Phizer's fraud enriches informers

Phizer have to pay for its fraud around $60 million. Wednesday’s history making $2.3 billion settlement with Pfizer over charges it illegally marketed some of its drugs will provide Florida with a $1 million shot in the arm to battle Medicaid fraud.

On Thursday,the state’s attorney general Bill McCollum said $1 million of it will go toward paying rewards to informants who help to catch those involved in Medicaid Fraud.

“Encouraging people in the health care system to ferret out fraud and report back to authorities will be an excellent resource for our Medicaid Fraud Control Unit,” McCollum said in a news release. “Every dollar saved from Medicaid fraud is a dollar we can spend providing care to those who need it the most.”

The program was created during the last legislative session, and funding has come from some of the recoveries made under the state’s False Claims Act. Informants can receive up to 25 percent of the amount recovered, or a maximum of $500,000 per case.

The Sunshine State is a hotbed of health care fraud activity. A report released last December by the Florida Agency for Health Care Administration and McCollum’s office found increased vigilance against Medicaid fraud by state agencies has prevented more than $100 million in Medicaid overpayments during the past three years,

The attorney general’s Medicaid Fraud Control Unit recovered more than $56.7 million during fiscal year 2007-2008, including court judgments, fines and civil penalties, according to the report. During fiscal year 2008-2009, the state's Medicaid Program Integrity division’s cost prevention and overpayment recovery efforts for totaled approximately $65 million, with imposed fines of approximately $475,000,

This year, Medicaid Program Integrity opened 3,766 files for review of provider activities and conducted 1,438 cases in pursuit of overpayment recoveries.

Tips can be reported by calling the Attorney General’s Fraud Hotline at (866) 966-7226 or (850) 414-3990. The Medicaid Fraud Control Unit has a process to protect the identities of confidential informants. The money will only be paid out after a case has been resolved.

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