for-profit customers.
Pharmaceutical companies must rebate to state Medicaid programs the difference between the price they initially charged Medicaid and their "best price" each year. In certain instances, drug companies have engaged in fraud against the Medicaid program by failing to report the discounts or other payments they have offered to pharmacies or other providers. Such misreporting can improperly reduce the rebate the pharmaceutical companies owe Medicaid by millions. This type of Medicaid fraud could be the basis of a qui tam lawsuit under the False Claims Act.
